Will revitalization of Primary Health Care lead to ‘BETTER HEALTH FOR ALL?’

President Muhammadu Buhari last week commissioned the newly revitalized Kuchigoro PHC. The event also served to flag off the start of the Primary Health Care Revitalization Programme, the flagship programme of the Minister of Health, Professor Isaac Adewole. This, according to Adewole, is the first step in achieving his short-term goal of revitalizing 110 PHCs across all the senatorial districts in the nation leading up to his overall target of 10,000 revitalized PHCs.

President Muhammadu Buhari at the commissioning of the Kuchigoro Primary Health Centre, Abuja. Photo courtesy @BashirAhmaad.

A clearly recurring theme in this programme is the word revitalization. Used as a term to describe the Federal Government’s efforts to improve the provision of basic healthcare package for all Nigerians, revitalization here would mean to revive or infuse life into an already existing system.

How important exactly is the PHC system to the sustainability of a community’s health and to the nation as a whole?

Primary Healthcare as an ideal model of healthcare was adopted in the declaration of the International Conference on Primary Health Care held in Alma Ata, Kazakhstan in 1978, known as the “Alma Ata Declaration“, and became a core concept of the World Health Organization’s goal of Health For All. The Alma-Ata Conference mobilized a Primary Health Care “movement” of professionals and institutions, governments and civil society organizations, researchers and grassroots organizations that undertook to tackle the politically, socially and economically unacceptable health inequalities in all countries.

Action points from the Alma Ata Declaration in 1978. Courtesy: inseparfoundation.wordpress.com

Over the years, governments, through the WHO agreed that the ultimate goal of primary health care is better health for all which is the crux of the Health Minister’s health reform campaigns across the nation. As a further guide, WHO outlined the key elements to achieving that goal:

• reducing exclusion and social disparities in health (universal coverage reforms);
• organizing health services around people’s needs and expectations (service delivery reforms);
• integrating health into all sectors (public policy reforms);
• pursuing collaborative models of policy dialogue (leadership reforms); and
• increasing stakeholder participation.

PHC revitalization goes beyond refurbishing of old buildings and buying new equipment. This is an important first step in setting up systems that work, however, it is not the only step needed. The Federal Government seems to understand this too as the President in his speech at the revitalization kick off in Kuchigoro, Abuja, was clear in identifying that the sustained success of the programme depended largely on the ability of health professionals to continue to deliver quality services.

Delighted to welcome Prez @MBuhari who will flag-off 110 revitalised Model PHCs (109 Senatorial Zones + Fuka, Niger) today at Kuchigoro pic.twitter.com/pFrp8WvQGD

— Prof. Isaac Adewole (@IsaacFAdewole) January 10, 2017

The Federal Government has decided to refurbish the infrastructure needed for the most basic access to healthcare. This should serve as a catalyst for state and local governments to develop health systems that are tailor-made for each community. This way, communities develop a sense of ownership for healthcare as opposed to the previous approach of waiting for the Federal Government to take care of every need.

The primary health care system aims at improving health at the grass root level through diagnosis and treatment of common diseases as well as counseling and referrals, health education, disease prevention, and screening. In a nutshell, a primary health care center caters to the community at the family level.

Primary Health Care is the first line of defense in a national health delivery system. Credit: Nigeria Health Watch

This statement by Prof. Eyitayo Lambo best describes the need for an effective primary healthcare system; “An effective primary healthcare system is one that can resolve 80% of the health needs of the people close to where they live and work.”

A system is clearly not a building, and while a good building and working facilities are a step in the right direction, we won’t get there until a clear-cut and universal framework for the operations of PHCs is developed, and this must be followed closely by training and re-sensitization of health workers at the PHC level on the role they play in building a stronger, healthier community.

Many PHCs around Nigeria still lack basic infrastructure and equipment and are poorly staffed. This is the delivery room of a PHC in Kuje, on the outskirts of Abuja. Photo Credit: Ifeanyi Nsofor/Nigeria Health Watch

So, what does revitalization mean? In the coming weeks and months, we will follow the commissioning of the Minister’s first phase of 110 PHCs. We hope that this would mean an infusion of sustainable life to systems required for the day to day running of these centres. We hope that when this is done, we will be closer to achieving a more equitable Nigerian society in terms of access to health services.