Zamfara Ranks Worst in Poor Healthcare System; FCT, Enugu, Anambra Rank Top Performers


Alt: = "Governor Matawalle of Zamfara State and National Primary Healthcare Development Agency logo"

Report released by The ONE Campaign, in partnership with National Advocates for Health, Nigeria Health Watch, Public & Private Development Centre (PPDC), and other partners have revealed that health systems in 13 Nigerian states are  with Zamfara State being the weakest, resulting in poor healthcare service delivery, especially in public facilities. 

“The Basic Health Care Provision Fund (BHCPF) was poorly implemented in 13 states. Zamfara is the most difficult state in Nigeria to access primary healthcare,” the report revealed. 

According to the report, Federal Capital Territory, Enugu and Anambra rank as the top performing states in primary healthcare service delivery among other.

The ranking was based on an in-depth and systemic review of the implementation of the Basic Health Care Provision Fund (BHCPF), compliance of the states with the National Health Act and National Health Policy.

The report made recommendations for how state governments should strengthen their weak health systems, enhance the existing implementation of the BHCPF, and raise strategic and operational planning for health to enhance access to primary healthcare services.

The National Health Act, 2014 established the Basic Health Care Provision Fund (BHCPF) to address funding deficits  hindering effective primary healthcare delivery across Nigeria. The BHCPF is sourced through 1% contribution from the Nigerian government Consolidated Revenue Fund (CRF) and additional contributions from other funding sources. The BHCPF was designed to support the effective delivery of Primary Healthcare services, provision of a Basic Minimum Package of Health Services (BMPHS), and Emergency Medical Treatment (EMT) to all Nigerians. 

The research findings expose the sorry state of healthcare system in Nigeria, where access to and utilization of health services continues to be hampered by systemic failures, which the report says is caused by “country’s weak governance structures and operational inefficiencies”, across the states, despite the provisions of the BHCPF.

“The public health facilities in all 36 states and the FCT are deficient, and the experiences of community members seeking health care at public facilities are consistently awful,” the report stated.

“The basic causes of Nigeria's deteriorating health care system are the country's weak governance structures and operational inefficiencies.”

Senator Ibrahim Oloriegbe, Chairman of Senate Committee on Health, while unveiling the report,  noted a need for continuous oversight by the legislature to ensure that the Basic Health Care Provision Fund (BHCPF) works for Nigerians.

 “We have recorded successes at the federal level because of the independence and the interdependence between the executive and the legislative arms of government and because the National Assembly has been able to perform its oversight functions. This must be replicated across the different state houses. It is also important for citizens to join in this advocacy and call on their state governments to release appropriate funds and ensure adequate monitoring of the funds to improve public health facilities, especially the primary health centers. We must ensure medical supplies and the required human resources are available,” he said.

The ONE Campaign's Nigeria Director, Stanley Achonu, said, “Weak governance continues to pose a major obstacle to improved healthcare delivery. It hampers efficiency and effectiveness and results in weak infrastructure, poor user experiences, and poor health outcomes. 

“The burden of strengthening the healthcare systems and services lies heavily on governance and leadership. At all levels, the government needs to take responsibility as a building block of the health system, especially in system design, policy guidance, oversight, regulation, accountability, coalition building, monitoring, and enforcement. 

“The success recorded with polio eradication, containment of Ebola and the COVID-19 pandemic has shown that Nigeria can deliver on critical health issues given the required political will and leadership commitment. We have to act quickly to avert primary healthcare collapse." 

Vivianne Ihekweazu, the Managing Director of Nigeria Health Watch, stated how the report will help stakeholders to improve healthcare system in the country.

"This report helps us understand where we are, the opportunities and gaps in state-level healthcare delivery. As partners, we are determined to disseminate the findings widely and use them to hold policymakers, especially at the subnational level, accountable for improvements in healthcare delivery for all Nigerians."

Some of other recommendations proposed by the report include states providing political leadership for establishing a State Health Insurance Agency, develop an electronic workforce registry at the state level, support management of human resources for health, and develop a health system-wide accountability and performance management framework.

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