It is absurd to state that the Federal Government has no business in the matters that have to do with PHC as well as with Primary and Secondary Educational Systems. Both health and education are concurrently under the purview of the three levels of government in Nigeria. Thus, the federal level has a lot to do with these social services, and we need to understand this.
On Primary Health Care
First, in its 2016 National Health Policy, which is the most recent of its health policies and which sets the direction and health policy thrust for Nigeria, the Government of Nigeria weaves its efforts at achieving Universal Health Coverage, UHC, round about PHC. In other word, to achieve and ensure health for all Nigeria, primary Health Care remains the main means for achieving this. The policy specifically emphasizes the “Prioritization of Primary Health Care (PHC) and rural poor in funds allocation” towards ensuring infrastructurally developed and adequately resourced PHC system for impactful PHC services.
The policy clearly states how the Federal Government will do this through “increasing allocative efficiency by redistributing resource allocation between levels of care to ensure adequate allocation to preventive and promotive care”. Remember that “promotive and preventive care” remains the central theme and purview of PHC system.
Secondly, and in pursuant to achieving UHC, we need to state that the Federal Government through the National Primary Health Care Development Agency, an agency of the Federal Government, is substantially involved in PHC implementation in Nigeria. The Act setting up the NPHCDA clearly spells this out.
Thirdly, the National Health Act succinctly outlines how the Federal Government through NPHCDA will drive the improvement of PHC through the “BHC Provision Fund, intended to significantly increase government financing for PHC and targets universal coverage with at least basic services”. The Act spells out the sharing formula and process in ensuring the disbursement of this fund, targeting primary the PHC for its enhanced funding.
The use of the fund and its sharing formula are as summarized below:
i. 50% for the provision of basic minimum package of health services to all citizens, in eligible PHC facilities through the National Health Insurance Scheme, NHIS.
ii. 25% to provide essential drugs for primary health care.
iii. 15% for the provision and maintenance of facilities, equipment, and transport for primary healthcare
iv. 5% for the development of human resources for eligible PHC facilities
v. 5% by the Federal Ministry of Health for National Health Emergency and Epidemic Response.
In all, 95% of this Fund will go to PHC system in Nigeria, and NPHCDA, an organ of the Federal Government of Nigeria, will be responsible for disbursing the funds for essential drugs for PHC, facility maintenance and human resource development through State PHC Boards for distribution to LG Health Authorities.
So, the Federal Government is fully and statutorily involved in the affairs of PHC in Nigeria.
Education at Primary and Secondary Levels
The Federal Government’s role in primary education in Nigeria, is that of intervention to ensure uniform, equitable and qualitative provision of basic education throughout the country. While primary and secondary educational system are administratively and executively the responsibilities of the state and local government respectively, the Federal Government, through the Federal Ministry of Education is responsible for overall policy formation and quality control.
When the Federal Government of Nigeria launched the Universal Basic Education Programme on 30th September 1999, among its intended roles was “provision of necessary infrastructure and enabling logistics for the effective implementation of the scheme”, with emphasis on “building and equipping schools and employment of qualified teachers so as to enhance appropriate ratio to student population of 1:40”.
In any social services or ventures that run concurrently in the country, what is needed for efficiency and effectiveness is proper and appropriate co-ordination. Achieving this has always been difficult as political differences and ego-centric posture of key players always derail the implementation.
State governments are closer to the people than the Federal Government, while the Local Government is the closest. A serious-minded state government will pro-actively seek the Federal Government out and have its involvement in addressing such services for the benefit of its people. Where the state government fails in this respect, such social infrastructures and services will suffer to the detriment of the people that ought to benefit thereof. It is wisdom for a state NEVER to alienate itself from the Federal Government.
So, to those pandering the notion that the Federal Government has no business or hand on issues of PHC as well as primary and secondary educational systems, let them know that this is not true. They should encourage the states to pro-actively seek out the Federal Government to help them address the challenges of PHC and educational systems in their states for the states’ good.
– Professor Haroun Omeiza Isah
Public Health Physician, Academic and Development Work Specialist