Primary Health Centre placed emphasis on preventive medicine and healthcare services at the grass root. This was the reason behind the establishment of National Primary Healthcare Development Agency (NPHCDA). The current state of Primary Health Centre system in Nigeria is being reduced to only the edifice without the necessary man power and equipment with only about 20% of the 30,000 Primary Health Centre facilities across Nigeria working. As most of these facilities in Nigeria lack the capacity to provide essential health care services, in addition to having issues such as poor staffing, inadequacy of health care services, poor condition of infrastructure and lack of essential drug supply. The problems of Primary Health Centre can be related to the handing over to the Local Government Area to be administering which is the weakest level of government in the country. The Primary Health Centre under one roof (PHCUOR) policy was formulated in 2011 to address the problem of fragmentation in Primary Health Centre and ensure the integral of Primary Health Centre services under one authority. Its impact is yet to be felt in 2020 on health status since the policy became a national issue, few years ago.

The Primary Health Centre have created a big vacuum for his inability for the centre’s to provide basic medical services to the Nigerian population have made both secondary and tertiary health care facilities experience an influx of patients. Health is a fundamental human right and government should be responsible and responsive for the health of the people which have shown as part of the unpreparedness as seen by all in combating the spread of Covid-19 by all sphere of government. As health is rarely seen as a fundamental human right to the common man on the street by policy makers in Nigeria; hence, the inability to implement the Abuja Declaration in which African Heads of state pledge to set a target or earmarking at least 15% of their annual budget to improve the health sector. Increasing investment in health of the people has been a challenge for decision makers in spite of evidence showing the link between health and economic development.

It is established that the successful implementation of Primary Health Centre in any country requires adequate financial resources.
Therefore, governments have to maximize the opportunity provided by the existing Primary Health Centre facilities to make Primary Health Centre sustainable in order to strengthen Nigeria health care system. The running of Primary Health Centre facilities would be more effective if federal and state governments took over their administration from the local governments.

According to a survey research conducted by HEINRICH BOLL STIFTUNG NIGERIA (HBS) in 2018 titled “Improving Access to Clean Reliable Energy for Primary Health Care Centers in Nigeria”. In a 2018 report, the World Health Organization (WHO) ranked Nigeria’s health care system at 187th out of 190. These indexes measured the accessibility of health care across countries from 1990 to 2015. It focused on the number of deaths from 32 causes that could have been prevented by ‘timely and effective medical care’. Many of these deaths are highly preventable if effective (functional) Primary Health Care Services are in place.

Unreliable electricity access leads to vaccine spoilage, interruptions in the use of essential medical and diagnostic devices, and lack of even the most basic lighting and communications for maternal delivery and emergency procedures.
According to WHO, as disease patterns change, more energy is required to expand services for the prevention and treatment of non-communicable diseases (NCDs).
Over 80 million Nigerians, representing 60% of the country’s population, lack access to grid electricity. Currently, Nigeria’s power generation, transmission and distribution rates are not commensurate with energy demands of the population, giving rise to consumers depending on dirty and outdated energy sources that have adverse health and economic consequences on them and the society at large. Nigeria’s energy demand is estimated to rise to 88,282 MW by 2020 from 15,730MW in 2016. There is a need to gather accurate data on the sources of and energy cost of Primary Health Care Centers (PHCs) across Nigeria.
Government should redirect resources for health care from curative in order to preventive services to improve Primary Health Centre infrastructure, encourage the migration of health workers from urban areas to rural areas and provide acceptable level of health care services for all thereby reducing the gross inequality in health status of the people. Political actors and policy makers could guarantee the right of health of all citizens by signing and implementing this necessary legislation. This will end will we come out of this the sun will rise again.

Shuaib is of the Good Governance Team, Abuja.

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