SIR: When Prof Isaac Adewole, Minister of Health, announced last year that the federal government will build one primary healthcare (PHC) centre in each of the political wards of the country, many stakeholders in the nation’s health sector welcomed the statement as a right policy pronouncement that will positively impact on our already collapsed PHC system. However, the news now coming out from the same direction that the federal government will cancel the proposed plan to build 10,000 new PHCs is most troubling. It would amount to changing the goal post in the middle of an on-going game.
Why should the minister raise false hope knowing well he can’t carry out this important policy intervention? In any case, if our government has never complained of lack of funding for elections and in fact always raise money to conduct increasingly expensive elections, I see no reason why the government cannot find money to provide affordable and quality healthcare for the people. Perhaps, it is another confirmation that our governments consider Nigerians’ health as a non-issue. This is the more reason I don’t find the excuses put up by the health minister to cancel plan to build one PHC per political wards plausible. As it is commonly noted, primary healthcare is the cornerstone of Nigeria’s health policy, the first point of contact for most Nigerians with the health systems in the country.
It is therefore instructive to remind the federal government that if the ward health system (WHS) is to represent the thrust of our national strategy for the delivery of PHC services using the electoral ward as the basic operational unit for the delivery of effective services, there is need for such special intervention to revitalise already collapsed PHC system. This is only mirroring similar intervention in the primary educational sector like what the Universal Basic Education Commission (UBEC) is doing. As such, it is very significant that the federal government support the subnational level authorities particularly the local government with adequate healthcare infrastructures like the proposed construction of PHC centres across the country.
Be that as it may, an inventory of all PHC centres in the country is necessary with the view of ascertaining actual number of wards lacking PHC facilities. It’s on the basis of such physical assessment and counting that the proposed repackage of the concept be predicated going forward. Or, on what basis is the hinted new 110 pilot PHC project will be anchored? Otherwise it will be arbitrarily determined. More so, we also need to know how much a prototype cost of building a PHC will be. What specific components of total cost will be bear by each tiers of government?
We strongly believe that government can still fulfil its promises of one PHC per ward if available resources are prudently utilized. For example, a 2006 Actionaid report entitled: Find the money: a guide to monitoring allocations to the MDGs through the debt relief gains disclosed that the government earmarked the sum of “N5, 478,000,000 for construction of 166 PHCs across the 36 states of the federation” amounting to N33, 000,000 per one PHC under the 2006 budget (Actionaid, 2006:13). Another total sum of “N2, 090,000,000 [were] to be spent on renovating and equipping PHCs in 209 sites across the 36 states and FCT” at the rate of N10, 000,000 each (ibid., p19). That was on the high side. The forthcoming report by the Centre for Social Justice (CSJ) recommends a modest price of N10m per PHC as a more reasonable cost which this writer also finds very acceptable.
- Tunde Salman,
Grassroots Development & Advocacy Centre,
Ilorin, Kwara State.