By Racheal Abujah
On December 12 when the world will celebrate the2024 World Universal Health Coverage (UHC) Day Nigeria is expected to reaffirm its commitment to achieving that feat.
The UHC, according to World Health Organisation (WHO), means that all people have access to the full range of quality health services they need, when and where they need them.
This is without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.
It is the key to addressing the healthcare challenges faced by millions of Nigerians particularly among women and children.
The celebration of UHC Day serves as a reminder that health is a fundamental human right, and no one should be left behind in accessing essential healthcare services.
With about two billion people facing financial hardship including one billion experiencing catastrophic out-of-pocket health spending, globally, or 344 million people going into extreme poverty due to health costs, achieving UCH becomes imperative.
At the 65th National Council on Health in Maiduguri, Borno State, the Federal Government, in collaboration with the Association of Local Governments of Nigeria (ALGON), urged collective action across all sectors to drive sustainable healthcare improvements.
This call aligns with the global UHC Day theme, explaining the importance of collaboration in achieving health equity and ensuring that everyone has access to the health services they need without suffering financial hardship.
The Coordinating Minister of Health & Social Welfare, Professor Mohammed Ali Pate, underscored the need for collaboration across all levels of government, healthcare providers, and the civil society to overcome healthcare delivery barriers, particularly maternal health challenges.
Local Governments, according to ALGON, are playing a pivotal role in this effort through their Primary Healthcare Revitalisation and Operationalisation Programmes (APH-ROP).
These initiatives are crucial to ensuring that no one is left behind in Nigeria’s journey toward achieving UHC by 2030.
In remote Burra community in Ningi Local Government of Bauchi State, Mrs Safiya Abdullahi, a housewife recalled the time when fever could mean a life-threatening journey to the nearest town.
“Today, thanks to investments in revitalised primary healthcare systems led by our local government management, we can access essential health services a short walk from her home,” Abdullahi recalled.
Her story reflects a broader transformation driven by Nigeria’s local governments in their quest to bridge healthcare gaps.
With renewed commitment from ALGON and collaboration with state and federal stakeholders, local councils are becoming critical players in Nigeria’s journey toward UHC.
Aminu Juaro Hassan, ALGON Chairman, Taraba State and ALGON Welfare Officer, said that ALGON, representing all 774 Local Government Councils (LGCs) in Nigeria, has launched the Primary Healthcare Revitalisation and Operationalisation Program (APH-ROP) to strengthen PHCs service delivery nationwide.
Hassan said that the programme aligned with the Nigeria Health Sector Renewal Investment Initiative (NHSRII) and aimed to achieve UHC and the United Nations Sustainable Development Goals (SDGs) by 2030.
He said the key objective of APH-ROP was to: “Empower Local Government Councils to lead and manage primary healthcare services autonomously.
“It also seeks to establish mechanisms for prioritising health expenditures to drive economic development and shared prosperity an Foster collaborations with federal and state governments, the private sector, development partners, and community leaders.
“It aims to create a centralised data-driven health information system linked to National DHIS2 to monitor health trends and outcomes and build a high-performing and motivated health workforce through systematic training, monitoring and evaluation,” he said.
National President of ALGON, Bello Lawal said the implementation would be a multi-sectoral initiative to improve health outcomes and achieve the SDGs.
“It involves the use grassroots advocacy, community sensitisation, and resource mobilization to strengthen demand for healthcare services,” he said.
Speaking on a multisectoral and inclusive approach, he said that these underscored: “gender, equity and social inclusion.”
He said that the policy roadmap would be, to reorient LGCs for improved health leadership and stakeholder engagement, and build resilient health systems to meet UHC and health security standards.
Amongst others, he said would enhance accountability in health resource management, ensure integrated, data-driven decision-making and invest in continuous capacity building for health workers.
Speaking on how to overcome geographical barriers to the project using drones, Dr Seiyefa Brisibe, Commissioner for Health, Bayelsa said the state already used them in logistics distribution including vaccines.
He said they were used to deliver the vaccines to remote, waterlogged communities which were not accessible by road.
Brisible said the state also integrated community leaders into Primary Health Care Task Force meetings to review progress.
In Ogun, Dr Tomi Coker said the state leveraged baseline data revealing only 40 per cent of women delivered with skilled birth attendance.
Coker said Ogun implemented targeted interventions such as training Traditional Birth Attendants (TBAs) to improve referrals and outcomes.
“This was a major concern, particularly when facility deliveries were concentrated in urban areas.
“With this data, the state designed a comprehensive intervention aimed at addressing both demand‐side and supply‐side factors that affect maternal health.
“The state worked closely with TBAs, providing them with training and assurances that they would not be blamed if complications arose.
“The state encouraged TBAs to refer women with high‐risk pregnancies to health facilities, and women were reassured that they could register with both TBAs and health facilities,” she said.
She said that this could be replicated nationwide as part of the vehicles towards the attainment of UHC.
Dr Bolanle Olusola-Faleye, Chief Party, United States Agency for International Development (USAID)-funded Local Health System Sustainability Project (LHSS), expressed optimism about the initiative’s potential.
Olusola-Faleye said the programmes would help reduce maternal and child mortality and strengthen healthcare service delivery nationwide.
However, she stressed the importance of monitoring, sustainability and a focus on equity to ensure that no community is left behind.
“The implementation phase is expected to begin next year, with ALGON and other partners working collaboratively to establish governance frameworks, enhance human resource capacity, and drive community-based advocacy.
“This landmark commitment sets a new standard for local government’s involvement in healthcare transformation in Nigeria,” she said.
For Dr Walter Kazadi Mulombo, Head, WHO Nigeria, the importance of global partnerships in advancing health and education at the local government levels could not be overemphasised.
Mulombo praised the ongoing technical support efforts to strengthen health systems across the country and expressed optimism about the future impact of the initiatives.
Dr Pamela Ajayi, President of the Healthcare Federation of Nigeria, stressed the role of the private sector in healthcare delivery at the local government levels, underscoring two key initiatives – the GDP and the New World Initiative – which use telecommunications and mobile health technology to improve primary healthcare in underserved areas.
Dr Garfa Alawode, Co-convener of the UHC2023 Forum, also called for a united effort to reduce preventable deaths, improve healthcare infrastructure, and support healthcare workers.
“Addressing Nigeria’s healthcare challenges requires collective will and action,” Alawode said.
ALGON’s APH-ROP initiative and its alignment with NHSRII and SWAp reflect the critical role of local governments in driving UHC in Nigeria.
Through innovative programmes, collaborative leadership and strategic partnerships, ALGON is positioning Nigeria’s local governments as leaders in primary healthcare delivery.
This comprehensive approach ensures that countless Nigerians have access to life-changing healthcare services, bridging the gap toward a healthier and more equitable Nigeria. (NANFeatures)
