Covid-19 a wake-up call to primary healthcare
BUSINESS DAILY AFRICA
By Angela Nguku, Executive Director, White Ribbon Alliance Kenya 03/29/2020
On March 11, the Covid-19 was declared a global pandemic by the World Health Organisation (WHO), with the first case of the virus reported in Kenya by the Ministry of Health two days later. Many other African countries have also reported cases. But even as the Kenyan government races against time to contain the pandemic, many Kenyans do not seem to take it seriously.The government regularly disseminates information around its public health guidelines, including social distancing and preventive measures such as handwashing with soap or use of hand sanitisers.
Sadly, many Kenyans haven’t changed their behaviour and to be part of the solution to slowing the Covid-19 spread. To them, Covid-19 is still an issue that must be dealt with by the government as they go along with their usual daily chores. Information coming from the government and other reliable channels tends to emphasise a personal and communal approach to dealing with this pandemic. The key questions, however remain, why is this critical life-saving message falling on deaf ears? Why are a majority of Kenyans still reluctant to heed the call and change behaviour? Why are many not ready to embrace the preventive and promotive measures proposed for the sake of their lives and that of their fellow countrymen?
If there is one important lesson the Covid-19 pandemic is teaching us, it is that there is an urgent need to embrace primary healthcare (PHC) with a focus on self-care. The concept of PHC gained traction over 40 years ago, with the famous Alma-Ata declaration. It put forward eight essential components, among them health education about prevailing health problems and how to prevent and control them; adequate supply of safe water and basic sanitation; prevention and control of endemic diseases among others.
PHC takes a holistic view of health that goes beyond the narrow medical model. It recognises that many causes of ill health and diseases lie beyond the control of the health sector and thus must be addressed through a wider societal approach. PHC is increasingly being recognised as having the potential to revolutionise health systems and outcomes through enhancing community literacy and action; improving healthcare costs; arming people with the knowledge, skills, tools and confidence to proactively maintain health and effectively participate in decision-making. It further places individuals, families, communities and countries on a path of self-reliance, providing a new way to message and sustain interest in health literacy and behaviour change and spurring innovation in form of tools and technologies to reach ever greater numbers of people.
Growing up the in the village in the 1980s, this model was central to the many gains that the country made in public healthcare then. Communities were better informed and took charge of their own health. Healthcare was not just the role of the Ministry of Health alone but one that was embraced by all players. Fast forward to today, and has transiently died off and given way to emerging models that seem to focus more on curative services. However, the Covid-19 crisis and the realisation that everyone, including individuals and communities are key in the control of its spread, is a reminder that PHC is needed now more than any other time in the history of this country.
This is the practical model that will help the country in addressing not just the current pandemic but also the double burden of both communicable and non-communicable diseases. Strengthening of primary healthcare will be at the core of efforts to achieve strong and sustainable health systems. Going by the laxity, panic, misinformation and rumours that have become the norm among Kenyans amid the current pandemic, Kenya must invest in proper health literacy all year round.
Without these building blocks, communities and individuals are unlikely to take full advantage of health interventions or make and practise informed, responsible healthcare decisions that will ultimately save them and the nation at large from catastrophic consequences of the current Covid-19 crisis. This will require a paradigm shift in the way healthcare is organised and delivered and individual and community behaviour change. Post the pandemic, the current mass media campaigns and digital innovative approaches must be embraced and incorporated in the universal healthcare coverage (UHC) agenda as long term and sustainable models to promote self-care literacy, practice and rights.