Our intern, Dr. Tola Oladimeji, explores how Nigeria can boost primary healthcare by redistributing health workers
The government of Sokoto state has signed a Memorandum of Understanding (MoU) with the federal government to ensure health workers from the Usmanu Danfodio University Teaching Hospital (UDUTH) in Sokoto are redistributed across the general hospitals in the state.
Under the agreement, the doctors will remain on the payroll of the federal government, and may, in addition to their salary, receive some incentives/bonuses to provide qualitative services across the state, and transfer skills to staff in those state hospitals.
The MoU was signed by the Minister of Health, Dr Isaac F. Adewole and the Sokoto state government.
Well-trained medical personnel are an important input into the health system of all nations. It is no news that Nigeria does not have enough doctors, nurses and other specialized medical personnel, with the daily increasing rate of emigration of trained medical personnel.
In addition to this nation-wide shortage of personnel, there exists alongside an inequitable and non-sustainable distribution of the available medical personnel, with news that Federal hospitals such as Teaching hospitals and Federal medical centres are ‘over-staffed’ while general hospitals and primary healthcare centers are lacking essential personnel.
Out of the three levels of healthcare, the primary and secondary levels of care are closer to the people, delivering simple and everyday treatment. The tertiary healthcare centers such as theUniversity College Hospital in Ibadan and the Usmanu Danfodio University Teaching Hospital in Sokoto, provide the most specialized and advanced levels of care, training and research.
The primary and secondary healthcare centers are logically expected to be more numerous, providing daily and immediate care to most people right in the communities where we live, but instead have acquired a reputation for delivering poor and unsatisfactory care, and that they cater to only poor people. The inadequate staffing with well-trained staff across many of these primary healthcare facilities may be a principal contributing factor to this outcome.
It is expected that this move by the federal government and the government of Sokoto state will be replicated in other states as it will help in improving the quality of care delivered in these general hospitals and may also improve the referral system in the state.
In a high-functioning health system, the tertiary centres should not be the only source of good healthcare, the primary health care centres and the general hospitals should deliver good health care to most of the population and the tertiary health centres should provide the best specialized health care to a smaller percentage of the population who require specialized care.