National Health policy represents the collective will of the government and people of this country to provide a comprehensive health care system that is based on primary care. It describes the goals, structure, strategy and policy direction of the health care delivery system in Nigeria.
National Health policies, strategies and plans play an essential role in defining a country vision, policy directions and strategies for ensuring the health of its population.
Policy makers need to strengthen and revitalize PHC in Nigeria.
Prof. Ransome Kuti adopted PHC in 52 local government areas as models based on Alma Ata Declaration of 1978 (Lambo Etal. 2015).
Nigeria 1st comprehensive National Health Policy based on PHC was launched in 1988.
The challenges and opportunities in implementing PHC in Nigeria, as well as ways to maximize the opportunity.
From 1986 – 1990 Prof Ransome Kuti expanded PHC to all local governments achieved universal child immunization of our 80% and developed responsibility for PHC.
Prof. Ransome Kuti introduced a comprehensive national health policy well a focus on PHC, placed emphasis on preventive medicine and health care services at the grass root, ensured exclusive breast feeding practice.
Encourage the use of oral rehydration therapy by nursing mothers, made compulsory the recording of maternal deaths and encouraged continuous nationwide vaccination and pioneer effective HIV/Aids campaigns.
In 1992, the National Primary Health Care Development Agency (NPHCDA) was established to ensure that the PHC agenda is continued and sustained.
The military take one of government that occurred in 1993 brought to an end the giant strides recorded under the leadership of Prof. Ransome Kuti from 1988 – 1992.
Twenty four years after, the leadership of Prof. Olukoya Ransome Kuti, the need to strengthen the PHC in Nigeria is relevant as ever.
The current state of PHC in Nigeria is apathy with only 20% of the 30,000 PHC facilities across Nigeria is working. (Adewole .I 2016)
Most of the facilities in Nigeria lack the capacity to provide essential health care services most of the facilities are having issues such as poor staffing, inadequate equipment, poor distribution of health workers, poor quality of health care services, lack of essential drug supplies (Chinama J.M 2015).
Implementation of PHC in Nigeria are related to the hand over in 1980s to the local government administration which is the weakest level of government (Okarafor, 2010).
The PHC under one roof policy was formulated in 2011 to address the problem of fragmatization in PHC and ensure the integration in PHC services under one authority. Its impact is yet to be felt on health status and utilization of PHC. Since PHC under one roof became a national policy, only a few years ago.
The inability of PHC centres to provide basic medical service to the Nigeria population have made both secondary and tertiary health care facilities experience an influx of patients. This has had its stole on the secondary and tertiary level of care (Oyedeji R. 2014).
Part of the Alma Ata Declaration is that Health is a fundamental human right and government should be responsible for the health of the people (WHO 2016). Health is rarely seen as a fundamental human right by policy makers in Nigeria hence the inability to implement the Abuja Declaration in which the African heads of state pledge to set a target or air marking 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 (WHO 2001).
Many African countries including Nigeria fall short of the Abuja declaration of 2001 in spite of the pledges by the heads of state of African Union Countries (WHO 2016).
It is established that the successful implementation of PHC in any country requires adequate financial resources (WHO 2016)
The Alma Ata Declaration encourages partnership and cooperation with other related sectors of the economy in the development and implementation of PHC. Unfortunately, related sector are also battling a series of challenges and are yet to deliver on their own responsibilities to the people. The establishment of MPHCDA and 30,000 PHC facilities across Nigeria provide opportunity for effective implementation of PHC in Nigeria.
In conclusion, PHC policy in Nigeria can be strengthened through the implementation of the Abuja Declaration, thereby increasing domestic resources for health and improve budgetary allocation for the management of PHC.
Government should direct resources for health care from curative service to preventive services in order to improve PHC 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 to health of citizens by signing and implementing the necessary legislation.
References
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