Boosting primary healthcare delivery through GIZ’s intervention

Primary healthcare (PHC), the lowest level of healthcare system, is incontrovertible the closest to people. It is meant be easily accessible and provide basic healthcare services at the grassroots at the lowest cost possible.

When they function at their optimum, PHCs have the capacity to reduce maternal and infant mortality, manage illness such as malaria, and undertake routine immunization campaign and other campaigns against child killer diseases; among other important functions.

However, some stakeholders say PHCs in Nigeria have not fully delivered on expectations. They are not far from the truth given the myriad of challenges this very important of healthcare system faces.

Usually located in the rural areas, PHCs are not the preferred destination of many health workers as most of them opt for urban areas with good amenities, infrastructure that would enhance their wellbeing and practice.

The remuneration of the PHC health worker is not the best among health workers hence many qualified doctors and nurses will shun it for bigger hospitals with better pay package.

Usually operated in dilapidated infrastructure, PHCs are the most neglected and poor funded in Nigeria’s healthcare, hence many healthcare personnel would not want to practice in a place they will constantly have to improvise.

Over the years, government at various levels have beckoned on development partners and international donors to assisting in funding the PHCs and in providing logistics, including training, for their smooth operation

The German Agency for International Cooperation (GIZ), offers to help in making the country’s primary healthcare system effective.

Under the Pro-Poor Growth and Promotion of Employment Programme (SEDIN) and BACKUP-Health programme, GIZ works to improve capacities of national stakeholders and institutions.

GIZ supports healthcare delivery, primarily from global health initiatives to promote synergy in health sector.

Mr Markus Wauschkuhn of the GIZ-SEDIN programme, said that it would support the development of the country’s primary healthcare sector.

According to him, it will also promote the adoption of innovative business and digital solutions for the benefit of citizens and primary healthcare practitioners.

“To achieve this, SEDIN has carried out desk review, qualitative and quantitative research and analysis, validation session with critical stakeholders.

“Three winners emerged and they developed solutions at different stages of development and commercialisation.

“They address core challenges like maternal and infant health care delivery, data interoperability and management, mobile-based solutions for patients’ management and continuous learning for healthcare workers”, he said.

Ms Margherita Trestini, Marketing Director, Prototipi, said SEDIN Primary Health Care Quali-Quantitative Research was carried out between November 2022 and March 2023 focusing on five states.

She said Lagos, Edo, Ogun, Plateau and Niger were selected with the aim of understanding the level of awareness and adoption of digital solutions skills at the primary health care level.

Trestini said it also aimed to understand the risks and foreseeable challenges in the support to the selected sector in general and regarding the political environment, stakeholders involved and possibly distortion of markets.

She said that the research revealed PHCs challenges.

“For instance, it showed that the primary level of care is rather dominated by Community Health Extension Workers (CHEWs) and junior CHEWs, who make up about 36.8 per cent of all care providers at the PHC level.

She said the research showed that the awareness of the usage of technological innovations in Nigeria’s PHCs is limited to rudimentary and tradition where their operators mainly have knowledge of computers and mobile phones.

“Emerging technologies such as drones, AI and blockchain have a very low level of awareness.

“Some of the reasons why emerging technologies have low likelihood of adoption included; lack of knowledge about them and their functions as they are perceived to be expensive, very technical, undependable and even not feasible.

“Health workers perceive rural life as difficult and lack the desire to work in PHCs located in rural communities, lack of manpower, that is, low doctors to patients’ ratio, unbalance is service delivery between rural and urban areas.

“Other challenges are inadequate budgetary allocation by the Federal Government, lack of skilled personnel and lack of ICT infrastructure, poor funding, bad roads, among others, she said.

Trestini said that it was based on these that the Primary Health Care Hackathon challenges were formulated.

She said the aim was to provide mobile-based solutions for primary health care patient’s management.

She said it was also designed to monitor medication delivery, facilitate health workers continuous learning, solutions dedicated to improving women health or maternity care services, insurance, among others.

According to Mrs Sina Uti-Waziri, Team Leader, Local Economic Development, GIZ, “the research we run allows us to shed a light on the specific needs of primary health care workers”.

“We know that only innovation which meets the needs of healthcare workers can be successfully adopted”, she said

Some of the healthcare hackathon winners who spoke with our correspondent shared the solutions they created.

Mr Eric Maranga, Head of Growth, AfyaRekod, said the organisation addresses the gap in access, ownership and mobility of health records across Africa.

The initiative is a patient healthcare platform that focuses on consolidated ownership, continued access and mobility of healthcare data for patients across various value chain.

“It connects all the various ecosystems to the patient through the platform built using blockchain and AI technologies.

“Through this, patients are able to digitally store and access their health records, track their health status, communicate with providers among others.

Also, Mr Uche Udekwe of Natal Care said the organisation leverages on the power of mobile technology, machine learning and low-cost innovation to combat maternal and infant mortality in Nigeria.

He said it primarily focused on providing life-saving healthcare information, mental and emotional healthcare support.

“Natal also works to monitor medical emergency services to at-risk pregnant women, vulnerable children and nursing mothers reaching them in their home towns and advocating for better access to healthcare at PHC centres especially in under-served communities,” he said.

Dr Simpa Dania, Co-Founder at Healthstack Solutions, said the organisation is a global healthcare platform that digitilises all forms of provider organisations.

He said that the organisation provide solutions to primary, secondary and tertiary hospitals, pharmacies, laboratories, imaging centres, blood banks and health insurance.

“Healthstack uses technology to streamline various healthcare providers’ operations and processes to deliver high-quality care within the healthcare system.

“Such as telemedicine capabilities, appointment scheduling, medical record-keeping and payments, thereby reducing the administration burden on healthcare”, she said.

Given the enormity of competition for scarce government resources, stakeholders in the health sector say donor agencies and development partners should continue to support governments’ efforts to fund, equip and staff PHCs.

They say while this is important, governments should not continue with the culture of underfunding these centres and make them attractive for health workers.