Primary healthcare collapse bane of teaching hospitals – Minister

Nigerian teaching hospitals will not function optimally until adequate
attention is given to primary and secondary healthcare facilities,
Minister for Health Isaac Adewole  has said.

He also said 14 out of 36 states in Nigeria were yet to access the
Basic Health Care Provision Fund (BHCPF).

The BHCPF is one per cent of the federal government’s consolidated
revenue and contributions from donor grants set aside to fund the
basic health needs of Nigerians, approved by the National Assembly in

To access the fund, however, state governments will amongst other
conditions, contribute N100 million each as counterpart funding.
Adewole listed the non-participating states to include Kebbi,
Jigawa, Akwa Ibom, Cross River, Gombe, Rivers, Borno, and Zamfara.

Others are Ondo, Benue, Taraba, Nasarawa, Ogun and Sokoto.
The minister said this while appearing before the Senate plenary
Tuesday in Abuja. 

“What we have through your (Senate) support for approving the
Healthcare Basic Fund is a game changer. We have spent almost a year
developing the guidelines and over the last weeks, we have started a
rollout and as at the last count, 22 states have registered for the
basic healthcare provision fund. 

“What we have done with the fund is to structure it in a way that
money will flow from the Central Bank of Nigeria (CBN) to the primary
healthcare facilities, bypassing all obstacles. And last week, we
succeeded in moving out funds from the CBN to the agencies and from
the agencies, it will go to primary healthcare.

“To enable states access the fund in addition to the counterpart
funding, a state must establish Primary Health Care Development Board
and Health Insurance Scheme.”

He also spoke on the imperatives of a functional primary and secondary
healthcare for an improved service delivery to the people.

“The teaching hospitals by design constitute the apex of healthcare in
any country and for us in Nigeria, they represent the topmost and by
design, they are expected to receive referrals and manage complicated

“For them to function, they depend on primary healthcare centres and
functional secondary healthcare centres. When these two levels of care
are functioning, about 90 per cent of ailments can be taken care of at
primary and secondary healthcare centres. Only 10 per cent of
Nigerians who require care will need to go to a tertiary institution.”

Adewole said the tertiary institutions were suffering from various
challenges, chief of which he said was overcrowding.

Other challenges include power supply, water supply, capacity building
of personnel and the states’ neglect of other levels of health care.

“The states have literally abandoned healthcare such that everything
is handled by federal. We cannot succeed with this. Governors need to
invest in secondary health care. If we don’t solve this, we’ll just be
scratching the problem on the head with regards to tertiary. The
tertiary cannot expand beyond this, we have limitation with resources.
“The states need to partner with us so that the secondary hospitals
are working, so that our tertiary institutions can go back to being
referral hospitals.”

 Also speaking Tuesday in Abuja at the launch of the assessment
check-list for tertiary hospitals in Nigeria, the minister said
quality healthcare remained fundamental right of every Nigerian.

He said, “Even the uneducated Nigerians know quality. They identify
quality shoes, wrist watches. They know when there is quality health
service. We must put things right in the health sector. Our people
would rush to our University Teaching Hospitals if they know they will
get quality service.”

 “The major task of continuous quality improvement in federal tertiary
hospitals rests on the leadership. Every element in the complex
process of healthcare must be carefully managed and process variation
understood. Quality is a philosophy and an approach to management,”
the minister said.

On why  teaching hospitals won’t  function optimally until adequate
attention was given to primary and secondary healthcare facilities,
Professor Adewole  said the challenges facing the teaching hospitals
and other tertiary health institutions flowed from the inability of
the primary and secondary healthcare facilities to meet people’s

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