Nigeria announces policy proposal to restructure inefficient primary healthcare system

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To make Nigeria’s inefficient primary healthcare system effective, the government plans an overhaul that could lead to some sort of financial autonomy for individual health centres.

The Minister of Health, Isaac Adewole, who stated this on Monday, said the move could lead to primary healthcare centres, PHCs, “having full control of how they utilize the money” they are allocated.

Represented by the Director of Public Health at the ministry, Evelyn Ngige, Mr. Adewole spoke at the 2nd Annual Primary Health Care Service Lecture, held in Abuja. He said the current administration would want to be remembered for putting in place a functional primary healthcare system.

“The administration of President Muhammadu Buhari would love to be remembered in making basic healthcare services qualitative, accessible and affordable to all Nigerians,” he said.

“Financial autonomy at the PHC facility level, making sure money gets to the primary healthcare facilities directly with facilities having full control of how they utilize the money, will help enhance the viability of PHC in the country.”

This approach, according to him, “informed the budget process in 2017 and underpins the approach for increasing healthcare services as espoused under the approved guidelines at the basic health care provision function.”

He said the country was doing everything possible to reduce leakages through routine financial reporting and accountability at all levels.

“As we are all aware, healthcare in Nigeria is financed with out of pocket expenses, constituting 59 per cent of total health expenditure. This mode of financing is highly inequitable and puts citizens at risk of financial hardship,” the minister stated.

“Public health expenditure needs to increase from its current 25 per cent to ensure an equitable delivery of services.

“Unfortunately, our budgetary allocation has remained below 15 per cent … and the federal government’s allocation to health remains less than 6 per cent of our annual budget from 2011 to 2016,” he said.

At the lecture, stakeholders also agreed that the Nigerian government must spend more on the health sector to improve primary healthcare in the country.

The lecture, titled “Creating Sustainable Primary Health Care Financing”, was aimed at providing support to the National Health Policy for the development of primary healthcare.

The guest speaker, Obinna Onwujekwe, a professor at the department of pharmacology and therapeutics at the University of Nigeria, Nsukka, said primary healthcare in the country has been a total failure.

He stressed that everything about the country’s healthcare system is weak.

Expressing his disappointment at the state of primary healthcare in the country, he said that a well-funded and fully functional healthcare system can change the story of the country.

He urged the government to make use of multi-sectoral collaboration in improving funding for primary healthcare; stressing that the health system must be humanised by strengthening PHCs and making them people-oriented.

He added that priority attention must be on the poorest, and that the proposed 2017 health budget of N303.9 billion may not achieve much.

The President of the Nigerian Medical Association, Mike Ogirima, shared the concern raised by other stakeholders for creating sustainable primary healthcare financing.

He said the realisation of the need to have a functional primary healthcare system made his association call for the full implementation of the National Health Act.

He said “that the N303.9 billion proposed in the 2017 appropriation bill for Health cannot make any impact in our health system. We need more funds and efficient utilisation of the fund.”

“Primary healthcare is the fulcrum for reducing disease burden and achieve the health related Sustainable Development Goals (SDGs) in Nigeria,” Mr. Ogirima said.

Nigeria is a signatory to the SDGs which was introduced after the expiration of the Millennium Development Goals (MDGs) in 2015.

The Emir of Jiwa, Idris Musa, who was also present at the lecture, said PHCs are not functioning in most rural areas where they are needed most.

The emir also complained that PHCs have been abandoned in most local government areas, a trend he urged the government to reverse.

Mr. Musa, however, assured the government of the support of traditional rulers in ensuring the success of PHCs in the country.

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