Primary Healthcare: USAID-IHP, SPHCDA engages Ebonyi stakeholders on private sector investment


In efforts to reposition Primary healthcare delivery in Ebonyi State, the United States Agency for International Development's Integrated Health Program  in collaboration with the  State Primary Health Care Development Agency, has engaged community stakeholders on private sector investment in revitalizing primary health facilities.

In a 3-day interactive workshop, concluded on Friday, June 18, at the Cirene Hotel, Abakaliki, Ebonyi Primary healthcare stakeholders pledged to collaborate with the agencies to vigorously pursue community ownership of Primary health facilities in their various domains to enhance their effectiveness.

The event was part of USAID-IHP's "Adopt a PHC initiative" in.line with  its objective  of strengthening health systems, increasing access to and improving quality of primary healthcare through policy support. 

Participants at the workshop decried the deplorable condition of primary health centres in various communities across the State and undertook to leverage on USAID-IHP's support and  knowledge gained from the workshop to harness private engagement towards revitalizing  the health facilities and their services delivery.

They identified  part of the challenges hampering the functionality of these facilities to include dilapidated buildings, poor state of rural roads, absence of electricity, water and other basic amenities; inadequacy of essential drugs and human resources for health.

Observing that the lack or inadequacy of power fron the National grid is the greatest challenge to primary health, resource persons at the meeting advocated for investment in renewable sources of energy through coalition with private investors and philanthropists.

They also intimated stakeholders on available non-commercialized options for PHC electrification, through solarization and other sources aimed at sustainable electrification of the PHCs. interview, one of the key resource persons from Abuja, the IHP's Technical Lead on Health Systems Strengthening and Sustainability, Dr.Sunny Olukunle Phillips explained that the essence of the event was to get Ebonyi stakehders queue into government's strategic plan towards sustainable primary health service delivery.

He noted that the baseline assessment conducted in 2019 revealed that over 40 percent of PHCs have no electricity of any kind, adding that the role of USAID-IHP was to play a facilitator role toward actualizing government policies with regards to improving and Strengthening health systems.

Phillips said: "We have come to bring to the fore and to listen to how Ebonyi State indigenes can take ownership and provide oversight  and resource mobilization for Primary healthcare services across their communities.

"What we are looking at getting done across the the State was supporting them to see that policies of the government  are domesticated and implemented.

"There are several policies around PHC effectiveness across communities in Nigeria: to have the primary healthcare under one roof, ensure minimum service package, and currently, the Basic Healthcare Provision Fund for revitalizing healthcare services.

"So, our effort  is seeing to the actualization of the intentions of those policies, not just as policy statements, but to ensure that communities and citizens can feel the positive impact of these services."

In a remark, the Leadership and Governance Advisor for USAID-IHP in the State, Chinyere Ikwuakor, had drawn attention to the need for communities to mobilize both resources and actions towards improving both infrastructures and services at the various primary health centres in the State, emphasizing that government has so many competing priorities.

Ikwuakor added: "I will say that Government has done a lot, and there are so many sectors that government is overseeing, and all these sectors demand fund for them to implement their activities.

" Health as we know, is a human right, and the task of ensuring maximal performance of any PHC is a function that no community should delegate to the government.

"So we want to think outside the box: what can private sectors, individuals, philanthropists, and even non-governmental organisations do to complement the efforts of government because government cannot do it all.

"If we don't start looking inwards, our health facilities will continue to be in their deplorable state.

"So, that is why we are now promoting private sector investment: philanthropists, individuals to see ways they can help to support primary healthcare.

" Primary healthcare centres are the first point of call when somebody is sick, especially in rural communities, and that calls for the need for communities to own them, and hold health workers in them accountable..."

Some of the stakeholders who spoke to journalists including HRH, Ezeogo Bassey Onya Idam of Amasiri Community, in Afikpo North Local government area; John Igboke, Town Union President of Onuenyim Ishieke community of Ebonyi Local government area, among others, agreed that owning and sustaining improved service delivery at the PHCs by the communities were possible.

They however called on government to hasten the employment of health workers, including resident doctors and nurses into primary health facilities to tackle the challenge of human resources for health in the State.

Idam said: The initiative is a welcome development.

"The government of the day is letting us know that health, security are for the people to organise for themselves: don't wait for the government to always organise it for you.

"Lucky enough, in my kingdom, we have an age long tradition that as a male child in the whole of Afikpo area, you must contribute to the development of your community by way of setting up a standard called Age Grade.

"With that arrangement, any growing male child irrespective of religious affiliation has a responsibility to the community.

"At the age of forty years, you are duty bound to contribute to building schools town halls and the likes, to the extent that today, most of the shared facilities are built by these various age grades.

"As a traditional ruler, going would be to engage my people over the issues raised in this meeting by IHP, and if need be, invite all stakeholders to help us actualise them."

Igboke on his part,  enumerated rural poverty and ignorance as factors militating against utilization of primary health facilities by most women in rural communities. 

He also identified rural insecurity, lack of medical personnel and poor facilities at the primary healthcare centres as part of the challenges inhibiting their effectiveness.

Igboke noted: "Most rural dwellers are poor, and even the women find it difficult to patronize primary health facilities for fear of cost. 

" But as a members of my own Ward Development Committee, I used to encourage them, asking them to come to us if there are cost implications.

"Another constraint we have is the rising rate of insecurity, even in our own rural communities as well as non availability of health personnel in the health centres."

He suggested that government should partner community representatives in budget preparation and execution to enable their needs  be captured as well as ensure that votes to primary health are effectively employed.

Highlights of the event included the formation of PHC revitalization Core group for the State and the development of action points to enable its realization.

Members of the core group were to be drawn from Ebonyi State Primary healthcare Development Agency, chairman of Traditional rulers Council, President-General of Town Unions and representative of the Ministries of Power, Women Affairs and Social Development as well as Donor Agencies.

Others were leadership of Civil Society organisations, the Christian Association of Nigeria, Ebonyi Chamber of Commerce, the Media, among others.

Part of the action points included the involvement of traditional rulers, Town Unions, women groups as well as Ward development Committees in meetings with the local government health Administrative Secretaries where primary healthcare issues would be discussed, charting the way forward.

Key Participants in the workshop were drawn from among  Traditional rulers, Town Union executives, Local government area health Administrative Secretaries, Non governmental/Civil Society Organisations, the State Ministry of Power, the media, among others

Other resource persons who spoke at the event were IHP's Chief of Party, Marta Levitt and Ikenna-Donald Ofoegbu of  Heinrich Boll Foundation who connected virtually from Abuja.

The Team Lead, Off Grid, USAID Power Africa, Nigeria Power Sector Program, Mr.Balaji MK also spoke virtually from the United States on available alternative power sources for health facilities.

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