Preamble:

Civil Society Legislative Advocacy Centre (CISLAC) organised One-day South West Regional Policy Dialogue on Primary Health Care Revitalisation in Nigeria under the aegis of a project titled “Reinvestment: Increasing Legislative Oversight on Primary Health Care in Nigeria”. The Dialogue aimed at providing an enabling platform for legislators to interact in proffering holistic solutions to the current trend and challenges confronting adequate, accessible and effective Primary Health Care system in the South West geo-political zone coupled with the need to revitalise the system for high impact and efficiency. With extensive experience sharing on previous visits to other geo-political zones, the Dialogue provoked critical discussions towards harnessing potential for revitalising Primary Health Care to inform appropriate legislative decisions and policy directions for the zone. After exhaustive deliberations on various thematic issues such as Revitalising Primary Healthcare: Understanding the Role of Legislature and Financing for Primary Healthcare: Ensuring Implementation Compliance through targeted legislative oversight” the following observations and recommendations were made:

Observations:

  1. The existing disconnection between policy formulation and constitutional provisions for healthcare creates mismatch in adequate and sustainable revenue projection healthcare service provision and delivery in the country.

  1. While Primary Health Care is the cornerstone of the health system, effective Primary Health Care services remain out of the reach of the people in many communities across the six geo-political zones in the country, as observed in case of Ididep Ibiono PHC centre, Akwa Ibom state; Achigele PHC centre, Imo state; Wayo-Kpine PHC centre, Nasarawa state; Kurmin Mashi PHC, Kaduna state.

  1. The legislators own the mandates to ensure functional, accessible and affordable Primary Health Care through sufficient oversight on budgetary allocation, releases and implementation; women inclusiveness legislation; comprehensive healthcare package; appropriate community consultation in health policy implementation and transformation into legislation; assessment of the Primary Health Care efficiency in their respective consistencies.

  1. The delay release and implementation of the health care provisions as contain in the 2018 Appropriation Act constitutes major impediment to the operationalization of Primary Health Care provisions in the National Health Act 2014.

  1. Additionally, the appropriated fund captured in the service wide vote as against the statutory allocation further compounds the challenge with accessing the funds for implementation by key Ministries, Department and Agencies.

  1. The dilapidated nature of Primary Health Care in the country with resultant inaccessibility to first-line healthcare services increases healthcare burden on the already overstretched Secondary Health Care facilities.

  1. With 5% level of funding, Primary Health Care services are bedevilled by 80% disease burden as against 15% and 5% in Secondary and Tertiary Health Cares which are having 15% and 80% funding capacity respectively.

  1. The unwary individuals’ attitudes towards the use of Primary Health Care exacerbate level of dilapidation of the facilities.

  1. Delay in fulfilment of Federal Government’s policy commitment on Primary Health Care backpedals efforts at revitalizing Primary Health Care in Nigeria.

Recommendations:

Participants recommended as follows:

In short-term:

  1. Constructive development and submission of memos to the Office of Budget and National Planning by the line Ministries, Departments and Agencies to facilitate prompt access to budgetary releases for Primary Health Care service delivery.

  1. Proactive legislative oversight on Primary Health Care system in the country to ensure functional level of care.

  1. Creating high impact and efficiency in Primary Health Care service delivery through strict adherence to the healthcare budgetary provisions as contain in the Appropriation Act to avert recurring diversion of healthcare funds.

  1. Proper information dissemination and individual orientation and re-orientation to drive required discipline for judicious use of existing Primary Health Care facilities in the country.

  1. Adequate maintenance of the existing Primary Health Care facilities for effective functionality.

In medium-term:

  1. Embracing individuals’ contributory healthcare scheme through periodic contributions by both formal and informal sectors to alleviate existing funding gaps and create accessibility to adequate and effective Primary Health Services.

  1. Massive community sensitization and awareness to drive right health-seeking behavour and workability of health care contributory scheme.

  1. Appropriate political will to address needless administrative bottlenecks and bridge implementation gaps in the Primary Health Care provisions.

  1. Encouraged public-private partnership in healthcare service provision to reduce financing for healthcare burden on individuals or households.

  1. Increased human resources for health through persistent training/retraining programmes, task-shifting approach, recruitment of adequate number and unskilled distribution of healthcare workers, strict adherence to medical codes of conduct to improve better mind-sets, behaviour, encourage healthcare personnel, their supporting staff through pay-for-performance bonuses and other incentive programs for efficient high-quality care.

  1. Creation of State Primary Health Care Development Agency across the 36 states of the Federation to access funding provisions for Primary Health Care as enshrined in the National Health Act 2014.

In long-term:

  1. Creating alignment in funding provisions between Primary and Secondary Health Care systems to maintain a balance in budgetary allocation in accordance to the existing reality, giving cognizance that Primary Health Care receives highest diseases burden.

  1. Realistic implementation of minimum structural standards of Primary Health Care in Nigeria, as recommended by the National Primary Health Care Development Agency for high impact and efficiency.

  1. Adequate domestication and implementation of the Primary Health Care provision as enshrined in the National Health Act, 2014, to promote adequate, accessible and affordable healthcare system in the region.

  1. Adequate fund provision for the health sector in accordance to the agreed international benchmark.

  2. Prompt review of the exiting internationally ratified policy benchmarks for domestication to encourage realistic implementation.

Signed:

  1. Muhammad Usman

Deputy Chair, House Committee on Healthcare Services

  1. Jimoh Olajide

Member, House of Committee on Health Services

  1. Mustapha Dawaki

Chair, House Committee on Appropriations

2019-01-16T18:02:35+00:00January 16th, 2019|Categories: Communiques|0 Comments

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