THE NEW look Oba Salami Primary Health Care Centre, located at Onayale Street, Igbobi, Lagos, typically represents the kind of transformation of health care facilities currently going on in 926 Primary Health Care Centres (PHCs) in 185 Local government Areas (LGAs) in 36 states and FCT.The transformation embarked by National Agency for the Control of AIDS (NACA) through a five-year grant for Health System and Community System Strengthening (HSS) (2009-2013) secured from Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM), is expected to restore public confidence primary healthcare services in the country.Before the intervention of NACA, the centre just like many others in the country was in a sorry state.Besides, the notable infrastructural decay doting the faces of most primary health facilities in the country, drugs and other hospital consumables were in short supply, forcing many patients to look else where for their treatment.The Iwaya Primary Health Care centre, Simpson Primary Health Care Centre and Ondo West Primary Health Care Centre, all in Lagos were no different.However, the verification exercise in two local governments in Lagos State, carried by the National Agency for the Control of AIDs (NACA) officials led by Dr. Adaoha Anosike, identified some problems that must be addressed to ensure effective health care services in the areas.Specifically, the team identified, stock out of vaccines and other hospital consumables, absence HIV test kits and ARV Prophylaxis, laboratory facilities, poor turnout in antenatal care clinic and clear absence of Prevention to Mother to Child transmission (PMTCT) services.The Guardian, however, gathered that Family Health International (FHI) the sub recipient of the grant had completed most of upgrades itemised in the Bill of Quantity (BOQ) for most of the facilities.Professor John Idoko Director General NACA said: 'We secured a grant from the Global Fund to strengthen Nigeria's health system with particular emphasis on the primary health care system. The scope of the project is 926 PHCs in 185 LGAs in 36 states and FCT.'He explained that the key service delivery area under the grant is service delivery, which entails infrastructural upgrade, equipment supply and integrated training for PHC health care workers.'NACA engaged Family Health International (FHI), National Primary Health Care Development Agency (NPHCDA) and Institute for Human Virology Nigeria (IHVN) as sub-recipients (SRs) to implement the activities under this SDA.'He stressed that it was the mandatory obligation of NACA as the sole PR to undergo routine biannual supervision of these Primary Health Centres (PHCs) to evaluate the impact of the funding in achieving a better primary health care services and the effective utilisation of the facilities provided.Idoko explained that in fulfillment of its oversight role, the agency conducted an on-site verification visit to the PHCs in five states, which includes Lagos, Cross Rivers, Benue, Kano and Enugu states to assess the performance of the SRs.The assessment was conducted from September 12th to 14th October 2011. The Guardian gathered that a total number of 86 PHCs drawn from 18 LGAs across five states were selected for the HSS supervision exercise.In the roll out of the HSS grants in the first year, HSS activities, The Guardian learnt were implemented in five states; namely, Benue, Bauchi, Enugu, Cross River and Kano. All year one HSS states were selected for the supervision exercise. However due to the political unrest in Bauchi State, Lagos State was chosen as replacement.The Bill of Quantity containing the renovations reported by SRs was used along with the checklist to verify facility upgrade at the PHCs.The summary of findings of facility upgrade verification, submitted to the agency showed that out of the 86 PHCs verified, 56 PHCs (65 per cent) scored high marks.However, in 30 PHCs (35 per cent) the reported facility upgrade by SR differed from findings on site.Again, the summary of findings from the Monitoring and Evaluation M&E Information management system verification showed that the NHMIS tools are available in all the 86PHCs (100 per cent) that were assessed during the HSS supervision. Also, staff have been trained on the use of the NHMIS tools in all the PHCs visited except in two PHCs. They are Lajawa PHC in Wudil LGA of Kano State and Wanihem PHC in Yala LGA of Cross River State.In 72 PHCs (83.7 per cent) of the total PHCs assessed, NHMIS Health Facility Register is routinely updated. 79 PHCs out of 86 PHCs assessed provide labour and delivery services. Of the 79 providing labour and delivery services, 67 PHCs (85 per cent) routinely updated their NHMIS labour and delivery register.The summary of findings from HIV commodity verification showed that of the 86 PHCs assessed, 46 PHCs (53 per cent) had test kits available. In the year 2011, 34 (40 per cent) of the PHCs assessed experienced stock-out of test kit.Of the PHC assessed, 22 provide PMTCT services. 19 of the PHCs providing PMTCT services (86 per cent) had ARV prophylaxis available.In the year 2011, 19 (86 per cent) of the PHCs providing PMTCT services experienced stock out of prophylaxis.The summary of finding from verification of availability of HIV services showed that 64 (74.4 per cent) of the total PHCs assessed have HCT service available. . Also 26 (30.2 per cent) of the total PHCs assessed provide PMTCT services.In 2002, the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) was established as a funding mechanism to support developing countries to address these major diseases.A key component of the Global Fund Round eight (GFR8) grant proposal is the community health systems strengthen for delivering HIV/AIDS, tuberculosis and malaria programmes; thereby improving the quality of health service delivery in addition to scaling up health interventions against HIV, TB and malaria.The objectives of the supervisory exercise are' to verify the PHC facility renovations done by the SRs,' to verify the availability and use of NHMIS tools by PHCs,' to verify the availability of HIV/AIDs services and commodities at the PHCs, and' to verify the manpower available at the PHCs providing HIV/AIDS services.
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