Malam Iron Danmusa wrote from Kano
A healthy nation is indeed a wealthy nation and it is apparent that, every responsible government has taken the well-being of its citizens very serious and as such various mechanisms have been adopted to that effect.
However, it has been discovered that, primary health care (PHC) has become the frontline care of the health care system that is comprehensive and coordinated. It provides multidisciplinary, patient-centered care with a focus on both the treatment and prevention of various conditions.
Over the years, it has become the first point of contact to keep people well and improve their quality of life. No doubt a strong, accessible PHC system reduces pressure on hospitals by supporting people to manage their health issues in the society.
Primary health care was officially launched in 1978 at a World Health Organization (WHO)/UNICEF conference in AlmaAta, in the former Soviet Union, at which some 150 governments were represented. The Alma-Ata Declaration defined PHC as follows: Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.
It was documented that, in 1960, there was no strong focus on health systems development, policy makers and political actors made efforts to establish and expand health-care infrastructures with more emphasis placed on curative medicine rather than preventive medicine and from 1975 to 1980, health system development was initiated with PHC as the cornerstone.
It was then that, the National Basic Health Services Scheme (NBHSS) was developed based on a PHC approach. Unfortunately, the NBHSS program could not achieve its goals due to implementation challenges; hence, PHC services were not delivered across Nigeria.
It was in 1985 that, Professor Olikoye Ransome-Kuti was appointed the Minister of Health. Professor Ransome-Kuti adopted PHC in 52 local government areas in Nigeria as models based on Alma Ata Declaration of 1978. Similarly, Nigeria’s first comprehensive national health policy based on PHC was launched in 1988. From 1986 to 1990, Professor Olikoye Ransome-Kuti expanded PHC to all local governments, achieved universal child immunization of over 80%, and devolved responsibility for PHC to local government areas.
The ultimate goal of primary health care is better health for all. WHO, has identified key elements to achieving that goal: reducing exclusion and social disparities in health, organizing health services around people’s needs. The role of primary health care The primary care physician has a number of functions which includes provision of continuous and comprehensive care, reference to specialists and/or hospital services and to co-ordinate health services for the patient among other things.
It was based on the importance of PHC services that Kano state government held the PHC Summit with the theme- PRIMARY HEALTHCARE SYSTEM…THE JOURNEY SO FAR, and the Subtheme: Primary Healthcare Under One Roof (Prospects and Challenges).
It forms an integral part both of the country’s health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process. The Alma-Ata Declaration identified 10 activities as the basic elements of PHC (Table 1); as can be seen, general practice is only one component of this. The Declaration contains important socio-political implications that address not only treating disease, but also ensuring fair access to a positive state of well-being for all citizens.
In a communiqué issued at the end of the summit, It was observed that payment of salaries of PHC Staff is still undertaken by Ministry of Local Government, hence Kano State Government has committed to; Complete movement of staff salaries from the Ministry of Local Government to the State Primary Health Care Management Board by the end of March 2020.
It was also observed that, the state has committed to soon embark on renovation, upgrading and in some places, construction of healthcare facilities with a view to achieving the goal of one functional PHC per ward.
The executive governor of Kano state Dr Abdullahi Umar Ganduje had during the summit announced that Kano State has awarded contract for the construction and Equipping of 400 bed capacity specialized hospitals in all the newly established emirate councils in order to improve access to quality and affordable healthcare delivery services. The governor further revealed that, based on population growth in Kano State, the State Government has observed gaps in human resource for health and therefore it will continually recruit competent manpower in various PHCs in the state in addition to over 900 Health staff recently recruited.
The governor also revealed that within the next one month, Kano State Government will recruit and deploy one medical officer each to all the 44 LGA councils of the State with a view to improve delivery of Primary Healthcare Services.
However, during the 2019 End of Year Review of the state Health System Strengthening Program, that brings together governor Abdullahi Umar Ganduje of Kano state, with his team, Gates and Dangote Foundations, with the Minister of Health and Executive Secretary of the National Primary Health Care Development Agency (NPHCDA), at Africa House, Government House, Kano, Tuesday, via teleconference.
It was vividly clear that Kano state government has displayed commitment and high level political will in strengthening institutions and implementing, to greater extent, the signed Tripartite Agreement between the state and Bill and Melinda Gates and Dangote Foundations in the healthcare service delivery system.
The governor also assured all the partners that all the feats achieved would be sustained with all vigour and clear understanding of societal demands, highlighting that, “.For the year 2020 the state would scale up existing referrals network service between primary health care centres to secondary health facilities, by June 2020 and would implement resolutions of 2020 Primary Health Care Summit with emphasis on rationalization of the minimum service package investment plan,” he said.
He also revealed that, some of the state’s priorities for the year 2020 in to optimize Reach-Every-Ward (REW) micro-plan to incorporate other PHC services beyond RI by February 2020, develop plan to fill identified statewide human resource for health gap, by March, 2020, to achieve Kano state’s Polio Free Certification, by June, 2020, among others.
It was also reported that, in their separate remarks Minister of Health Dr Osagie Ehanire, Co-Chair, Bill and Melinda Gates Foundation, Mr Bill Gates, (who was represented) Chairman Dangote Foundation, Aliko Dangote and Executive Director of the National Primary Health Care Development Agency (NPHCDA) Dr Faisal Shu’aib, all commended the effort and commitment of Governor Ganduje in keeping faith to all sections of the MoU.
It is apparent that, Kano state health care development system will surely wears another new look.