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WHA73 – Rebuilding and reinforcing every element of Primary Health Care must be an essential element to combat and control COVID-19.


This year, The Wellbeing Foundation Africa’s participation to the virtual and unprecedented 73rd World Health Assembly, joining state leaders and world-renowned experts to discuss the state of the world’s current situation - was understandably focused — dedicated to strengthening global coordination on the COVID-19 crisis that has infected more than 4.7 million people, killed 315,000 and crashed the global economy.  As many countries and companies are striving with unprecedented speed to develop an effective vaccine, global leaders called for ‘the people’s vaccine’, concrete commitments to ensure that it is made affordable and available to all in the quickest possible time.

For the first time in modern history, the global health landscape has become a fragile and humanitarian setting, and we all have a role to play in this fight. Last month the Wellbeing Foundation Africa launched The Wellbeing Foundation Africa – PocketPatientMD COVID-19 e-health check tool freely accessible to African countries, our contribution to the global effort as governments strive to scale up testing, tracing, tracking and treatment, to combat, control and contain the COVID-19 pandemic.

 

For over a decade, The Wellbeing Foundation Africa has campaigned for the rights of women and girls, deploying our global platform to advocate for the most urgent health interventions including EmONC training for Midwives, Health Information and Education, Nutrition and WASH for all. These are crucial interventions for any country and health system, and even more urgent in times of crisis. At the community level we have worked tirelessly to ensure that we integrate these interventions into our frontline programmes. Our MamaCare classes started in 2015 providing antenatal education to pregnant women. This programme has evolved over time into include wider health education on all these areas for health workers, pregnant women and families. At a time when routine health services have never been more essential for those most at risk, including pregnant women and newborns, our MamaCare, WASH and Nutrition programmes continue to ensure we reach the most vulnerable populations with the information they need to protect themselves, their families and their communities.

 

Since the declaration of COVID-19 as a pandemic by the World Health Organisation, Nigeria like most countries across the world has been battling to contain the disease. The Federal Government stopped flights and closed borders, initiating total lockdowns in Lagos and Ogun states, and the Federal Capital Territory (FCT). Many states have also imposed lockdowns, border closures or restriction of movement while new isolation field centres are being built and existing ones are being repurposed. Laboratories have been mapped by the Nigeria Centre for Disease Control (NCDC) to carry out testing on samples of individuals suspected to be having the disease. Donations in kind and cash have poured in from individuals, companies and organisations to help the governments combat the pandemic. In addition, thousands of health workers are being trained by the Wellbeing Foundation Africa as well as the NCDC on infection prevention control and management as it relates to COVID-19.

However, fragile Primary Health Care systems leave us all vulnerable. Over the years, the WBFA Founder-President Toyin Ojora Saraki, who chaired Nigeria’s Civil Society Organisation’s primary Health Care Revitalisation Support Group to the 8th National Assembly, advocating successfully for the establishment of Nigeria’s Basic Health Care Provision Fund BHCPF has written many articles on the importance of strengthening our primary health care services to build the resilience and improve the wellbeing of citizens in the long-term. Having piloted a uniquely higher standard Maternity Referral Primary Health Centre model at Eruku, Kwara State, in 2015, it is evident that well equipped PHC’s can serve as an important link in the management of COVID-19 enabling diagnosis and treatment at a community level, while sustaining routine health services. However, in Nigeria we still face the reality of less than 45% of Nigeria's PHC's being equipped with the standard equipment typically required to provide effective and safe essential health services—compared to other low- and middle-income countries where this is measured, Nigeria’s performance on this indicator is the lowest.

Today, a primary health care system is imperative as the foundation and bedrock of achieving health for all and should be a focal point for investment, as we coordinate our responses to the pandemic. The road to rebuilding and reinforcing every element of primary health care must be an essential tool to combat and contain COVID-19. Universal health coverage does not rest upon one single static action, but on the spectrum of interventions and initiatives; from prompt easily available diagnostics and treatment, adequate water, sanitation and hygiene standards in healthcare facilities, maternity and family health and nutrition services, breastfeeding education and training for healthcare workers, to even providing a strong infrastructure to support the implantation of mental health and gender violence policies.

Tackling malnutrition must be a key factor in scaling our approach to containing the virus, as it affects our immune system and leaves us susceptible to infection. Poor metabolic health, such as obesity and diabetes, have been linked to worse coronavirus outcomes. According to the recently released Global Nutrition Report,[1] one in nine people in the world is hungry and one in three is overweight or obese.

In developed countries the pandemic has disrupted food production and the supply chain, but in poorer countries, where levels of malnutrition are already high, we must focus our health actions to avert an imminent hunger crisis, flagged by the United Nations as a famine of "biblical proportions", with 265 million people facing chronic food shortages due to a "perfect storm" of conflict, drought, climate change and coronavirus. It’s now more urgent than ever for global health leaders to come together with governments and businesses to provide consistent support to tackle malnutrition in all its forms as part of our COVID-19 responses.

There is much to be done and coming out of this pandemic in the right manner is going to be crucial for all parties involved. The Wellbeing Foundation Africa hopes that we learn, improve and enhance our behavior and our treatment of global health services accordingly. The Wellbeing Foundation Africa looks forward to seeing an activation of accelerated investments in primary health as the key driver in upholding community health, hygiene and nutrition as we strengthen national responses to global health security.

 


[1] Action on equity to end malnutrition, Global Nutrition Report (2020)                                                                            <https://reliefweb.int/sites/reliefweb.int/files/resources/2020%20Global%20Nutrition%20Report.pdf> accessed 20 May 2020

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