By CHARLES IWUOHA

South Saharan Social Development Organisation, an NGO, has advocated for more responsibility for Primary Health Care (PHC) centres as COVID-19 continue to spread in communities across the country.

The Executive Director of the group, Dr Stanley Ilechukwu, made the call in a statement issued on Wednesday in Enugu.

Ilechukwu, who is also a medical doctor, noted that the National Primary Healthcare Development Agency (NPHCDA) and state government should start full scale capacity-building and training of all PHC workers on COVID-19.

He urged government to provide incentives and Personal Protective Equipment (PPE) that is necessary for PHC workers to join in test collection and contact tracing properly as the nation’s tertiary and secondary health facilities are getting overstretched by the pandemic.

According to him, PHC centres, available at most communities, must be fully incorporated in the fight in-terms of testing/test collection; sending test samples to COVID-19 diagnostic facilities as-well-as contact tracing which is very difficult at community level.

He said that PHC centres should have capacity to take care of assymptomatic COVID-19 patient that might go for isolation in their homes with medical monitoring; thus, serving time, money and logistics of moving a “healthy patient” to isolation/treatment centre.

“The testing rate is alarming low considering there is evidence that community spread is widespread in some parts of the country and it is doubtful that current testing capacity would be sufficient to test and trace all suspects.

“Tracing is also made difficult due to the backlash from the prolonged economic shutdown necessitated by the pandemic.

“Nigeria is country with poor economic indices – and a poverty rate of 40.1 per cent, and as such it would be difficult to sustain a prolonged shutdown affecting the livelihood of millions without risking mass protests.

“Given these realities, the best strategy that can be employed by NCDC is targeted testing approach that does not restrict the ability of most citizens to carry out their functions while devolving and decentralizing COVID-19 management and contact tracing to the nearest PHC centre.

“While NPHCDA has commenced capacity-building of PHC personnel, it is pertinent that testing is ramped up, alternatively, symptomatic screening algorithm with moderate to high index of sensitivity for COVID-19 is utilized as the first line of management,’’ he said.

Ilechukwu said that the use of GSM technology would be the best to report suspected cases given Nigeria’s GSM penetration of 97.45 per cent.

“However, a call centre with the capacity to receive the numerous daily calls is currently lacking. The NCDC call centre is currently overwhelmed with calls, with citizens complaining of their inability to reach the NCDC despite calling numerous times.

“While COVID-19 apps are a good development, the number of citizens with internet access is limited.

“Finally, walk-in visits for screening without a triage mechanism might also overwhelm already fragile health systems given the poor doctor-patient and nurse-patient ratios in the country.

“An alternative screening method accessible to a vast majority of Nigerians, prevents both the NCDC and the state health system from being overwhelmed, and can be easily scaled across the country has to be designed and operationalized at the shortest possible time.

“As everyday lost further exacerbates COVID-19 community spread, putting more lives at risk,” he added.

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