Revitalizing Primary healthcare in Post-COVID pandemic
By Carl Umegboro
The fears, distresses that followed the contagious epidemic – Coronavirus which practically crumbled the world economy cannot be forgotten in a hurry. The pandemic led to shutdown of all businesses, schools, religious worship centres and leisure spots except essential services. An unimaginable, unprecedented global lockdown that apart from members of nuclear families, everyone isolated, restricted closeness with other persons for fear of infection. Sneezing became like a taboo let alone coughing. Wearing of face masks, compulsory hand-washing and use of hand-sanitizer suddenly became a norm. Governments and financial institutions across the globe operated skeletally with only management staff, and mostly from home digitally. The masses living on daily incomes without huge deposits in the banks were worse hit. These incidents cannot be forgotten in a hurry. It was hitherto unbelievable.
To confront the quandary squarely, nations across the globe synergized with sturdy policies, imposed travel bans on international tours, shut down airspaces, and set up jab centres for COVID vaccines. Although the concerted energies confronted severe conspiracy theories from some quarters, the fight against the pandemic was sustained. However, amid the dilemma, many people lost their lives even in the developed nations with functional primary healthcare systems including USA, Europe, among others.
Strangely, these developed nations recorded the highest casualties in the COVID deaths despite their huge commitments to the primary healthcare (PHC) compared to Africa particularly Nigeria with meagre attention to the health sector. In fact, some estimates at the WHO believe that COVID-19 deaths have been undercounted across the globe and that the worldwide tally of nearly 6.3million deaths may actually be two times higher. Last month, May 2022, in the United States alone, the Centre for Disease Control and Prevention reported that America has aggregately surpassed one million deaths attributed to the disease.
One could only but imagine what would have happened if the epidemic had its way at the same rate in the developing countries in deficit vis-à-vis primary healthcare. For example, all public officeholders and the affluent class in Nigeria depend on the western world for their healthcare and nuclear families. The healthcare in Nigeria is literally left in miserable conditions for the helpless masses except private hospitals, hence the tradition for government officials to always queue for foreign medical trips, sadly from tax-payers’ coffers. Nonetheless, the pandemic created some emergency interventions to primary healthcare in Nigeria including setting up COVID vaccination centres by governments.
Now, in this post-COVID pandemic, revitalizing the primary healthcare (PHC) in the country should be given a priority by the authorities as what happened during the pandemic should be an eye-opener. PHC, an ‘essential health care’ that is based on scientifically sound and socially acceptable methods and technology is the first level of contact for individuals, family and the community with the national health system, and addresses the main health problems in the community, providing health promotion, preventive, curative and rehabilitative services accordingly. Amongst its scope are routine medical checkups, screening for common health issues, prescribing necessary medications, treatment of minor illnesses and injuries, managing chronic conditions, and management of acute health conditions. Health, it is held, is wealth. Thus, revitalizing primary healthcare will impel economic recovery in post-Covid pandemic.
The second reason is the alarming WHO records which reveals that about 3,000 children die each day of preventable diseases resulting from lack of primary healthcare. Bringing it home, Nigeria from the said data represents 1 in 7 of the global maternal deaths, expressed in 119 preventable maternal deaths daily, and the impact this has on family health and child survival in general cannot be underrated. Furthermore, Nigeria is the top country in the world in terms of number of zero dose children (children who never received any single dose of vaccine since they were born). This is precarious. Necessarily, it is incumbent on the authorities to give the ‘one PHC centre per ward policy’ utmost commitment, alongside sensitization on child immunization.
In Lagos state recently, Mrs. Muyiwa Idowu-Olaleye, a resident in a ward in Ifelodun LCDA narrated how an emergency call to a health worker in a PHC centre saved the life of her 6year old kid, Sidikat from Cholera infection which began at midnight and almost dried up the child by strained vomiting and stooling in the middle of the night. She wondered what could have happened if she didn’t get anticipated attention from the health worker. The above story suggests that revitalizing Primary Healthcare in every ward with efficient services is essential.
Arguably, the ‘one PHC centre per ward policy’ in Lagos is rapidly gathering momentum. For instance, Lagos presently, has no fewer than 392 PHC centres spread across its 377 wards – (245 wards created by federal government and 132 wards created by the state from its 37 LCDAs) and strategic places, and progressively being boosted with needed workforce. According to the Permanent Secretary of the Lagos State Primary Health Care Board (LSPHCB), Dr. Ibrahim Mustafa, the state government employed 925 health workers in its recent recruitment drive including medical doctors, pharmacists, nurses, community health extension workers, laboratory scientists and technicians, environmental officers and health information management officers. This should be a template for other states for replication.
Furthermore, through funding from the Bill & Melinda Gates Foundation and support from CHAI, a development partner, Lagos reportedly has in place an effective and efficient data monitoring system. MTN Foundation had also donated six Mobile clinics to the state. Avid donors like USAID, European Union and other partners to the national body, NPHCDA deserve credits. More corporate organizations should key in as a social responsibility. The ‘one PHC centre per ward’ policy is a desideratum and should be jauntily implemented across the nation. Above all, sensitizing the rural communities on the importance of PHC is necessary particularly the worth of jabs against vaccines-preventable childhood diseases. Also, regular hand-washing for hygiene and hand-sanitizing embraced during the pandemic need to be sustained. These chores will no doubt boost PHC delivery.
Umegboro, ACIArb, a public affairs analyst and social advocate writes via umegborocarl@gmail.com