Boosting service delivery in health centres

In order to address the dearth of equipment in some of the health centres across the country and enhance service delivery, the federal government and the World Bank have embarked on the distribution of medical equipment worth $200,000 to 250 secondary health facilities in 30 states of the federation. According to reports, the intervention will enhance service delivery and reduce maternal and new-born deaths in the country. At the flag-off ceremony in Abuja, the Minister of Health and Social Welfare, Prof. Muhammed Ali Pate, stated that the initiative was part of the federal government’s renewed commitment to health sector reforms and universal health coverage (UCH).

The Executive Director of the National Primary Health Care Development Agency (NPHCDA), Muyi Aina, who represented Pate, described the initiative as a broader Health Sector Renewal Investment Agenda aimed at translating policy commitments into measurable improvements in healthcare delivery across the country. He mentioned that over 40,000 Nigerian women have already accessed life-saving maternal health interventions under on-going government-supported programmes, and “they represent mothers who have been given a second chance at life.”

The representative of the World Bank office in Nigeria, Mr Olumide Okunola, said the initiative resulted from deliberate reforms agreed upon by the federal government, states, and development partners since 2023. According to him, “What is different now is that there is a broad consensus that past approaches needed to change.”

It is good that the intervention is coming at a time that about 3,715 Primary Healthcare Centres (PHCs) across 19 states and the Federal Capital Territory (FCT) are reportedly inactive. Available information from the National Primary Health Care Development Agency (NPHCDA) revealed widespread inactivity in these PHCs established to deliver healthcare to millions of Nigerians. While Katsina has the highest number of non-operational PHCs with 349 dormant facilities, Osun State followed with 326. Other states with high numbers of inactive facilities include Kano, 279; Enugu, 268; Benue, 265; Delta, 246; Kogi, 230; Ogun 227; and Adamawa, 225.

The PHCs were established to serve as the grassroots foundation of a healthcare system, ringing affordable, accessible, and comprehensive medical service directly into local communities. According to the World Health Organisation (WHO), PHC is a whole-of-society approach to effectively organise and strengthen national health systems to bring services for health and wellbeing closer to the communities. This is based on the premise that all people, everywhere, have the right to achieve the highest attainable level of health.

However, millions of people lack access to the services of PHCs. The situation is even worse in Nigeria where many rural dwellers lack functional PHCs. Figures from the WHO showed that over 1.6billion people worldwide were at risk of being pushed into poverty or further impoverished due to out-of-pocket health spending of 10 per cent or more of their household budget in 2022.

The global health agency says that scaling up PHC interventions across low and middle-income countries could save 60million lives and increase average life expectancy by 3.7 years by 2030. It posits that an estimated 75 per cent of the projected health gains from the Sustainable Development Goals (SDGs) could be achieved through PHC.

As commendable as the intervention is, the federal, state and local governments must invest more resources in revamping the dormant PHCs littered across the country. The UHC goal cannot be achieved with this one-off intervention. The country’s annual health budget put at 5 or 6 per cent cannot do much in rehabilitating our moribund PHCs. The annual health budget should be increased to at least 15 per cent, a benchmark agreed by African leaders in Abuja in 2001. Since the PHC bears over 70 per cent of our disease burden, government should intentionally fix the ailing PHCs.

Since the brain drain in the health sector is alarming, the government must come up with a scheme to retain our some of our medical doctors and other health professionals at home. The dearth of doctors, nurses, laboratory scientists and other health professionals is seriously affecting our health care delivery system.  It is likely to get worse in the years ahead.

Unfortunately, the situation is precarious at the PHCs, especially those located in rural communities. Therefore, we call for seamless distribution of the medical equipment in the affected 30 states and Abuja. Government should also equip other hospitals and health facilities that urgently need attention.