Still on building of 10,000 PHCs in Nigeria
When Prof Isaac Adewole, the Minister of Health, announced that the federal government would build one primary healthcare (PHC) centre in each of the political wards of the country, many stakeholders in the nation’s health sector were thrilled, as they saw it as a policy pronouncement that would positively impact on the country.
It was, therefore, disappointing to hear that the plan had been discarded. According to a newspaper report, “the decision to cancel the project was on the advice of Minister of Finance, Mrs Kemi Adeosun, who felt that the states may not be able to meet up with their contributions” meaning that only the federal government will bear the financial burden of the project.
That’s why the World Health Organization (WHO) suggests that developing countries should have a mechanism to bring both the health and fiscal authorities together under what it called macro-economic commission on health, whose role I believe is now being played by non-state actors like civil society organizations in the area of advocacy for better public finance management and sustainable public health financing.
In any case, if the government does not complain of lack of funds for elections, I see no reason why the same government cannot find money to provide affordable and quality healthcare for the people. I don’t think the excuse given by the finance minister to cancel the plan is plausible. As it is commonly noted, primary healthcare is the cornerstone of Nigeria’s health policy; the first point of contact for most Nigerians with the health system in the country.
It is, therefore, instructive to remind the federal government that if the ward health system is to represent the thrust of our national strategy for the delivery of PHC services using the electoral ward as the basic operational unit for the delivery of effective services, there is need for such special intervention to revitalise the already collapsed PHC system in the country, mirroring similar intervention, in the primary education sector like what the Universal Basic Education Commission (UBEC) is doing.
As such, it is important for the federal government to support the local government with adequate healthcare infrastructure. Be that as it may, an inventory of all PHC centres in the country is necessary with a view to ascertaining actual number of wards lacking PHC facilities. It’s on the basis of such physical assessment that the proposed concept can be predicated going forward. More so, we also need to know how much building a PHC will cost and what specific components of total cost will be handled by each tier of government.
Meanwhile, for some of us at the level of advocacy for better maternal, newborn and child health outcome in the country, we strongly believe that government can still fulfil its promise of one PHC per ward if available resources are prudently utilized.