The Director, Basic Health Care Provision Fund (BHCPF) has said Nigeria cannot afford to continue to have “a fragmented health care system” where states and local governments, including the federal government take different directions in health care delivery in the country.
“It has to be coordinated with an approach and understanding”, Dr Mukhtar Muhammed said while speaking recently in a programme, Morning Brief, on Nigeria’s Channels Tv.
He said there must be a very good understanding between the federal and state governments on how primary healthcare services should be operated.
The National Health Act provides that there should be a national body that comprises the federal and state governments to operate the health system in the country.
“We have agreed with the states that the primary health care services will be provided and everyone will have their responsibilities, including the federal, state and local governments, with the current autonomy.
“So, far, under the leadership of the Coordinating Minister of Health and Social Welfare (Prof Muhammad Ali Pate), we have managed to build on that strategy. He is in constant communication with the governors and the association of local governments to ensure that the understanding and strategy is sustained because, that is the only way we can succeed in delivering an effective Primary Health Care in the country.
“Over the years, stakeholders have realised the huge burden on the health sector, as seen in cases of maternal and under five mortality. These are the most important variables of measurement. The health sector has pushed towards having a dedicated fund that will serve as special intervention to improve the delivery of primary health care”, Dr. Mukhtar said.
He further revealed that the federal government provided one percent from the Consolidated Revenue Fund for this purpose to ensure that primary health care centres are enabled to provide health care services and to ensure that the vulnerable population are enrolled into health insurance plans “with very minimal or out of pocket expenses”.
The fund which is also meant to be administered through four gateways which are agencies of the government that statutorily provides certain functions like the National Primary Health Care Development Agency (NPHCDA), which is a regulatory agency providing oversight of the National Primary Health Care System in the country, working very closely with the state governments who have established their states agencies, the National Health Insurance Agency (NHIA), which has the statutory function of ensuring that all Nigerians are under a health insurance scheme, having access to health care services at a very minimal rate, Emergency Medical Treatment Committee, providing medical emergencies and Nigerian Centre for Disease Control which has the statutory function for epidemic preparedness and response to react to epidemics, also has provisions for donors and the private sector to provide theirs within the framework.
Dr. Mukhtar further added that in terms of proportion of the fund, what the BHCPF under the Coordinating Minister of Health and Social Welfare, does, is to distribute these funds. 45 percent he sais goes to the NPHCDA, 48.75 percent goes to the NHIA, 1.25 percent goes to the NCDC, while 5 percent of the fund goes to the Emergency Medical Treatment.
These responses are coordinated under the Ministerial Oversight Committee chaired by the Minister and other stakeholders.
The Health Act was passed in 2014, while the funds became available in 2019. Over the years, the funds have increase over the years and the agencies first have access to primary healthcare facilities, onboard and get accreditated with NHIA. The vulnerables also have access to these facilities.
According to Dr. Mukhtar, the number of facilities have steadily increased and the laudable idea of having one PHC per ward has been achieved.
“We currently have about 8,300 primary healthcare facilities, which means almost every ward is fully covered. Funds are provided to improve the infrastructure, ensuring that they have water and electricity. Funds are also made available to the facilities to make decisions, in terms of buying drugs needed and other necessities”, he enumerated.