Effective health care delivery at the grassroots: The PHC challenge



The Federal Government recently announced of Nigeria plans to establish one Primary Healthcare Centre (PHC) in each ward across the country. Nigeria’s Minister of Health, Professor Isaac Adewole, while speaking at a forum in Abuja, said the plan is to ensure the PHCs provide better access to health care for Nigerians.

Prof. Adewole who was represented at the forum by the Minister of State for Health, Dr Osagie Ehanire, disclosed that establishing a PHC in each electoral ward in Nigeria will culminate in Nigeria having about 10,000 PHCs and enabling the nation to provide quality health care to many Nigerians at affordable cost.

We commend this initiative of the Federal Government and hope that this laudable idea is expeditiously pursued and properly implemented because a major bane of health care delivery in Nigeria for years has been unavailability of health care facilities for Nigerians, especially at the grassroots.

There is no gainsaying that the near absence of PHCs in Nigeria in the past years has significantly hampered the hospital referral system and cases that should have been treated at the PHC level now go straight to the teaching hospital which is at the tertiary level. Consequently, our teaching hospitals, which should be the apex centres for treating difficult cases and providing advanced medical interventions and innovations, are now being inundated with mundane health care conditions that PHCs should be handling.

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A major reason the Nigerian nation has had the unenviable record of being ranked a sone of the worst countries in terms of maternal and infant mortality rates is poor access to health care, especially at the grassroots. Consequently, prompt quality care does not reach millions of Nigeria when they need it. This is why thousands of childbirths are still handled by traditional birth attendants and when things go wrong in the process, as it frequently happens, the consequence is almost always fatal.

Thousands of children and pregnant woman have lost their lives over the years because of a deficient and lopsided health care system. Thus, any attempt to tackle the challenge of maternal and infant mortality in Nigeria without ensuring improved access to health care for pregnant women and nursing mothers at the grassroots is futile. It is our view that establishing functioning PHCs in all the electoral wards in Nigeria will not only help to enhance Nigerians’ access to health care but also considerably boost ongoing efforts to reduce maternal and infant mortality rates in Nigeria.

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Additionally, the PHC initiative will significantly facilitate collation of vital national health statistics that will be valuable for national health planning. Not only that, having PHCs  in all the wards will equally enhancethe success rates of our various national immunisation programmes as it will improve the coverage of the nation during the exercise and help to ensure that the nation is able to better contain disease outbreaks.

For now, the attention of all stakeholders in the health care sector must be focused on successful implementation of the new PHC programme. We consider this the most crucial part because, in reality, the concept of primary health care is not new in Nigeria. It was adopted in the National Health Policy of Nigeria as far back as 1988 and, ordinarily, by now, the system should have become entrenched and thriving. This, however, did not happen because of poor implementation.

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To ensure the success  of this initiative therefore, therefore, the National Primary Healthcare Development Agency (NPHCDA) which was established in 1992 must be strengthened and adequately funded to deliver on its mandate. The agency must be actively engaged in facilitating universal health coverage and ensuring that standard health care is accessible to all Nigerians who need it.

We call on the Muhammadu Buhari administration to ensure that this initiative does not end up as one of the many promising ideas that failed in the past due to poor implementation. The Nigerian government must ensure that primary health care is used as the cornerstone to drive health care delivery to Nigerians without geographical, social and financial barriers.


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