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Nigeria: Closing access gaps, rural populace solicit for more functional primary healthcare centres

Early in the morning on 24 September 2013, Rukayat Yunsa went into labour and was rushed to the Primary Healthcare Centre (PHC), located close to her home at Kuchingoro community, Abuja Municipal Area Council (AMAC), Abuja.

Rukayat, who is currently seven-months into her third pregnancy, said she was not perturbed about the health facility where she would give birth to her baby because the PHC in her area is functional and works 24 hours.

“The PHC is good, and they provide 24 hours service. I gave birth to my two children here, and I will give birth to this baby here too. My family use this health centre for other health services like routine immunization and treatment of disease. Health workers are always on duty anytime you get here. The service is good, but we need a machine for pregnancy scans as it would reduce the stress of looking for a place to conduct a pregnancy scan,” she said.

Primary Healthcare Centres (PHCs) play vital roles in the healthcare system and were introduced worldwide after the Alma-Ata Declaration of 1978, and its reaffirmation with the Astana Decalration in 2018, global healthcare leaders established to fulfil the goal of better health for all. The PHC is a grass-root management approach to providing health care services to communities.

Community partnership 

In line with the five guiding principles (accessibility, community participation, health promotion, use of appropriate technology and intersectoral cooperation) of a PHC in the Alma-Ata declaration and the quest to achieve universal health coverage for Nigeria, the federal government and partners have been making efforts to reposition PHCs to function properly across the country.

The World Health Organization (WHO) affirms that for every human being to enjoy “The highest attainable standard of health” – a functional PHC  addresses the majority of a person’s health needs throughout their lifetime.

The residents of Kuchingor0 and its environs have been relying on  the health facility  for healthcare services.

In the case of 56 years old Hope Ihemeje, she prefers to transit about 25 minutes from her residence, boarding bikes, cars and crossing a busy highway to seek medical attention at the PHC located in Kuchingoro.

“It is not that there is no PHC in my area in Lugbe, but I prefer the services rendered at Kuchingoro, and the service is affordable. You can be sure you are getting quality health services, but the only problem is drugs. Patients have to buy the unavailable medication at a pharmacy,” she said.

Notwithstanding the services rendered at the Kichingoro PHC, a community leader and vice chairman of the Ward Health Committee (WHC), Oba Abdulrazaq Oyewole, said the centre still faces some challenges hindering it from operating at its maximum capability.

“The facility provides quality, timely, affordable health services to the community. However, it is short staffed and constantly run short of drugs. As WHCs, we support the daily activities, and we encourage community members (pregnant women and children) to use the PHC due to its proximity to the community, he said.

PHCs engine for UHC

“The  role of a functional PHC in the community can never be overemphasised because the clinic should be the first point of call for the people. With a functional PHC at all wards across the country, Nigerians (women, children and men) would be able to access health services in quality time,” said Dr Udak Archibong, a medical doctor at Kuchingoro PHC.

“When people in a community can access quality health care services in their locality, at affordable cost and on time, it will enable early detection and notification of infectious diseases, reduce maternal and child mortality, and improve immunization coverage across the country. PHC’s are essential for achieving UHC. The WHO has been a supportive partner in assisting to discharge our duties, especially, in terms of rountine immunization and health workers capacity building,” she said.

Meanwhile, at the recently concluded PHC summit organized by the , National Primary Healthcare Development Agency, NPHCDA to reposition PHCs across the country, the WHO Regional Director for Africa, Dr Matshidiso Moeti, said that the COVID-19 pandemic has shown that healthcare is a critical aspect of the economy.

She said the Alma-Ata declaration identified the PHC as key to the attainment of health for all as adequate public health financing will reduce out-of-pocket payment and improve access to health services.

Similarly, the Executive Director, NPHCDA, Dr Faisal Shuaib,  said that Nigeria has a four-point PHC agenda to implement.

The four-point agenda is about implementing strategies that work and thinking about those strategies that will drive more service delivery and revitalisation of our Primary health care sectors in Nigeria. Everybody has a part to play in changing the current state of our PHCs, he said.

A functional PHCs is the pillar of any medical care system. It includes measures for prevention, diagnosis and treatment of diseases and specific conditions, medical rehabilitation, monitoring the course of pregnancy, the formation of a healthy lifestyle and sanitary and hygienic education of the population.