Ranti Ekpo, a public health consultant, has advocated for increased community participation in primary healthcare delivery to guarantee greater access to healthcare, especially for Nigerians at the local level.
In addition, she wants in place, appropriate healthcare delivery systems that work for people in rural communities rather than policies imported from other climes, to accelerate access to healthcare for our local communities.
Ekpo made this advocacy in Calabar during a sensitization workshop organized by a non-governmental organization, Afterschool, to engage with the public as well as relevant stakeholders on steps to improve healthcare delivery in our communities.
She further maintained that primary healthcare is quite large and government alone cannot own all of it, so in order to improve on its efficiency, the healthcare system can be designed on an 80-20 ratio where government owns 80% and the community owns 20%.
“We need to develop appropriate healthcare delivery systems that work for us because it is something that has worked across the world. You cannot bring policies that are good in Asia, China or even from Ghana to Nigeria and think that they will work. Just because we are black or a developing nation does not mean that whatever works in other nations will work here. So in that way, I have seen that in different local government areas in Cross River, each one has peculiar problems and they are in a peculiar environment. What is working in riverian areas will definitely not work in mountainous areas, in that way if we talk to the people themselves particularly with those who live there, work there and do know what the challenges are; if you sit down with them you will find solutions to some of these problems”, she said.
The medical practitioner stressed that in addition to community ownership, appropriate technology can also be used to train residents of these communities in basic healthcare delivery so as to help address the problem of staffing, troubling most of our primary healthcare centres.
“They are several centres but staffing is a problem as well as equipments. For instance, why do you bring a big machine that is not needed to an area where all they want is drugs to treat malaria. So the community has to get involved and then we recruit people who live in those communities to be trained appropriately and deploy appropriate technology for our own people. Government cannot do everything and so the communities have to get involved in the ownership and management of some of these centres”, she also pointed out.
Director General, State Primary Health Care Development Agency, Betta Edu, who also spoke at the occasion, said government is addressing the problem of manpower in these centres and has recently secured approval for the State School of Nursing and Midwifery which lost accreditation since 2012.
She added that in order to address the problem of staffing, the government recently introduced a task shifting policy where most of the task which used to be done by doctors, nurses and midwives is shifted to Community Health and Extension Workers at the community health level.
Government as part of the save one million lives programme, she disclosed, has recruited 196 health volunteers to help at the community level while the first set of graduates from the School of Midwifery whose accreditation was secured will be out next year, with an arrangement in place for them to serve in the state’s primary healthcare centres.
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