Monday 23rd October, 2017
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Lamentations over neglect of primary health care delivery in South-East, Nigeria

Lamentations over neglect of primary health care delivery in South-East, Nigeria

STEVE OKO writes that stakeholders in the health sector have continued to express worry and concern over the neglect of the Primary Health Care (PHC) system in Nigeria.
The poor attitude of the state actors towards this criti­cal health service came to the front burners at a one- day meeting of the Primary Health Care Under One Roof ( PHC­UOR), Civil Society Organiza­tions ( CSOs), the media and other stakeholders in the health sector in partnership with Dr. Ejike Oji Community Development Foun­dation ( DEOCDF) , held recently at Ovim Centre, Isuikwuato, Abia State.
Participants lamented that while the tertiary and secondary hos­pitals only cater for about 20% of health care seekers in the country, 80% mostly, rural dwellers depend on the primary health care for medical attention.
Speaking, Dr. Ejike Oji noted that Nigeria has the second high­est number of maternal deaths due to gross neglect of health centres which are the first port of call for most pregnant women. PHCUOR is an agency comprising of health experts set up by the federal gov­ernment to monitor the imple­mentation of funds meant for pri­mary health care across the states.
The former country Director for IPAS also advocated financial au­tonomy for Primary Health Care Development Agencies (PHCDA) of every state to enable them re­spond to health emergencies in­stead of waiting for directives from the governor who for political rea­sons sometimes delay action. He frowned that only 28 out of the 36 states in Nigeria has PHCDA most of which are not functional due to poor funding.
Ejike further explained that about N49 billion is earmarked annually by the federal govern­ment for health care services with about 95% of the funds meant for states which meet the criterial for accessing it. He also said the Euro­pean Union has released $500,000 to every state in Nigeria for prima­ry health care with additional $1.5 million each to be accessed only by the states which meet up with the needed conditions.
The three important require­ment to qualify for the funds include: State Primary Health Care Development Agency; Ba­sic Minimum Packages ( BMP) comprising skilled health workers, community health workers, avail­ability of essential drugs in health centres among others; and the involvement of local government authorities.
He called for constructive en­gagement on the state actors on the need to have a functional primary health care system in the country to save the populace from vari­ous avoidable deaths, advocating for one functional health center in every political ward rather than proliferation of ill equipped ones.
Participants were told that only Jigawa State has 100% functional primary health care delivery as the state government has dutifully paid its counterpart funds to qual­ify for the various funds by donor agencies and the federal govern­ment meant for primary health care.
South East zone has the worst case scenario even as Abia State, which was said to be the best so far in the zone was rated to have only 55%. The forum further noted that Abia State, for instance, loses about N5 billion annually being funds it could have accessed if it pays its counterpart funds for pri­mary health care services.
One of the participants, Com­rade Orji Idika of the Rural Alert group, decried lack of competent hands in Abia State primary health care, saying there are only 27 med­ical doctors in the system.
In his contribution, Dr. Chijioke Kaduru, said a lot of lives would be saved if Nigeria has effective and functional primary health care system where facilities, the essen­tial drugs, and competent hands are made available at the health centres. He lamented lack of refer­encing from primary to secondary and Tertiary health institutions in Nigeria.
He advised states yet to key into the PHCUOR to do so without delay because of the immense benefits accruing from doing so. According to him, 80% of World Health Organization (WHO) grants as well as 45% of the funds for primary health care can only be accessed through PHCUOR.

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