Ebai: Primary Healthcare is Critical to Achieving Universal Health Coverage

Mr. Eyong Ebai is the General Manager, West, Central and sub-Saharan Africa, GE Healthcare. In this interview with Martins Ifijeh, he posited that primary healthcare is critical to achieving Universal Health Coverage in Nigeria. He also spoke on the role of GE in addressing healthcare issues in the country. Excepts;

How can we improve primary healthcare in Nigeria?
As the General Manager for GE Healthcare, it is not really my mandate to offer ratings on primary healthcare centre facilities, but what I can talk about from the GE perspective is that primary healthcare is very key and important. It is the bottom of the healthcare pyramid which impacts most numbers of people. So, if you can fix primary healthcare, then a large number of Nigerians will be healthier. Primary healthcare for us is fundamental, critical and important for achieving Universal Health Coverage (UHC). Because it is the first point of contact a patient will have in the healthcare system. What is currently happening in Nigeria and across sub-Saharan countries is that the primary healthcare system is not working the way it should. Ideally, patients can be treated earlier and quicker in PHCs, but what we see is that people go straight to the secondary and tertiary hospitals, thereby causing a lot of congestion in those levels of healthcare. By fixing primary healthcare, you can deal with issues earlier before it escalates to something that requires a higher level of clinical intervention.

GE has a program called Primary & Referral Care which combines appropriate and affordable medical technologies, training and capacity building of healthcare workers, including task shifting; monitoring and evaluation; multi-lateral partnerships; and localised deployment methods, in programs that are designed to improve access to quality and affordable essential health services to patients and support better health outcomes and the attainment of health for all on the continent.
If patients in a rural area have something wrong with them, they go to the primary healthcare centre where they will have basic diagnostics and typically can be treated at that level or if they see need for a referral, then appropriately can be referred to the secondary care hospital. GE’s goal is to ensure that the appropriate technology is deployed and has an impact on clinical outcomes.

What are those solutions that can be deployed to make primary healthcare work?
Primary healthcare involves the state and local governments, and there is no one approach to making primary healthcare work. That is why the primary healthcare strategies are devolved to states and local government levels so that they can deploy the right strategy to the community that they are serving. From a GE perspective, we have appropriate technology for all levels of healthcare. Secondary or tertiary healthcare technologies are not deployed to primary healthcare, that way we call it adaptive technology.

What is GE’s relationship with the Oloibiri Health Programme (OHP)?
GE Healthcare is the implementation partner for OHP. We are responsible for the execution of the programme up to this day. The execution phase took about two and a half years. Back in 2015, we signed a memorandum of understanding with Shell organisation. There are other key institutions under the programme, such as Bayelsa State, local governments, federal universities and the World Bank IFC.

Our job was to ensure that by the end of the programme completion, the goals and objectives were met. There were several elements in the project, including civil work, implementation of the health insurance scheme, delivery of the revolving drug fund, among others. We provided a small level of equipment, but the vast majority was provided by many different organisations across the healthcare system. So, our relationship is more on project management.

How would your role in the OHP help Nigeria’s healthcare system?
It is less about the relationship and more about what we are trying to do. This programme for the first time is a fully holistic approach where you can offer UHC to an entire community. Historically, what was done, is that they would fix the healthcare centre, then if light is not working, they would try to fix the light, same with water or other infrastructure gaps. This was done independently from each other and a lot of the time would not be fixed despite the investment in renovation of the health facility . But this programme took a holistic approach. We took all the determinants of health and addressed all in one programme. This programme is not just about equipment; it’s about how to improve health that will be sustainable.

We have a lot of healthcare equipment companies in Nigeria. How is GE different?
GE Healthcare is a solutions provider with a wide spectrum of technology that can be deployed to improve healthcare outcomes and to improve diagnosis. What GE realised early in its 120 years in Africa is that providing technology is not enough. We also try to be involved in the process to ensure healthcare is deployed and not just equipment. The OHP is a good example of how GE can take project management and expertise to another level. We are able to utilise a number of different skills, knowledge and understanding with a small technology component to improve the entire healthcare system. Yes, we are a 100 per cent technology provider, but we also have a more holistic view in how the technology is deployed and maintained, the infrastructure that surrounds our equipment and the human capacity to utilise the technology to improve clinical outcomes is part of our broader way of approaching Africa.

What other areas is GE supporting Nigeria to achieving UHC?
We are doing a number of interventions towards achieving UHC for Nigeria . For instance, we recently partnered Access Bank to offer a solution that provides private healthcare providers with loans to support and buy technology. This is a way we are trying to stimulate the market as regards to financing targeting private but also Public Private Partnerships (PPPs). The program is set up so that private healthcare providers can borrow up to 800,000 dollars (N288 million) but this is specific to small and medium sized healthcare businesses. So we expect to see small ticket medical technologies benefit from this program.

Is Nigeria’s healthcare issue and poor budgeting affecting your work in the country?
Over the last three years that I have been doing this job, we have seen more focus from the federal and state government on healthcare. We are having more conversations with governments on how we can improve and impact on the healthcare infrastructure in Nigeria. In my assessment, there is more focus and interest in having a healthy population. Stakeholders need to support the federal, state and local governments to ensure we achieve UHC by 2030.

What is your take on the low healthcare budgeting by the federal and state governments?
We will continue to work with the country to ensure prioritisation of health for all. What we can also do is show outcomes. When investors be it government or private investment sees the benefits their investments, it would then stimulate more inflow into the health economy. A good example of this is when we deploy our Primary & Referral Care solutions, we continue to monitor and evaluate health outcomes to see how effective the investment was and did it achieve the original goals of the program