By Chioma Obinna
To achieve Universal Healthcare Coverage, UHC, in the state, Lagos State Commissioner for Health, Prof. Akin Abayomi on Saturday said the State government is revitalizing the Primary Health Care (PHC) system to ensure quality, efficient and accessible healthcare services for all Lagosians.
Speaking at a Breakfast meeting organised by the Franco Nigerian Chamber of Commerce and Industry stated that PHC system, which comprises of the primary healthcare centres form the foundational healthcare structure at the community level of any UHC strategy, Abayomi said most of the Primary healthcare centres across the country are dilapidated and cannot provide the needed services.
He added that the situation was not very different in Lagos. “Therefore, it is imperative that we begin to engage all tiers of government to find the right funding and operational model. In addition, the right statutory governance oversight is required to ensure that we jointly take responsibility for these centres through efficient management systems”, he said.
Abayomi noted that the Nigerian constitution and the Lagos State Health Reform Act placed huge responsibilities and roles on the Local Government Area, LGA, health authority and Ward Committees to be responsible for the functioning of the PHCs.
He opined that concerted advocacy efforts at the three tiers of government are required to initiate the revitalization process and long term sustainability of the PHC system.
He explained that the success of the State’s mandatory health insurance scheme aimed at delivering basic health care to the majority of the resident of Lagos was dependent on a functional PHC system.
Noting that the Lagos State government had developed policies and currently implementing strategies aimed at reviving the PHC System, Abayomi said the resources of the State Government are under strain and to attain UHC in record time, there is a recommendation for the State and local government to partner with the private sector for innovative solutions.
“One of such innovations is the ‘Access to Finance Scheme’ where the State in the previous dispensation had commenced a pilot where 43 of underutilized PHCs would be allocated to the private sector for revitalization in a PPP arrangement. These private sector players would also have access to concessionary repayable loans bankrolled through blended financing which would ensure they have the capital for start-up and to provide affordable services to the enrollees of the State mandatory health insurance scheme”
“But for this pilot project to be potentially effective, further stakeholder engagement at the community and LG level is necessary to get the buy-in of the necessary structures to ensure the pilot is viable.”
He explained that the present administration Governor Babajide Sanwo-Olu as part of the THEMES mandate has pledged to gradually increase the allocation to health from present eight per cent to approach 15 per cent over the tenure stressing that this is aimed at achieving UHC and in line with the Abuja declaration of allocating 15 per cent of the budget to health.
“Although allocation is different from drawdown on the approved budgetary allocation, All efforts will henceforth be made to ensure that funding is available for capital and recurrent expenditure to ensure public facilities are well maintained and running efficiently”.
“Moving forward, we will prioritise income generation projects, efficiencies, and cost containment”, Abayomi said.
Outlining the demographic profile of Lagos as a challenge that needs to be addressed in attaining UHC, the Commissioner stated that the population of Lagos State has surpassed 20 million and rising daily qualifying it as a hyper city.
He explained this situation is brought about by constant migration of people into the city, either induced by the insurgencies and climatic forces north of Lagos or the attraction of the economic viability of Lagos.
“This brings about a great strain on the existing facilities in the State by people who require healthcare services and also threatens its biosecurity. This is why there is an urgent need for all relevant stakeholders, including the Federal Government, to be involved in the propagation of primary care to congregate and brainstorm on the appropriate financing mechanism to rejuvenate this system”.
“As a matter of priority, we are going to deeply engage with the LG structures and the house of Assembly on this critical issue. It is of utmost importance that all stakeholders agree on a collective and unified common agenda on a way forward and the State Ministry of Health will go to all lengths to find a funding model and administrative support to the local government structures in this endeavour”, he said.