He said that teaching hospitals were not expected to treat malaria as is the care but to handle complicated health challenges. The minister stressed the need for the country to invest in primary health centers to function effectively to dissuade people from going to teaching hospitals.

The minister named the 14 states that were yet to key into the basic healthcare provision fund initiative to include Kebbi, Jigawa, Akwa Ibom, Cross River, Gombe, Rivers, Borno, Zamfara, Ondo, Benue, Taraba, Nasarawa, Ogun and Sokoto.

He described the approval of the Basic Healthcare Provision Fund as a game changer in the health sector. Adewole who noted that the States have literally abandoned healthcare such that everything is handled by the Federal Government insisted that “we cannot succeed with this.”

He noted 22 other states have complied with the conditions required to benefit from the scheme.

“What we have done with the fund is to structure it in a way that money will flow from the Central Bank to the primary healthcare facilities bypassing all obstacles.

“Last week, we succeeded in moving out funds from the Central Bank to the agencies and from the agencies, it will go to the primary healthcare.

“As of today, 14 states are yet to show interest in the basic health care provision fund and because senators represent the entire country, I want to quickly seek your permission to tell you the states. It is unfortunate because this is a game changer.

“These funds provide free ante-natal care, free delivery, take care of malaria, screen for tuberculosis, hypertension, and diabetes.”

He said: “We have 22 teaching hospitals in the country, 20 federal medical centers and 17 specialist hospitals all over Nigeria under the direct purview of the federal government. Most states also have teaching hospitals to provide tertiary care.

“The teaching hospitals by design constitute the apex of healthcare in any country and for us in Nigeria, they represent the topmost and by design, they are expected to receive referrals and manage complicated cases.

“We have 22 teaching hospitals in this country, 20 Federal Medical Centers, and 17 specialist Hospitals all over the country under the direct purview of the Federal Government

“For them to function effectively they depend on functional primary healthcare, functional secondary healthcare centers. When these two levels of care are functioning 90% of ailments can be taken care of by the primary and secondary health care levels.

“In other words, only 10% of Nigerians who require care will need to go tertiary health institution. The PHC 70% and secondary health institutions 20%.

“However, over the last couple of years we have a major challenge, the healthcare system can be described as a pyramid, the pyramid has PHC at the base, secondary at the middle while the tertiary at the tip.

“We can also liken the healthcare system to a building. The primary Health care is the foundation, Secondary the wall and the tertiary the roof.

“The problem we had is that the foundation is bad the wall is weak and we are only concerned about the roof. Under the Babangida administration, the then minister of health Professor Olukoya Ransom Kuti invested and concentrated a lot of attention on the PHC because it is the foundation and is also in keeping with the declaration in 1978 that countries should invest in PHC because it is the healthcare that is the closest to the people.

“However, for some other reasons, this effort collapsed after a few years. When the Obasanjo administration came there was a lot of concern for the tertiary and it invested in the tertiary but that is like investing in the roof when there are no walls and no foundation.

“When this administration came we did a quick diagnostics and said that for the health system in Nigeria to function properly we need to restructure the pyramid.

“When we were training you cannot enter the University of Ibadan Teaching Hospitals without a referral letter. You must be referred from a primary or secondary but because the primary and secondary have collapsed people just walk into the tertiary health.

“Somebody had malaria and could not be admitted because there is no bed, the teaching hospitals are not expected to take care of malaria. In fact, they are expected to take care of complicated cases.

“What we have done through your support and I must publicly commend you and the Senate for approving the Basic Healthcare Provision Fund, it is a game changer.

“By way of history, Nigeria started primary Health care in the world, we started in 1962. PHC started at Igbora in Oyo State 1962 with support from Rockefeller Foundation.

“We own PHC, it doesn’t belong to the world, we own it and what we then decided to do is to invest in the PHC. We believe that if we invest in PHC a lot of people would not have cause to go to the tertiary.

“That is what we have been doing through your support monies there, we spent almost the whole year developing the guidelines and in the last two weeks, we started the rollout. As at the last count 22 of our States have registered with the Basic Healthcare Provision Fund.

“What we have done with the Basic Health care Provision fund is to structure it in a way that money will flow from the Central Bank to the PHC facility bypassing all obstacles. We succeeded in moving out from CBN to the agencies and from the agencies, it will move straight to the PHC. Even before we started this meeting I had a discussion with a distinguished senator that as of today 14 States are yet to show interest in the Basic Health

“These are States that have not shown interest. This is unfortunate because this is a game changer because money will come to the PHC. PHC for the first time in this country will get regular subvention. You will get money every month to take care of water, leaking roof, buy consumables so that they can function.

“There would be two signatories to the account the head of the community where the PHC is located and the Head of the facility. Through this initiative, we would reach 10,000 PHC and 100, 000, 000 Nigerians with basic care. What did we promise Nigerians when we started? We said there would be free antenatal care, there will be free delivery including cesarean session, we would take care of malaria which is the commonest reason while Nigerians fall sick.”

He appealed to senators to use their leverages with governors to invest in secondary health care.

According to him, the secondary healthcare centers in the states have “no staff, no doctors, no nurses and even when they are there they are not paid.”

“Even when they are paid, they are paid only a fraction of what people get in the tertiary health institutions and that is the only problems we have today.

“I have been to states wherein a general hospital you find only one doctor, in some no doctor at all, that is the problem and if we do not solve this we would be scratching the problem on the head with respect to tertiary healthcare, we cannot expand the tertiary beyond limit, we have limitation with resources and that is why it is important for states to partner with us so that we can address this problem,” he said.

Saraki said, “We are concerned with the deteriorating condition of the facilities across the country despite the annual budgetary allocation to the Sector. Nigerians are still dying because of obsolete equipment, lack of power, lack of a diesel, lack of drugs, we are concerned about.”

Most senators who spoke prayed the minister to do something urgently to rescue the country’s health sector.

Senator Kabiru Marafa in his contribution wondered why the minister did not investigate the alleged mismanagement of N500 million he provided for the establishment of Federal Medical Center Gusau and payment for primary health care insurance scheme for people of Zamfara State.

The Zamfara Central Senator said that he provide the fund to a former Minister of Health (Dr. Onyebuchi Chukwu) to establish a Federal Medical Center and to pay for primary health care insurance for the people of the state.

According, the former minister diverted the fund to buy mosquito net in Enugu.

He said that the minister connived with a permanent secretary to divert the fund meant for the welfare of Zamfara State to Enugu.

Senator Olusola Adeyeye wondered why Marafa did not report the matter to the Senate for investigation.

Adewole said that what Marafa said happened in the past.

He said, “As a minister, I don’t want to investigate what happened in the past. I have investigated and found out that the fund was actually used to but mosquito net. We should bury the matter and move forward.”

Source: The Nation