Challenges Before The NPHCDA

The National Primary Health Care Development Agency (NPHCDA) was set up in 1992 to extend healthcare delivery services to the rural areas, a role it took over from the Federal Ministry of Health.

The Agency plans to solve more than 70 percent of the nation’s health care problem by collaborating with the rest of the health system. It also draws upon as much resources as it can from within and outside the country.

Since 1999 the NPHCDA has built 200 health centres in wards throughout the 36 states and Abuja. Each of the 200 health centres is equipped with facilities for the implementation of a community-based PHC work plan.

In addition, one million treated insecticide bed nets have been distributed to pregnant/nursing mothers nationwide as part of the move to achieve the goals of Roll Back Malaria in the country.

These activities have consequently advanced the progress of improving the health and quality of lives of the people.

Primary healthcare agency has made some progress in polio reduction as it has also trained traditional birth attendants and midwives, through the Midwifery Service Scheme.

A year ago, the agency carried out a nationwide integrated measles campaign to forestall epidemic in the country.

Dr Mohammed Pate, former Executive Director of the agency describes the exercise as an “injection that needed more qualified health workers to deliver”.

Pate also says: “There is a nationwide integrated measles campaign so that we don’t have measles epidemic in 2011.

“I don’t want to be in a position whereby we are reacting to an epidemic, we should be preventing this epidemic from happening.”

He says that the micro planning will be done with the states, adding that the campaign which will begin soon, will be in two phases.

“January is for the Northern states while February is for the Southern states,” he said.

In 2011, the agency also immunised 50 million children against polio and 13 million against measles.

The integrated vaccination campaign began in late January of 2011, distributing measles vaccines to the northern states and oral polio vaccine nationwide.

The second phase in February of the same year included measles vaccine for children under five years in the 17 southern states and oral polio vaccines nationwide.

In 2010, the country recorded only 11 cases of polio virus compared to 338 cases in 2009 but in 2011, 44 cases were recorded.

Dr Emmanuel Abamida, former Acting Executive Director, explains that the immunisation campaigns organised by the agency were interrupted by numerous political situations and events going on in the country between 2010 and 2011.

He says within the two years, the country witnessed voter registration and elections which he said, largely accounted for the low turnout of children for the immunisation exercises as their parents were also engaged in the electoral processes.

“Many of those responsible for ensuring that children were immunised ran to where the electoral processes were conducted, which made the turnout and quality of the polio campaign to be very low.

“ Unfortunately, we did all our immunisation exercises on Saturdays, which were also the days of elections”.

“It was hard to convince people to take their children for immunisation rather than go for voting or the electoral processes which they were interested in”.

Abanida notes that although some setbacks were observed, the agency is quickly engaging all the governors to buy into the immunisation campaign.

In an effort to address the poor Maternal and Child Health (MCH) outcomes and get Nigeria on the track towards the attainment of the Millennium Development Goals 4 and 5, on maternal and child health, the Federal Government introduced the Midwifery Service Scheme (MSS).

In 2010, the Federal Government trained 2,488 midwives in life-saving skills and integrated management of childhood illness and a year later, the number trained increased to 4,000 qualified midwives.

The MSS was scaled up to cover 1,000 rural Primary Healthcare Centres in 36 States and FCT while 1,000 community health workers were enrolled in the scheme. The rural facilities were organised with 250 general hospitals providing back-up referral support.According to data, the number of babies born nationwide under the MSS rose to 42,000 in 2010 from 27,000 in 2009, indicating that the measure will undoubtedly reduce maternal mortality rate and improve basic services.

Data were collected from 652 facilities across the 36 states and FCT, covering a population of 10.7 million, from July 2009 to December, 2010.

“Women receiving two doses of tetanus toxic during antenatal care in 2009 were 96,000, while in 2010, the figure was 110,000, representing 30 per cent increase.

“For those attending family planning clinics in 2009 were 24,000 women while in 2010, the figure had risen to 55,000.’’

However, it has been observed that lack of resources has hindered further recruitment of midwives by the agency.

Dr Ado Mohammed, the new Executive Director of the agency, promises to evolve strategies to ensure all priority activities are implemented within the limit of funding.

“Under my administration, NPHCDA will continue to build on achievements of its seven goals and vision of making Nigerians healthier by intensifying the fight against wild polio virus as a national priority”.

According to him, NPHCDA will expand and sustain the midwifery service scheme and reinforce the concept of primary health care under one roof to improve access to quality health care delivery.

He reassures both local and international partners of his commitment to continue to work closely with them to achieve the aims and objectives of the agency.

He also promises transparency and accountability for meeting the agency’s national objectives in line with the transformation agenda of President Goodluck Jonathan.

Observers say although the agency has recorded a modest achievements, the litmus test is meeting with the set targets of the Millennium Development Goals in maternal and child health as the country inches towards 2015.

Ofili writes for News Agency of Nigeria (NAN).

Francis Ofili