Primary Health Care (PHC) facilities, by their very nature and relevance in Nigeria’s healthcare delivery system, are usually the first port of call especially during emergencies. In the country today, there are many PHCs spread across the states and 744 local governments of the federation. Yet, it is sad to note that most of these PHCs remain empty and inadequately equipped, with little or no facilities as well as no resident medical personnel to handle cases when they occur. For every community, local government and even at states and federal levels, the primary health care centres play this daunting role as the first port of call for all emergencies. Even with this reality, PHCs are the most neglected, ill- equipped health facility lacking the necessary qualified personnel needed to handle emergencies that sometimes become epidemics
The challenges of modern primary health care facilities in Nigeria vary and they include basic infrastructure such as power, mini laboratories and, as minor as, sterilizing equipment, syringes and first aid kits. Existing PHCs are challenged by low or no access to drugs from government, lack of access to power for storage of various vaccines. They lack supervision as they are left at the mercy of over-worked nurses in charge and equally lack laboratory services to conduct tests.
Considering the fact that this cadre of health facilities cater for that segment of the nation’s population that often does not have access to any other health facility, the need to make the PHCs functional becomes really urgent. This is important so as to make them available to provide some acceptable level of healthcare delivery services when needed. In the rural areas where most of these PHCs are located, almost all health issues assume emergency status due the absence of facilities to handle them before they spiral out of control.
It is pertinent to note that most preventable ailments acquire epidemic proportions as a result of poor management at that primary level. These health facilities can also be of assistance even in the urban areas which, sadly, experience insufficient distribution of much needed health institutions.
It goes without saying that putting in place functional PHCs promotes inclusiveness. Another way of making the PHCs functional is through Public, Private Partnerships (PPP) that could help address the challenges they face while at the same help the country manage its special professions to avoid depleting the available qualified health personnel.
We recall that, recently, President Muhammadu Buhari was applauded for assenting to the Medical Residency Training Act, 2018. The Act is aimed at ensuring quality and competence of medical practice and practitioners with a view to encouraging medical tourism from other countries to Nigeria.
While this move is commendable, there is no doubt that Nigeria is far from providing quality medical health care, not to talk of attracting medical tourists. As a means of addressing these challenges, the federal government, on January 10, 2017, through the Saving One Million Lives Initiative, kicked off a scheme to revitalise over 10,000 primary healthcare centres across the country. The event, tagged “Revitalisation of PHCs for Universal Health Coverage,” took place at the renovated Kuchigoro model PHC, Kuchigoro village, in Abuja.
At the event, President Muhammadu Buhari called on state governors to adopt the initiative and make the revitalisation of PHCs a priority in their state development agenda.
Under the scheme, it is estimated that $1.5 million will be made available to each state government—and the Federal Capital Territory—to ensure the delivery of quality health care to women and children.
On his part, the minister of Health, Prof Isaac Adewole, said the plan will give poor Nigerians access to affordable, quality health services. The Federal Ministry of Health has made a provision for the revitalisation of more than 10,000 PHCs in the 2017 budget, in addition to the 2,923 PHCs that development partners have committed to revitalizing.
However, in spite of these efforts, not much can be said to have been achieved towards ensuring the upgrades of PHCs. As such, in order to address the challenges listed above, it is necessary that regulatory agencies ensure that PHCs are run according to global standards and equipped to provide emergency services.
To bring this about, it is necessary that government provides alternative power supplies, such as generators to help PHCs overcome the problems of power failure. Also, there is the need to provide laboratory services at that level of healthcare delivery so as to reduce overcrowding in hospitals in the urban centres. We cannot over-emphasise the imperative of qualified medical personnel at all times in these health facilities.