Strengthening And Revitalisation Of Primary Health Care (PHC) In Nigeria Through Policy Formulation

The Primary Health Care (PHC) system in Nigeria has completely broken down. Currently, only about 20% of the 30,000 PHC facilities across Nigeria are functioning efficiently. The remaining 80% lack the capacity to provide essential health-care services. This appalling state of affairs is often attributed to factors such as; lack of political will, inadequate funding/misappropriation of funds, inadequate inter-sectoral collaboration, lack of motivation in the workplace, inconsistent and inadequate power supply, poor condition of infrastructure, and lack of essential drug supply etc. These factors all point to the fact that the PHC system in Nigeria is grossly underfunded and deprioritized.
The consequence is that about 51.40% of Nigerian citizens who live in the rural areas are unable to access proper healthcare services due to the ineffective PHC system, a development that accounts for the increase in maternal mortality and infant deaths in the rural areas. While the PHC under one roof (PHCUOR) policy was formulated in 2011 to address the problem of fragmentation in PHC and ensure the integration of PHC services under one authority. Its impact is yet to be felt on health status and utilization of PHC in Nigeria since it became a national policy a few years ago.
With the emergence of the Covid 19 virus, the need to strengthen the PHC in Nigeria has never been more timely and relevant. While foreign donors like UNICEF and USAID have consistently worked to improve the functionality of the PHCs across the country, not much has been done in terms of policy decisions and actions by the government. For instance, the document detailing the minimum standards for primary health care in Nigeria was last updated in 2012. Such a review is long overdue and is necessitated, especially by the current upsurge of covid 19 and the challenges with vaccination storage.
These developments underscore the need for policy makers to strengthen and revitalize primary health care in Nigeria. This may necessitate a review of the minimum standards for primary health care to include renewable energy as a viable source of electrification of PHCs across the country. This is for the reason that epileptic power supply accounts for the most significant factor responsible for the inefficiency of PHC centers across the country, and the need for adequate storage facilities for the covid 19 vaccination programme.
Some states in the country, such as Kaduna and Edo States have seen the need to explore the renewable energy option and have begun implementation. The results speak for themselves; the states have recorded increase in the number of patients that reports at the PHC centers – where the renewable solar energy options were deployed- for treatment also, the health workers reported better and more conducive work environment. Both factors have helped in contributing to increased efficiency of the PHCs and confidence of beneficiary communities in the PHC healthcare system.
Likewise, the Rural Electrification Agency is currently implementing the Nigeria Electrification Project (NEP), a Federal Government initiative that is private sector driven and seeks to provide electricity access to households, micro, small and medium enterprises in off grid communities across the country through renewable power sources. The project would provide renewable clean energy to 204 PHCs across the country. While these efforts are commendable, it is pertinent for the government to make a policy that demands the use of renewable energy as an alternative to grid.
The Good Governance Team (GGT), a Non-Governmental Organization with funding from her partners, the Green Foundation, Heinrich Boll Stiftung (HBS) Abuja Country Office is currently advocating for the review of the minimum standards for Primary Health care to include renewable energy as default alternative to the grid. It is believed that if this is achieved it will contribute to improved primary healthcare system in the country, especially with the buy-in of the state governments.

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