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By Emejuiwe Victor
One of the major policy thrusts of the Federal Government is to revitalize the 10,000 moribund PHCs in each of the 9,423 wards in the 774 local governments in Nigeria. The revitalization of the PHC involves upgrading the existing PHCs to the acceptable minimum standard as recommended by the World Health Organisation (WHO). This requires the availability of required number of qualified medical personnels, facilities and medical equipments to be functional in each of these wards. Information available from the Ministry of Health reveals that, the Federal Government has kick-started the process with some wards; so far only 133 wards spread across the six geopolitical zones have received attention. This spate of progress shows that 10 years down the line, Nigeria might not achieve much if adequate measures are not taken.
With the economic recession currently being witnessed in the country, the dream of revitalizing these PHCs might hit a brick wall if there is lack of collaborative effort from all stakeholders. To successfully revitalize the PHCs, there is need for Nigerians from all walks of life to take ownership and responsibility of the PHCs in their wards. This collaboration should be sought for from the following stakeholders, the federal, state and local governments, the private sector, the lawmakers, donor agencies, religious organizations and individual citizens.
The lack of harmony between the Federal Government and the State to implement programmes that will benefit the citizens, in this case primary health care, has been a major challenge in revitalizing the PHCs. The cooperation of state government is needed for the Federal Government to achieve its goals in the state. To achieve this, the state and local government should sign a memorandum of understanding with the Federal Government on areas of collaboration. Both parties can share the burden of providing resources, personnels, medical equipment and management of the PHCs. This means that that the state government must make budgetary allocations in its annual budget for the revitalization of PHCs. The duty of monitoring of services and management of facilities and equipment also rests in the hands of the state and local governments without which any effort made towards revitalizing the PHCs will not be sustainable.
Revitalizing 10,000 PHCs is quite enormous, this makes it pertinent for the private sector to take part in the partnership. There are significant numbers of business entrepreneurs who can invest in revitalizing the PHCs. They should be provided with the necessary template and given certain incentives to invest in the project. Such incentives could be the provision of tax rebates; they should be made to access foreign exchange at the official rate and also made to recoup their investment within a reasonable time frame.
There is need for concerted effort in the alignment of national goals and prioritize the use of resources generated in Nigeria along these goals especially in this period of recession. Therefore, every member of the National Assembly should align their constituency projects with the goal of the Federal Government. In this case, they should consider the revitalization of the PHCs in their ward as one of the major goals of the Federal Government and make it a priority in their constituency project. They are in a better position to ensure that these PHCs are well managed and are offering the required service that is needed in their constituencies.
Nigeria has also enjoyed partnership with international donor agencies especially in the area of health care, however, the challenge is that donor assistance to Nigeria has not been harmonized as a result there are little or no information about what each donor is doing or how to measure the milestone achieved and the impact created. A way out of this is for the donor agencies to key into the programmes of the government and also tie their funding to the programmes. The projection from donor funds should be captured in the budget.
The donors should see the project of revitalizing 10,000 PHCs as a major priority of the Federal Government in the provision of primary health care to 80% of Nigerians and invest in it. The revitalization of the PHCs will curb the high incidence of maternal and neonatal mortality rate in Nigeria and reduce the health care burden of majority of Nigerians who do not have access to functional health care.
The religious bodies such as churches and mosques should take part in the project of revitalizing the PHCs in the various wards. The religious bodies should see this as a welfare project meant to curb incessant death of Nigerians due to lack of access to a functional health care system. The aim of the church as much as we know is to save souls; before a soul can be saved the life must be saved and preserved, this makes any intervention towards the project of PHC revitalization evangelistic.
Finally, the call for this collaboration is borne out of the fact that health is a priority of all; the state of health of a citizen affects everyone directly or indirectly. The health statistics of Nigerians especially maternal and neonatal care is worsening by the day and the cost of reducing the mortality rate is beyond the reach of one segment of the society. Hence, this collaboration should be given due attention by all concerned stakeholders.
Victor writes from Abuja.