CSOs call for strengthening of PHC system in Nigeria

CIVIL Society Organisations (CSOs) have called for the strengthening of the Primary Health Care (PHC) system in Nigeria.

Representatives of CSOs who participated in the Public Policy Dialogue on Primary Health Care System Strengthening in Abuja on Thursday decried the poor state of PHCs in the country, despite the Basic Health Care Provision Funds (BHCPF).

The dialogue was organised by the International Centre for Investigative Reporting (The ICIR), International Budget Partnership (IBP), ONE Campaign and Justice, Development and Peace Commission (JDPC).

Speaking at the event, Editor, The ICIR Bamas Victoria highlighted findings on the implementation of the BHCPF by journalists who carried out investigations in 12 states across all geo-political zones in Nigeria.

Bamas noted that similar challenges existed in PHCs across the states, including inadequate manpower, dilapidated structures, security concerns and a dearth of midwives.

Stating that the BHCPF was available to all the PHCs visited, she said that many states only started the implementation of the funds in 2021, even though the facility was launched in 2019.

“In some of the PHCs that could access the BHCPF funds, they were able to record increase in terms of health care delivery and people coming in for services,” she said.

You can read the reports from the investigations here.

The BHCPF was established to improve primary health care in states across the country. The funds were provided by the Federal Government to cater to daily operations costs in PHCs, with the aim of improving citizens’ access to medical services.

Also present at the event was the Head, Civil Rights Concern (CRC) Okey Onyeka, who noted that shortage of staff was a significant challenge faced by PHCs, particularly in Anambra.

“There are areas you go to, you won’t even see one staff. It will be one community volunteer who is not even trained that will manage the health facility,” he said.

Onyeka noted that states lacked the political will to contribute counterpart funds, despite the (BHCPF), and government representatives at policy-making levels were not in tune with their responsibilities.

Also speaking on challenges facing PHCs, Head of Research, BudgIT Iniobong Usen said low remuneration of staff was making it difficult to retain qualified personnel in PHCs.

He said audit reports were not released in good time to encourage accountability and identified this as a challenge with monitoring funding in PHCs.

“How do you expect to retain midwives when there are states that pay their workers 25, 20 per cent of their salaries monthly? There is no way you can retain people with that kind of remuneration package.

“States are complaining of credit crunch, there is not enough transfer from the Federal Government, but these same states still sponsor people on pilgrimages, they still have funds to build religious centres, while their health centres are grossly underfunded,” he said.

During a panel discussion held at the event, President, National Association of Nurses and Midwives in Ogun State Roseline Solarin agreed that retaining personnel at PHCs had become an arduous task, especially with the exodus of health workers from the country.

However, she pointed out that many nurses were still unemployed, and the infrequent recruitment of staff into PHCs was making adequate health care more difficult to access by average Nigerians.

“Presently, we have a mass exodus of health care workers out of the country right now, and it is a national issue. It is not only limited to a particular state. Even at that, we still have many of them that are unemployed.

“Not everybody has moved out of the country. Our colleges of nursing and universities are still producing nurses. But they are not employed. Even when they are employed, how much are they being paid?” she asked.

Executive Director, Paradigm Leadership Support Initiative ([PLSI) Segun Elemo, who spoke on the decreasing staff strengths within PHCs and increasing overhead costs, noted that a lack of accountability was also a challenge in the system.

“Over time, the structure of accountability at state and local government level has been poor such that you are not even able to monitor payroll systems. Politicians always want to keep the numbers inflated, especially when there is brain drain that should reduce the number,” he said.

Elemo called for a convergence of social and statutory accountability to support structures being put in place at subnational levels.




     

     

    However, Onyeka noted that accountability mechanisms were available, but officials were not conversant with their responsibilities.

    Making recommendations, Policy and Advocacy Manager, One Campaign Razaq Fatai, who noted that budgetary allocation by some states had actually been growing, said current economic realities had to be considered during budget preparation.

    He called for strong political commitment to laws and policies such as the Abuja Declaration that support increased funding of the health sector.

    Also making recommendations at the event, Data Analyst at Dataphyte Charles Mba said stakeholders in the health sector should be involved in the planning and implementation of the budgeting process.

    Ijeoma Opara is a journalist with The ICIR. Reach her via [email protected] or @ije_le on Twitter.

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