The Place Of Primary Healthcare In Society

SCRIPTS BY MONDAY UWAGWU
SINCE Long ago, two proverbs have been of inimitable value and relevance to man, with regard to healthcare. They are the ones that hold that prevention is better than cure, and that health is wealth.
Both these proverbs, probably woven when time was in infancy, have remained relevant today as when sages long made them.
In net, the wise cracks co-terminate at the point of consensus to the effect that while good health is vital to man, a veritable way to attaining it is via effective preventive action. And the import of these sayings is pure wisdom, simplicita.
It is on account of the overall importance of good health-sustainable good health, that is-and the vital role that effective preventive action plays in that regard, that at both the individual and corporate levels, the truly wise lay due slant on the necessity for prevention of diseases that would otherwise plague man and his society.
As is evident, effective preventive action is attainable through many strategies, but mainly enlightenment/awareness creation, since ignorance is largely responsible for the affliction of man with ailments and diseases, many of which often prove deadly, if not fatal.
In fact, many informed minds are of the strong opinion that the most efficient way to tackling any challenge is by effective preventive action. And a strong allusion to this important fact is the lamentation in the Bible, the Christian holy writ, to the effect that ‘my people perish for lack of knowledge.’
However, where, as is clearly evident in today’s world, that preventive actions and measures prove imperfect, the first resort is the first line of treatment which is obtainable at the primary healthcare (PH) segment of the service delivery ladder or chain. The healthcare available at this level is accessible at the primary health care centres (PHCs) which are the most ubiquitous of the three rungs of the healthcare service delivery ladder.
By their nature, the PHCs are the nearest to the people of the three rungs on the health care ladder in two broad senses-geographic and emotional. Geographically, they are the most proximate to the grassroot-since they existing in all wards in the state-and presumably in all states of the country. Emotionally, they hold the same enviable record on account of their social proximity to the people of the grassroot.
Given these areas of geographic and emotional proximity to the people, the PHCs are best suited to meet the basic medical needs of the grassroot-rather than the secondary healthcare institutions that are more technically called hospitals. This is the real reason that, in Nigeria as indeed other advancing parts of the world, the slant is on the development of the PHCs, rather than the secondary and tertiary segments of the healthcare chain.
The reason?
Yes, you are right to hold that, as it is said and was quoted so amply in the opening paragraphs of this write up, effective prevention is better than cure, particularly in the medical and health sector.
In Delta State, the wisdom inherent in the saying that prevention is better than cure and that health is wealth was never to be lost to the state government, particularly under the watch of Senator (Dr) Ifeanyi Okowa, himself a medical officer of health, who qualified at just 22 years of age , from the University of Ibadan (UI) in flying colours with the Bachelor’s Degree in Medicine and Surgery (MBBS).
A great testimony to this fact is the ubiquity of PHCs in most cities and towns in the state. In fact, so many are the centres that, by the last count, no fewer than 402 such centres were in existence in different parts of the state. They are all managed/run by the Delta State Primary Healthcare Development Agency (PHCDA), now headed by Dr. Isioma Okobah as Chairman.
With respect to its humongous mandate, the Delta State PHCDA augments the services provided by the healthcare centres (hospitals) at the secondary and the tertiary (referral ) levels.
Delta State has two tertiary hospitals in Asaba and Oghara (Delta State University Teaching Hospital< DELSUTH, Oghara) and 63 general hospitals that are publicly owned. Under the aegis of the PHCDA, Delta State operates a format or module that is unique, in relation to other states: it is perhaps the only state in all of the country that runs the PHC system under one roof. This module –of Primary Health Care Under One Roof (PHCUOR)-enables the state to harmonise and run the entire gamut of health care services under the PHC segment, within one structural compartment run by the state PHCDA. A great testimony to the potency of the PHCUOR is the recent official launch by the wife of the state governor, Dame Edith Okowa, of the under five health care services for the benefit of Deltans . As for the PHUOR policy and strategy, it was initiated by the Okowa administration partly in response to the questions of access, information flow, effective personnel management and coordination in the system. Anchored on the global best practices available, PHCUOR, according to Dr. (Mrs) Gloria Patrick-Ferife, Director in charge of Planning, Research and Statistics of the Primary Health Crae Development Agency (PHCDA), is “ geared towards international best practices based on the WHO (World Health Organisation ) guidelines stringed under one management, one plan and one monitoring and evaluation system.” The PHCUOR target, she said, was “ to reform and strengthen the state health sector by creating an integrated and decentralised management structure for primary health centres in line with the state government’s SMART Agenda.” She sought for the reorientation of staff, repositioning of staff and logistics and for the sustainable funding of the system. Since its timely introduction, it has amply proved to be a vital tool for the enhanced success of the service delivery mechanism.