Aina: Nigeria targets over 17,600 primary healthcare facilities within next 4 years

Guardian Nigeria

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00:00The Executive Director and the Chief Executive Officer of the National Primary Healthcare

00:04Development Agency, Dr Mouye Aina, says work has begun to double the number of fully operational

00:10primary healthcare facilities in Niger to over 17,600 within the next four years.

00:16Now in a chat with CNBC Africa, he says revitalising the primary healthcare system

00:21is part of key priorities while addressing issues of infrastructure, medical staff training and

00:26overall welfare moves needed to improve the overall quality of healthcare services here

00:31in the country. Have a look. When the President came in in 2023, one of the things and he

00:39assembled his health team headed by the Coordinating Minister for Health and Social Welfare.

00:44One of the first things that we had to do based on the mandate that the President gave was to try

00:50to understand the state of primary healthcare. So we did an assessment of the 8,400 PHCs that

00:57are being supported by the Basic Healthcare Provision Fund and we found some good things,

01:03but we found a lot of gaps and immediately got to work. So at that time, just about 20% of the

01:09facilities met the bar of what we could say, you know, what we call level two, but what that really

01:17means is fully functional, meaning you can go there and receive services that a primary health

01:23centre should provide for 24 hours. Meaning there's infrastructure, there's enough staff who are there

01:29for 24 hours because they have accommodation or because there are enough of them that they are

01:34doing shifts, but you also have the equipment and the basic commodities to function. So in December

01:44of 2023, just giving some context here, the President signed a compact with all of the states

01:51in Nigeria Development Partners and that compact is in the process of being expanded to include

01:56the local governments as well to identify priorities that we focus on as a primary

02:04healthcare system and one of them is revitalizing primary health centres. So that is really two

02:12things, taking the 8,400, moving them gradually towards full functionality, meaning getting all

02:18of them to meet that bar earlier, then expanding the number, basically doubling it to 17,600.

02:26I think what is important to note about the doubling is that it's not in the, you know, two per ward

02:34model doubling. We're going to have a minimum of one per ward as the government has committed to

02:38for a long time, but beyond that, we're following the needs, disease burdens, gaps in access, you know, to

02:46prioritize where we move additional facilities to in that expansion. So over the last year, we've

02:53got to work within the prioritization, the Minister and the President, you know, mobilize resources,

02:59government resources, but also partner resources. We're in the process of getting almost 4,000 this

03:07year. Well, by 2025, almost 4,000 will be done. So last week, when I last checked,

03:15we have completed about 309. We had completed about 309 here. There's a couple more because

03:20we're just keeping track, but in the process of also being revitalized, another 311 or so that

03:28the National Primary Healthcare Development Agency is doing, apart from the Global Fund is doing 200,

03:33and between the 36 states and FCT, there are about 3,018, I believe, that are right now in

03:40the process of also being revitalized. Many refurbishment of the infrastructure,

03:46many repowering them, providing basic equipment for them. In addition, the President committed

03:53to retraining 120,000 health workers, health workers that are working in facilities, and

03:59to date, we have trained 53,000, over 53,000 today, in integrated primary healthcare services.

04:08So what we did was to look at all of the important components, and say rather than doing

04:13vertical treatments where half the year, the sparse, sparsely distributed health workers

04:20are being drawn out into different vertical treatments, can we have an integrated curriculum?

04:25So we pulled all of our stakeholders and partners together, built a curriculum that covers all of

04:30the elements, and started to train them. Again, with collaboration with the states and the partners,

04:36and now we have 53,000 people out there who are currently employed and working in facilities.

04:42When that process is continuing, we have also identified about 30 to, between 30 and 40,000

04:49volunteers across the country that currently provide some services, but not in the

04:56obligated way, and we're working with the states to try to see how we absorb some of that.

05:01I can tell you that the states are in the process of hiring. There are, I think, I forget the exact

05:07number now, but I think in the last year alone, at least we can document somewhere between two

05:12and 3,000 additional health workers that were hired by New Jersey State, by Borneo State,

05:19and a few other states that we have been able to access the records. We also directly hired

05:262,000 health workers that we are now working with the states to absorb into their workforce

05:31while we support the women in NPHE, with some of the resources to pay their salaries at least

05:38upfront. So, these are some of the, of course, we also looked at the disease areas that have

05:46been, that have suffered the most neglect. So, reproductive health, for example, you know, access

05:51to maternal and child health services, access to family planning, decision making, and agency

05:58in the, by the women. So, we've directly intervened through some food procurement and

06:05distribution we just provided in communities. There's been lots of resources mobilized to map

06:10the states against partners. As of today, 28 states have partners that will support them.

06:16Talk about how the strategy around financing of all of these initiatives and speaking to the

06:22details around the work with state governments to ensure that they also effectively came into

06:28the basic healthcare provision fund. How does this really work? How does it operate?

06:35Yes. So, a number of things. One, I mentioned earlier that the president had signed a compact

06:41with all of the states, which is being, and flagged up the Nigeria Health Sector Renewal

06:47Investment Initiative. And what that does is it anchors all of the stakeholders, the federal

06:54government, the state government, the local governments, and development partners, who are

06:59signatories. Well, the local governments will be added at the time they were not, to this compact,

07:06which anchors all of us around a few priorities and specific targets that the president set forth.

07:13So, that's a commitment that moves everyone. But also, if you think about the law that really

07:19guides the health sector, it's the National Health Act. The National Health Act, there's

07:24no federal health act or state health. It's a National Health Act that prescribes a national

07:30health system where there is a role for the federal government, there's a role for the state

07:34government, there's a role for the local government authorities spelled out in the act. And there's

07:39even a role, and there's a mechanism for engaging non-state actors or development partners,

07:45our donors, or even the communities. You know, all of that is spelled out.

07:50And that was Dr Mui Aino, the Executive Director and Chief Executive Officer

07:54of the National Primary Healthcare Development Agency, speaking then.

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