… On Primary Healthcare
About 30 out of the 36 states of the federation have failed to disburse funds to their Primary Health Centres (PHCs) even after receiving N13.2 billion from the federal government as grant.
LEADERSHIP findings revealed that out of the 36 states and the Federal Capital Territory (FCT) that received the Basic Health Care Provision Fund (BHCPF) from the federal government to equip their various Primary Health Centres (PHCs), only Abia, Anambra, Delta Ebonyi, FCT, Niger and Osun States have disbursed the funds. The funds were given to the states and the FCT by the federal government through the National Primary Health Care Development Agency (NPHCDA) to address challenges of poor facilities and lack of manpower at the primary health care centres. LEADERSHIP checks showed that misplacement of priority and poor funding of the country’s PHCs is putting undue pressure on the general and specialist hospitals.
Nigeria is operating only 10,000 funded primary healthcare centres (PHCs) across the country, notwithstanding the 30,000 PHCs that have been built.
It was gathered that the masses are the ones paying dearly for the poor PHCs, leading to the death of about 148 women daily as a result of complications related to pregnancy or childbirth, according to a report from NPHCDA.
Authorities said the majority of the deaths are from conditions that could have been prevented if the women had received the right medical care throughout their pregnancies and during birth at the primary health centres.
Confirming the disbursement of the N13.2 billion Basic Health Care Provision Fund (BHCPF) to the states, the executive director of National Primary Healthcare Development Agency (NPHCDA), Dr Faisal Shuaib, said it was a gateway of the Basic Health Care Provision Fund disbursed to the 36 states of the federation and the Federal Capital Territory (FCT) Abuja.
He said, “The N13.2 billion gateway fund is for the Basic Health Care Provision Fund which has been disbursed to the 36 states of the federation and the Federal Capital Territory (FCT) Abuja. “Of all the 36 states and FCT Abuja that received the funds, only Abia, Anambra, Delta, Ebonyi, Niger, Osun and FCT had commenced disbursement to primary health centres”.
He also noted in a document that the certification of Nigeria as polio free does not amount to them taking chances, insisting that children who missed the vaccination during the coronavirus lockdown would be traced. “To improve immunization coverage, NPHCDA will be implementing an innovative strategy – Modified Integrated Medical Outreach Programme (mi- MOP) to reach unvaccinated/ missed children amid COVID-19. This is aimed at improving immunization and Primary health care delivery in targeted 409 low performing LGAs,” Shuiab added, but could not name the areas.
Shuaib said that the agency has renovated about 4,000 primary healthcare centres across the country, just as he called on states and local governments to employ medical professionals at such centres. “Through the Reach Every Ward with Adequate Skilled Birth Attendants (REWSBA) strategy, skilled birth attendants will be mobilized, trained, equipped, deployed, supported and retained for PHC service delivery in every ward,” Shuiab said, adding that in driving the Universal Health Coverage, NPHCDA would focus on attaining the set target of 10, 000 fully equipped and functional primary healthcare facilities in Nigeria, and ensuring the resilience of the PHC system while leveraging on the Basic Health facility.
Meanwhile, some state governments have responded to enquiry from LEADERSHIP on why the said funds have not been disbursed to such important health facilities. While some promised to begin the disbursement of the fund after training officers of the PHCs, others failed to respond.
In Kwara State, the government confirmed receipt of the BHCPF fund from NPHCDA but admitted it has not been distributed. The state commissioner for Health, Dr Rasaq Raji, said there were certain criteria to be met before the state could commence the disbursement of the funds to the benefitting facilities.
He said one of the criteria is capacity building exercise for facility staff and work development committee, adding that “this is ongoing and will be completed by the end of October”. Raji continued: “After the exercise, work plan will be submitted to the federal for approval. The accreditation team will then come from the federal to Ilorin for verification exercise. “The money is already in Kwara State government account but yet to be disbursed because of some of those criteria that are yet to be certified. The process is ongoing”.
In Imo State, the government said that mechanism had been put in place towards the implementation of the BHCPF. The state commissioner for Health, Dr Damaris Osunkwo said the state government was conscious of the health needs of the citizens and will work assiduously so as to strengthen the state Health Insurance scheme. Dr. Osunkwo explained that a committee has been put in place to work out modalities for the takeoff and realization of the objectives of the federal government novel project.
But the executive director, Kano State Primary Health Care who is also the coordinator of COVID-19 taskforce, Dr Tijjani Hussein, who confirmed that the state has actually gotten the funds, said that they were yet to disburse it. Dr Hussein who confirmed receipt of the funds to LEADERSHIP in a Telephone interview said even though the funds are currently in the coffers of the state, the delay in disbursement was as a result of the inability of the state to train the PHC staff. He said until the training is conducted, the money will continue to lie idle in the state account.
Jigawa state government, while responding to enquiries, said it was yet to access the funds. The permanent secretary in the ministry of Health, Malam Salisu Muaz, told our correspondent that training was ongoing for the health ministry personal, accountants and other staff to handle the programme across 287 wards in the state. He said the review of operational guidelines by the federal government on the programme made it difficult for the state to access the fund, noting however the state government is working hard to meet up the criteria for accessing it. Noting that the state has a target to start accessing the fund before the end of 2020, Muaz hinted that over 100 health facilities across the 27 local government areas of the state have been listed for the commencement of the programme.
Meanwhile, the Sokoto State government said it got the fund penultimate week and is yet to disburse it. The State commissioner for Health, Dr Ali Muhammad Inname, who confirmed receipt of the fund, however, said that they have commenced technical process of banking to get the needed pin before disbursement.
In Plateau, the state government said it was yet to commence the disbursement of the fund it received from the NPHCDA. The commissioner for health, Dr Nimkong Lar, who confirmed receipt of the sum of N337million from NPHCDA to be disbursed to all the PHCs in the state, said the government needed to conduct training workshop for PHCs handlers before the commencement of the disbursement of the fund. “We will not disburse the fund until we conduct training workshop for all the PHCs handlers. It is after that the government will disburse the fund to ensure the goal is achieved through effective implementation,” Lar said. When asked how soon the government will conduct the training for the participants, Lar said, “Very soon,” adding that once the training for the participants is conducted, the state will commence the disbursement.
The State commissioner for health, Dr Saka Audu, said that disbursement of fund which was given to the 21 local government areas has further facilitated the Basic Health Care Provision Fund.
In Borno State, the executive director, State Primary Health Care Development Agency, Dr Aliyu Shettima, said the agency was yet to disburse the fund to various primary health care centres in the state. According to Shettima, the delay in distributing the fund is as a result of change in leadership of the agency, saying the state is still perfecting change to signatory of the account to enable it access the fund. “I am just taking over leadership of the agency from my predecessor. By Monday, we will send the form to the federal ministry of Finance and from there, we can access the fund and begin the disbursement to various healthcare centres in the state,” Shettima said.
In Rivers State, the commissioner for Health, Professor Princewill Chike did not respond to messages sent to him on the matter. When our correspondent visited the ministry of Health, a senior official of the ministry who pleaded anonymity said it was only governor Nyesom Wike that could speak on the matter.
Officials in Katsina state could not confirm whether the government received the NPHCSF or not as effort to speak with the commissioner for Health and the executive secretary of PHCDA, Dr Abdulkarim Yahaya proved abortive. A source within the government cycle however said the state government is concerned about health and will not hesitate to give such areas the needed attention.