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Our Expectations on Primary Healthcare

Posted: May 2, 2015 at 12:31 am   /   by   /   comments (0)

By Yinka Shokunbi


There is no doubt that the foundation of every health system in any country is primary healthcare and according to the World Health Organisation (WHO), it refers to the first-contact care, in which the majority of health problems are treated.  It is known as the foundation of any health care system.



The WHO adopted the primary health care approach (PHC) as the basis for effective delivery of health services as outlined in the Declaration of Alma-Ata in 1978 and this was replicated in Nigeria in 1988 with its launch by former health minister, late Professor Olikoye Ransome-Kuti and in 1992; the National Primary Healthcare Development Agency (NPHCDA) was established to support the Primary Healthcare level of care. But over the years, this level of health system has gone through a lot of challenges that have almost brought the level out of extinction.

With the expected change in governance by May 29, many stakeholders are already clamouring for concerted effort to revamp this level of health system to enable the country build a more formidable sector that it can be proud of in a short while.

Speaking on his expectations for this basic healthcare system, Permanent Secretary, Lagos State Primary Healthcare Development Agency, Dr Kayode Oguntimehin told DailyIndependent Health, “Basically, what we need is a re-orientation”.

According to him, “A lot of the cases you find at our tertiary and secondary hospitals and a lot of people who will fall ill are people who can be treated as outpatient and go home. “But what we have done over the years is put in so much emphasis on in-patient treatment and that has led to scarcity of resources for easy things to be done”, said Oguntimehin.

He pointed out, “With the new National Health Act, the realization is coming home that what we need first and foremost is to strengthen that foundation in terms of funding, in terms of staffing, in terms of equipment and in terms of structure”.

In setting new agenda for the in-coming administration, Oguntimehin noted, “The good part of the PHC business is that you actually don’t need to over-train people to be functional in primary healthcare system.

“We could actually take a lot of people that are not specifically medical personnel such as people with science background, those with knowledge of rudimentary science and train them to be functional at our PHCs and theses ones would then be monitored and evaluated from time to time.

“For instance, when the WHO began the IMCI which is the integration of management of childhood illnesses, it was meant to be done by people who are not medically trained. They are meant to be given certain criteria to be followed and you monitored them and by that, would have taken away the bulk of the people that go to the secondary health facilities

“We should do what is right by pushing resourcing back to the primary health care system and from there we can build on”. The change that is being clamoured for across the country especially in relation with the PHC should start from the political point of view”. Oguntimehin averred

In his own opinion, former commissioner for health Dr Leke Pitan, “the new agenda on Primary healthcare for the incoming administration would be to always put the people first whether it is applied to economy, education or even health. If it is agreed that we put the people first, you will find out that there would be unanimity of purpose”, he said..

According to him, “It would mean ensuring that the woman on the street has a safe delivery and that both she and the baby are happy because that would guarantee our future as a nation.

What we should be looking forward to is to make sure there is health for all that is there. That there would be a basic minimum package which every Nigerian that is, the over 170m Nigerians whether old, young, man or woman or even a child,  would be put on and I am talking about the National Health Insurance Scheme. If you look at the APC manifesto, it says free health for all through the instrumentation of NHIS which then therefore becomes compulsory and would be there for everybody to come on board.

The modality and mechanism of coming on board are what the in-coming administration are already working on and which they would bring to bear regardless wherever one is coming from.It is the beginning of nationhood” Pitan noted.