Franka Osakwe
An expert in health system, Dr Fausat Oluyombo Sanni, Director of Medical Services, Lagos State Primary Healthcare Board (LSPHCB) has outlined diverse ways of strengthening primary healthcare system in Nigeria using the primary health care system Under One Roof Policy. This procedure she said, will help reduce endless and needless maternal deaths in Nigeria.
This was the focus of a day-workshop organized by DevComs, a non-nongovernmental organization, last week with the theme: Strengthening Health System in Nigeria through PHC Under One Roof: Progress, Challenges and Way Forward.
Dr. Sanni noted that there is need to strengthen whatever we have because we have not achieved much in terms of health care service delivery in the country. In her words: “In spite of the potential capacity of PHC to meet the health needs of majority of Nigerians, over the years the outcomes has been suboptimal owing to a weak system particularly at the implementation level,” she said. Explaining the policy she said, Primary Health Care Under One Roof (PHCUOR) is a policy to reduce fragmentation in the delivery of Primary Health Care (PHC) services which involves the integration of all PHC services under one authority. Fragmentation has been identified as the most significant problem facing PHC services, and significantly affects utilisation rates and health indices.
She However, recalled that over the years, PHC was everybody’s business – all manner of players have been involved in it and that led to poor coordination, overlaps and concomitant inefficiency/ineffectiveness.
“Our desire to remedy this is the wisdom behind primary health care under one roof, PHCUOR: To strengthen the governance system. We are happy to note that PHCUOR is a reigning buzzword in the health sector today,” she said.
She itemized those factors fuelling the weak PHC system in Nigeria as follow: fragmentation, leadership conflicts, wide span of control, duplication of roles and concomitant wastage of resources, weak collaboration and coordination, PHC structure and organization is out of tune with international best practice.
Dr. Sanni however, said the concept of PHCUOR is to harmonize the PHC sub-system, overcome structural constraints and improve coordination at the state level; to create unitary, integrated and decentralised management bodies/structures and systems; to position the states for effective Implementation of National Health Act.
According to her, PHCUOR approach enhances coordination, collaboration, effectiveness & efficiency; eliminates constraints, fragmentation and managerial uncertainty, wastage of resources and creates enabling environment for implementation of the proposed Health Act.
In terms of compliance in Lagos state, “we have PHCs in 248 of our wards and we are still trying to establish more in those wards without facility. It’s not that we just totally neglect them; we have outreach services for such wards. From time to time when we have programmes everybody will be well mobilized within the local government and we make sure we have temporary or outreach cites,” she said.
In terms of collaboration, Remi Akinmade, chief executive officer of CHIEF NGO noted that if the indigenes of a particular state can be trained that it will break issues of trust and language barriers. “It is high time we strengthened the community too. They can be volunteers, they can be mobilized during immunization, let there be a role for them to do. If they go to secondary school, let them also go to school of nursing or community health school so by the time they are through with education they will be retained within the community with their own people. This could reduce issue of trust within a community,” she advised.
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