Obstacles To Primary Health Care

In an ideal environment, primary health care delivery is an entrenched institutional process through which government impact positively on the health care needs of its populace, essentially those in the suburbs, or if you like, hinterland.
That is no mater how far-flung the villages, communal settlements, hamlets, or hovels are from the cities, or the seat of power, it is the duty of government to provide those who dwell in such communities, health care and medical facilities, once such settlements are within the geographical territory of the state.
In essence, it is the duty of the government to invest in the health of its citizens; to ensure its populace is healthy; to positively reduce the rate of mortality; to preserve its population; and consequently, guarantee a healthy supply of human capital, the fountain of its continued existence.
Politically, the Nigerian federation is structured along three tiers of government: federal, state and local government. Since the local government is nearer to the people, it is undoubtedly, regarded as the most effective channel through which government can successfully get its health care programme across to the rural areas.
The question is: How effective are the local government councils in government's drive towards optimum health care delivery?
Now hear this! The Team Leader and National Programme Manager, European Union Partnership to Reinforce Immunisation Efficiency in Nigeria, (PRIME), Dr. Abba Umar, says the low capacity utilization of health care workers is the major reason primary health care has remained in a poor state at the local government area (LGA) level in Nigeria.
According to Umar, “sometimes you go to a health facility in the LGA and you find out that it is only one person you have managing a whole centre”. He further remarked: “it is a serious problem. The capacity is low. We need more commitment at the LGA level. We need to have more trained people at that level of funding”.
Dr. Umar also complained of political will and lack of adequate funding as some of the factors militating against effective primary health care delivery in Nigeria.
The Managing Director of EPOS Health Consultants, Dr. Robert Geartner, whose German firm is also participating in the Immunisation Efficiency Project in 26 states of the country, corroborates Dr. Umar's observation on the wretched state of the nation's primary health care delivery scheme.
He stressed that government should adopt a major policy shift in the way it currently runs its primary health care system, and rather contract private charities, Non-Governmental Organisations, (NGO'S), and Missionary bodies who have the service capacity to deliver such essential services.
 “I don't think that in the next five to 10 years,” Dr. Geartner noted, “the LGA'S and states would be able to deliver those services by themselves, even if they were to have the money”.
Geartner further observes that there is a yawning gap between what the population rightfully expects and what is actually delivered, which have led to severe shortcomings in the nation's health care delivery points.
In all of these, the political will is the most formidable. Unfortunately, the local government, as crucial as they are to integrated national development, are painfully regarded by politicians as the spoils of political power.
Inefficient or low capacity utilization is of no consequence to the politician, provided, his supporters are rewarded with appointments. Additional funding will obviously translate into more largesse to be expended on fanthom projects and on endless queue of political wanabees.
So what can be done? An effective primary health care delivery system remains a desideratum for a successful national health programme. And so, it can't be wished away.
Sincerely, the current dislocation of the nation's health care programme further reinvigorates the call on government to unabashedly recognise and formally incorporate traditional medicine into the nation's rather shambolic health care delivery system.
Despite the invectives, sly talk and negative campaign against traditional medicine, its positive contribution to the nation's health care is unquestionable. Its marketing is more penetrative and reaches the poor, whether, in the cities or rural communities, who really need medical succour because herbal medicines are cheaper, effective and affordable.
Let government encourage and support the passage of the Traditional Medicine Bill that is lying prostrate at the National Assembly. When passed, it will establish a Traditional Medical Council, (TMC), that would define and regulate the practice of traditional medicine in Nigeria.
The TMC would register reputable Traditional Medicine Practitioners, (TMP), through whom the government can strike a synergy with orthodox medicine practitioners as well as organizational service bodies, such as charities, NGO'S, missionary and rural based groups; working in concert to complement the effort of the states and local governments to evolve a co-ordinated health care delivery system for Nigeria.