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As stakeholders advocate for improved health centres in South East

By Okechukwu Onuegbu

Health is wealth is a popular maxim encapsulating the importance of health to mankind. This is obvious given that only a healthy person thinks of what to consume, where to go, what to do, among other things. While the usual dream of the sick would be to get well. And to actualise this, the sick seeks physician (at hospitals and health centres) as aptly captured by the Holy writ.
Perhaps, this entails why Partnership to Engage Reform and Learn (PERL), a UK-Aid Department for International Development (DFID) governance program, recently convoked one-day health sector contextual analysis and experience sharing workshop for the media, women organisations, legislative staff, and other stakeholders in the South East geopolitical zone on health care & health center status in the region.
According to the 1999 Constitution of the federal republic of Nigeria (as amended), the provision of health care at Primary Health Care (PHC) level is largely the responsibility of local governments with the support of state ministries of health and within the overall national health policy.
Speaking at the event held at Abakaliki, the Ebonyi state capital, Mrs Judith Emma-Ugwoke, the Regional Partnership Facilitator for PERL-ECP, observed that the goal of PHC was to provide accessible and affordable basic health services for all that is Universal Health Coverage (UHC).
“The revised National Health Policy 2016, enumerated health services, based on Primary Health Care (PHC) to include among other things: education concerning prevailing health problems and the methods of preventing and controlling them, promotion of proper nutrition, maternal and child care, family planning, immunisation against the major infectious diseases, prevention and control of locally endemic and epidemic diseases, and provision of essential drugs and supplies,” she added.
Emma-Ugwuoke, while stressing that everyone was at risk of falling sick due to ecological, socioeconomic and other issues, explained that enrolling on Health Insurance would help to achieve relevant, equitable, high-quality, and cost-effective health care, even as a ‘strong’ government commitment was needed to strengthening primary health care through recruitment, education, and retention of primary healthcare workers (nurses, family physicians, and mid-level care workers).
Government commitment was actually needed as the current health indices and status of health care centres in the region presented at the programme by Dr Cosmas Ohaka called for concern. Ohaka’s report which pegs National life expectance of Nigeria at 54, shows that life expectance per a state in the South East were Imo (53), Abia (52), Enugu (52), Anambra (48), and Ebonyi (48).
It also showed that South East was lagging behind in terms of proportion of health facilities with basic medical equipment. The statistical report by geopolitical zone in the country as regards Primary Health facilities are South East (20%), North West (23.5%), North Central (30.6%), South South (32.2%), South West (33.3%) and North East (36.7%), while in Secondary Health facilities, South East (43.3%), North East (47.2%), North West (52.4%), South South (57.9%), South West (68.6%) and North Central (71.4%).
On average proportion of essential drugs available in health facilities in the country by geographical zone, South East had a record of (37.4 primary health facilities, 41.8 secondary health facilities and 37.8 for all health facilities), while the same statistics for South West were 27.9, 43.1, 29.1; South South (30.2, 50.9, 31.6); North West (34.5, 59.6, 38.4); North East (35.2, 56.3, 37.8); and North Central (31.3, 54.3, 35.5).    
The report also enumerated ten top causes of death in the country to include lower respiratory infections, neonatal disorders, HIV/AIDS, malaria, diarrheal diseases, tuberculosis, meningitis, ischemic heart disease, stroke and cirrhosis. Blueprint also observed that different group presentations at the event indicate that each state in the zone were facing myriads of challenges in their primary health centres including lack of adequate staff, poor use of health centres by the citizens, insufficient drugs and other facilities, among others.
In another presentation, the Zonal Coordinator, National Primary Health Care Development Authority (NPHCDA), Dr Eric Nwaze, said that the Basic Health Care Provision Fund (BHCPF) established by Section 11 of the National Health Act 2014 and launched on January 8, 2019 would help the populace to improve on their health.
“The BHCPF is composed of 1% of Consolidated Revenue Fund (CFR) of the federal government and contributions from other sources including donors. The BHCPF will support the effective delivery of Primary Healthcare services, provision of a Basic Minimum Package of Health Services (BMPHS) and Emergency Medical Treatment to all Nigerians. BHCPF shall be disbursed through three gateways; the NPHCDA gateway, the NHIS gateway, and the EMT gateway.
“The 50% from the NHIS gateway will be used in paying for a basic Minimum Package of Health Services (BHMS to be provided in primary and secondary levels of care) to Nigerians. The Benefit package was defined by the manual and this consists of nine services delivery focus and 52 intervention areas. Maternal Health interventions for pregnant women (ANC, Labor and Delivery, EmONC and caesarean section), Children focused interventions (curative care and immunization), Routine screening and checks for NCDs (blood pressure check and Blood sugar checks) for adults, Treatment of malaria for all Nigerians, Nutrition and Family Planning,” he further revealed.
On her part, Pharm (Mrs) Chinasa Agwunobi, the Southeast Zonal coordinator, National Health Insurance Scheme (NHIS), listed ongoing efforts at revitalising primary health care in Nigeria to include the Midwives Service Scheme (MSS), PHC Reviews, National Health Management Information System (NHMIS), and the Maternal, Newborn and Child Health (MNCH) programs, Private HC Interventions and Basic Health Care Provision in the National Health Act.
“The PHC Under One Roof Initiative aims to strengthen the primary healthcare system through the implementation of the Principle of ‘Three Ones’ namely; one plan, one management and one monitoring and evaluation system- for Primary Health Care. The concept is international best practice, based on WHO’s guidelines. It will harmonise the PHC sub-system in order to overcome structural constraints and improve coordination (planning, management and governance) at the state level and establish a unitary, integrated and decentralised management structures and sub-systems,” Agwunobi added.
She said the programme became necessary to revive the current weak and dysfunctional PHC system, and provide quality of service so as to address or exterminate morbidity and mortality of preventable diseases.
Mr Ibiam Azu, of Health Policy Plus, averred that joint efforts were needed by all stakeholders including the government and communities (beneficiaries) for effective planning and execution of health programmes for ownership and sustainability of the project.
In a separate interview, Mrs Nneife Appolonia Chimezie of Idikacho Women in Governance and a media practitioner, Mrs Njideka Okoye, said the programme would spur them to embark on public enlightenment campaigns, advocacy and others with government and the governed using different channels with a view to help improve the status and utilisation of health centres in the zone.

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