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LAGOS, Nigeria– The overarching objective of the Lagos State Family Planning Costed Implementation is to increase the overall Contraceptive Prevalence Rate (CPR) from 48 per cent to 74 per cent by 2020. Achieving this target is not only an indication of Lagos State’s commitment to ensuring the achievement of the goal of the National Blueprint (36 per cent CPR), it is also a way of fore-grounding the role of Lagos State as one which sets the pace for innovation and development in the country.
In its bid to achieve this goal as well as provide universal coverage of quantitative and efficient primary health care centres, the Lagos state government resurrected the Primary Health Care Board, PHCB. PHCB is tasked with the responsibility of implementing health care services through community participation, intersectoral collaboration, utilize appropriate technology for health-integrated services as well as supply essential drugs and comprehensive monitoring and evaluation of the process. This is where the need to integrate healthcare providers at the local government level comes in.
All twenty local government areas in Lagos state have more than two-hundred and eighty-eight Primary Health Care Centres, including flagship centres which have as part of their core duties, provision of Reproductive Health and Family Planning (RH/FP) services. The idea is to take health care services into the communities in order to ease the pressure on secondary and tertiary healthcare facilities and ultimately and better serve the people at the grassroots.
In past months, the Lagos state PHCB has hosted RH/FP managers from the twenty LGAs in the state to meetings which aim at tackling the challenges experienced by these LGAs in the delivery of health care services especially in the area of reproductive health and family planning. These meetings which often comprise RH/FP officers from different LGAs in the state, directors and officials from the PHCB, also look into strategies on how to ensure the achievement of the state’s share of the National Blueprint goal.
The August edition of the monthly Family Planning (FP) Managers’ Meetings was hosted on Monday, 13th August 2018 by the Lagos State Primary Health Care Board (PHCB). In its usual fashion, it was attended by Reproductive Health/Family Planning Managers (RH/FP) and relevant Directors from the Lagos State PHCB along with the NNNGO-PAS team who provided support.
Data on RH/FP services carried out in PHCCs from all twenty LGAs of the state between June and July 2018 was presented and revealed that the number of women who registered with the PHCCs for antenatal care increased from 11,878 in June to 12,075 in July 2018. Of this number, there were 1, 511 deliveries in June and a decrease of 1, 328 in July. Statistics also showed that despite the gap between the number of registrations for antenatal services and delivery rate, a silver lining was the decrease in the occurrence of still-births at the PHCCs within Lagos State.
RH/FP managers noted the less than 10 per cent ratio of women registered for antenatal care with PHCCs to women who undergo delivery of their babies at PHCCs in the state is largely a function of the unideal health care system. They bemoaned the dearth of adequate facilities at the PHCCs, lack of adequate community involvement which breeds ineffectiveness.
These challenges which pose a threat to the lives of grassroots women and their unborn children have also resorted to lack of trust in the system; on the part of the patient and their families. RH/FP managers noted that many pregnant women tend to employ the services of trusted but unskilled health caregivers or religious centres which many noted have resulted in health complications over the years. They indicated that since many grassroots women live distances away from the closest PHCCs, therefore, they often resort to undergoing home deliveries due to inability to transport themselves to the centres especially during the night when many go into labour.
Health care officials who manage PHCCs said, a cause for concern is the attitude of relevant authorities towards funding and provision of RH/FP consumables. Many LGAs have not received steady funding for the running of the centres while almost none of them receive imprest on RH/FP care, in recent times.
Barr. Ayo Adebusoye, Project Officer for NNNGO-PAS identified that the duty of Civil Society Organisations is to put pressure on stakeholders and relevant authorities, through the collective efforts of the Lagos State Advocacy Working Group, NNNGO-PAS, Pathfinder and NURHI, in order to ensure that health becomes a priority to government and adequately funded. He noted that statistics from the FP budget tracking conducted in Lagos state from January 2018 to June 2018 revealed that the Ministry of Health released forty-eight million Naira and provided FP consumables to LGAs through the Saving One Million Lives Initiative. The next step is to make enquiries into how these resources are utilized in order to advocate for more in subsequent years. This, in his opinion, is a direction worth taking to achieve the common objective of a better health care system.
Oyebisi Oluseyi, Project Director of NNNGO-PAS commended the board and managers for their work while noting that it was refreshing to see such a level of commitment in the public sector. He encouraged that they be accurate in their data collection and recording in order to assist the government in identifying what requires attention and the measures to employ. This will aid the fight against maternal and infant mortality in the country while ensuring that the sustainability of resources for the coming generation is guaranteed.