The Federal Government is pursuing a policy thrust aimed at revitalising the 10,000 moribund Primary Healthcare Centres (PHCs) in each of the 9,423 wards in the 774 local governments in Nigeria. The policy involves upgrading the existing PHCs to acceptable minimum standard as recommended by the World Health Organisation (WHO). This requires the availability of qualified medical personnel and functional equipment.
Information available from the Ministry of Health reveals that the federal government has kick-started the process with some wards; so far only 133 wards spread across the six geopolitical zones have received attention. At this rate, what it means is that in 10 years Nigeria may not achieve much as far as that policy is concerned.
Again, with the economic recession, we fear that the dream of revitalising these PHCs may not be realised. In our opinion, there ought to be a collaboration among all stakeholders — the federal, state and local government as well as the private sector, the lawmakers, donor agencies, religious organisations and individual citizens. Especially, the cooperation of state government is needed if this goal is to be achieved in the state. To this effect, we suggest that states and local governments should sign a memorandum of understanding with the federal government on areas of collaboration. Both parties can share the cost of providing resources, personnel, medical equipment and management.
This means that the state governments must make budgetary allocations to accommodate the revitalisation of PHCs. The duty of monitoring the services and management of facilities rests on the state and local governments without which any effort made towards revitalising the PHC’s will not be sustainable. This makes it pertinent for the private sector to take part in the partnership. There are significant number of business entrepreneurs who can invest in the effort and they should be provided with the necessary template and given certain incentives to invest in the project. Such incentives could be the provision of tax rebates; they should be made to access foreign exchange at the official rate and also made to recoup their investment within a reasonable timeframe.
Similarly, in our view, there is need for concerted effort in the alignment of national goals so as to prioritise the use of resources generated in Nigeria. Members of the National Assembly should align their constituency projects with the goal of the government. In this case they should consider the revitalisation of the PHCs in their wards as a priority. They are in a better position to ensure that these PHCs are well managed and are offering the required service.
Nigeria has also enjoyed partnership with international donor agencies especially in the area of health care. However, the challenge is that donor assistance to Nigeria has not been harmonised and as a result there are little or no information about what each donor is doing or how to measure the milestone achieved and the impact created. A way out of this is for the donor agencies to key into the programmes of the government. The projection from donor funds should be captured in the budget.
The donors should see the project of revitalising 10,000 PHCs as a major priority of the federal government in the provision of primary health care to 80 per cent of Nigerians and invest in it. The revitalisation of the PHCs will curb the high incidence of maternal and neonatal mortality rate in Nigeria and reduce the health care burden of majority of Nigerians who do not have access to functional health care.
The religious bodies such as churches and mosques should take part in the project of revitalising the PHCs in the various wards. The health statistics of Nigerians especially maternal and neonatal is worsening by the day and the cost of reducing the mortality rate is beyond the reach of one segment of the society. Hence this collaboration should be given due attention by all stakeholders mentioned.