VIEWS: HOUSE OF REPS PROBE ON LEGALITY OF FG’s INVOLVEMENT IN PHC
A. Poor Health Indices Under Five Mortality About 20 children out of 100 born alive never celebrate their 5th birthday. About 10 of these die within one month.
Maternal Mortality Ratio
According to WHO the MMR of Nigeria is 814 (per 100,000 live births). The lifetime risk of a Nigerian woman dying during pregnancy, childbirth, postpartum or post-abortion is 1 in 22, in contrast to the lifetime risk in developed countries estimated at 1 in 4900. Why? Due to cause due to unskilled pregnancy, delivery and newborn care. (Local and unorthodox care) Solution is to provide Skilled pregnancy, delivery and newborn care closest to women and babies in the 8,813 political wards of the 774 LGAs.
A fragmented Health System weakens and disjointed work is cacophony work without direction. This was why a change was needed and it came. In form of the National Health Act. 2014.
1. National Health Act. 2014 Created framework of the Health System
Part 1 of thus Act by NASS
(b) Promote a spirit of cooperation and shared responsibility among all providers of health services in the Federation and any part thereof; (FG and parts)
(c) Provide for persons living in Nigeria the best possible health services within the limits of available resources; (Hence BHCPF in the act)
(e) Protect, promote and fulfil the rights of the people of Nigeria to have access to health care services.
BHCPF – funding at Federal Level funds pooled (with State Counterpart funds)to support Basic Minimum Package of Health Service (BMPHS) at LGA channelled through
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1. NHIS for effective, equitable demand and access to health with financial protection for the vulnerable at the PHC service level in the LGA2. NPHCDA to support and strengthen Primary Health Care’s at the LGAs to Supply equitable, accessible health care they need as a BMPHS at the quality acceptable. This is Primary Health Care to meet Universal Health Coverage.
The NASS will erode the gains made by them enacting this law and the National health policy.
2. Creation of the NPHCDA through an act. To coordinate the gains made by the late Prof Olikoye Ransome Kuti in Primary Health Care
3. PHC is the cornerstone of Nigerians Health Policy 2016 midwife by the National Council on Health and the goal is to meet Universal Health Coverage (UHC)
The cornerstone to achieving Universal Health Coverage (UHC) is through PHC system strengthening NOT weakening!
We should progress and not regress
NASS members seek our common good they should be made to remember that;
1. LGAs/States cannot fund Primary Health Care alone hence BHCPF
2. Health is on the concurrent list and PHC is at the base that needs all tiers to strengthen it with PHC under one roof to enable FG through NPHCDA support it
COVID-19 VACCINATION AS A CASE IN POINT Covid19 vaccination wouldn’t have had international technical recognition if NPHCDA didn’t have authority using the 3 one principle approach.
1. One PHC framework which is the PHCUOR to make it easier for the covid19 PSC to hand over the covid19 vaccination program to a Federal Agency that had been working in and specialised in immunization as one of the 12 PHC components for years.
2. One Coordinating Authority for Governance & Leadership Structure to coordinate, guidelines collect & support SPHCSAa and LGHAs/LGAs to Create SOPS, mobilise resources eg fund from Public and private sectors to provide materials and finding to pay personnel allowance and materials at LGA supporting states amongst others.
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3. One M&E framework that saw the records & EMID platform with a Federal Logo same for all and easier to change update and consistently for all vaccines across 774 LGAs, 36+1State.
Well-meaning Nigerians and Associations (NMA, AMOHN etc) WHO, UNICEF and others should plead with the National Assembly not to destroy what they began to build but complete the job for health for all Nigerians
CC: Dr Oladapo Asiyanbi
#goodluckandbesafe Member Association of Medical Officers of Health in Nigeria (AMOHN) Lagos State Chapter.