The chairman of the Nigeria Governors Forum (NGF), Kayode Fayemi, has said the country must address the issue of poor funding for Primary Health Care (PHC) to achieve Universal Health Coverage (UHC) by 2030.
Mr Fayemi said this on Wednesday at the opening ceremony of a two-day programme to discuss the role of states in PHC financing in Nigeria.
Represented by Nasarawa State Governor, Abdullahi Sule, he said health financing is a critical building block of the health system that directly affects the functionality of the overall system.
He noted that equitable access to PHC is a key component of all high-performing health systems and a prerequisite for achieving Sustainable Development Goal 3 and UHC.
“Until we address the issue of poor funding for health and the fragmentation of the health financing arrangements in Nigeria, we will make little headway in our pursuit for UHC,” he said.
The programme tagged: “PHC Financing Forum,” is organised by the Nigeria Health Commissioners’ Forum (NHCF) in collaboration with NGF.
Mr Fayemi reiterated that health systems are driven by their financing arrangements, which include the number of funds they receive, how these funds are distributed across the system, and how they are utilised to provide equitable access to services.
He said Nigeria is facing challenges in ensuring PHC is financed sustainably to cover risk protection, adequate infrastructure, human resources, and the delivery of quality health services.
He said for Nigeria to solve the problem of PHC financing and meet the demands for a responsive and high-performing health system, it must approach PHC financing and service delivery with four key focuses in mind.
He said; “The utilisation of the Basic Healthcare Provision Fund (BHCPF) to finance essential health services, especially for the vulnerable, and to improve the country’s capacity to address public health emergencies. Consolidate funding to address primary care and essential public health functions.
“An increase in budgetary allocations for healthcare both at the national and state levels and theexploration of innovative ways to pool funds for non-contributory healthcare coverage.”
In his remarks, the Commissioner for Health and Human Services, Yobe State, Muhammad Gana, said the COVID-19 pandemic has brought into spotlight the need for standard and functional PHC at the sub national levels.
Mr Gana, who doubles as the Vice-Chairman of the NHCF, said PHC is the most promising platform for providing basic essential preventive and promotive health interventions and other public healthfunctions.
He noted that PHC drives improvements in immunisation, communicable and non-communicable diseases, maternal health, and nutrition.
He said the theme of the event is one of the three activities under a state leadership collaborative of the NHCF, designed to share, showcase and highlight state level performance and accountability.
Mr Gana said the event also serves as an opportunity to examine the problems of PHC financing, interrogate how Nigeria can fund PHC services, especially for the poorest and most vulnerable populations.
Mr Gana said many countries including Nigeria is yet to achieve the desire of PHC four years after the Astana Declaration.
In October 2018 at the global conference on PHC, heads of states made a promise to strengthen their PHC systems as an essential step towards achieving UHC.
“Four years post declaration, we are yet to achieve the desire of PHC meeting the basic health needs of the population in most low- and middle-income countries,” he said.
He explained that public spending is insufficient, access is inequitable and out of pocket spending is on the high side thereby making people bypass PHC facilities to seek care in secondary and tertiary centres.
Nigeria PHC system
Primary healthcare is a level at which non-emergency, preventative health issues should be managed. It is meant to provide services to the majority of people based on need, without geographical, social, or financial barriers.
Unfortunately, only about 20 per cent of PHC facilities across Nigeria are fully functional. The rest cannot provide essential health care.
Some PHCs are faced with lot of problems, including poor distribution of health workers, poor quality of health care services, poor infrastructure, and lack of supply of essential drugs.
The inability of PHC centres to provide basic medical services to people especially at the rural areas, has increased the influx of patients to secondary and tertiary healthcare facilities. This has led to long queues in these hospitals and worsen patient experiences.
A recent report titled; “The State of Primary Healthcare Service Delivery in Nigeria,” shows that Zamfara and 17 other Nigerian states are weak in PHC service delivery.
The other states include Sokoto, Taraba, Kebbi, Katsina, Borno, Yobe, Kogi, Jigawa, Rivers, Gombe, Cross River, Edo, Bayelsa, Akwa-Ibom, Plateau, Imo, and Kaduna.
Findings from the report also blame Nigeria’s deteriorating healthcare system on the weak governance structures and operational inefficiencies.
The NHCF vice chairman said at the end of the forum, all stakeholders must take stock of the country’s achievements and make definite new commitments to accelerate progress.
“We can move the brick by working together to build a safer and healthier Nigeria for all of us,” Mr Gana said.
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