Adewole Advocates Direct Funding for Primary Health Care Centres


By Senator Iroegbu in Abuja

The Minister of Health, Prof. Isaac Adewole has said that “Decentralised Facility Financing” (DFF) was the best financing model for Primary Health Centres (PHCs) if Nigeria must achieve health for all by the year 2020.

He also pointed out that 80 percent of health problems in Nigeria could be solved at the Primary Health Care level of the health system if adequate attention was given to service delivery at the state and local government levels.

 Adewole stated this yesterday while on a One- day facility inspection of three PHC facilities funded in three different ways to test run the Nigeria State Health Investment Project (NSHIP) in Nasarawa State.

He said the inspection was part of a mid-term review of the implementation and the impact evaluation of NSHIP in the three pilot states of Adamawa, Nasarawa and Ondo to decide on which funding method is best for the management of PHCs in the country.

He listed the three models used by the projects to include: Result Based Financing (RBF), Performance-Based Financing (PBF) and Decentralised Facility Financing or Direct Facility Financing (DFF) as against a non- NSHIP facility otherwise known as Business –as- Usual facility.

While being conducted round the 13 staffed PHC center in Andaha Akwanga Local government Area, being funded under the PBF model, the Minister said he was impressed with the healthcare service delivery and management of the center.

Also inspecting the non- BPF 10 staffed facility at  Wulko, Nasarawa Eggon Local Government Area (LGA), the Minister observed that the facility was bedeviled with numerous challenges ranging from lack of skilled personnel, basic essential drugs, inappropriate drug storage facility, poor hygiene, low  morale and poor work ethics bordering on absenteeism, etc.

Adewole noted that this PHC which he described as Business as Usual model had no support.

However, at the 18 staffed PHC at Alizaga, Nasarawa Eggon, funded under the DFF model, the Minister noted that the facility was equipped with well stocked Dispensary, standard laboratory with skilled staff and basic testing tools, good record keeping and a neat working environment in a recently renovated structure.

In view of the above contrasting performances,  Adewole recommended the  DFF model used at the  Alizaga facility, as the best financing method for PHCs if quality health care service delivery must be achieved at all centers across the country.

He explained that the model, when adopted, would take into consideration the peculiarity of each community. This, he said would encourage the people to own the facility, identify with it and make it work. He further emphasised that the difference between the three facilities was in their funding method.

Other facilities inspected by the Minister included a Comprehensive Health Centre in Quandere, which President Muhammadu Buhari is expected to commission later, the State Specialist Hospital still under construction and the State school of Nursing and Midwifery, Lafia.

The visit was a step by the Federal government to make PHCs functional. The Minister later paid a courtesy call on the Executive Governor of Nasarawa State, Tanko   Al-makura.