PHC Dutse makaranta
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Manpower shortage and deficient infrastructure, especially
inadequate equipment and power supply, are the major obstacles to meaningful
primary health care delivery in Nigeria, an investigation by PREMIUM TIMES has
revealed.
The All Progressives Congress-led federal government under
President Muhammadu Buhari has anchored its public health agenda on a scheme to
revitalize primary health care, PHC, facilities across the country “to avail
poor Nigerians with qualitative and affordable health services”.
The initial plan of the administration was to build new
primary care centres but it later tweaked this plan last year to revitalizing
10,000 existing centres. The scheme, dubbed the National Primary Healthcare
Revitalization Initiative, and assigned to the National Primary Health Care
Development Agency, NPHCDA, and the Federal Ministry of Health, “aims to make
at least one primary health care centre fully functional to deliver a number of
services in each of the wards across the country”.
President Buhari flagged off the scheme on January 10 when
he commissioned the renovated Primary Health Care Centre in Kunchigoro, a
suburb of Abuja. The centre was adequately staffed and fully equipped,
including with ambulances and drugs, and has since been providing services to
the appreciation of patients.
But that is not the case in most other primary health care
centres in the country.
A visit to Asata Primary Health Centre in Ogui community,
Enugu North Senatorial District of Enugu State revealed the poor state typical
of these centres around Nigeria and the struggle of their workers to deliver
services to patients, especially at the grassroots.
“We use torchlight or our phone light to deliver women at
night or whenever the room is dark”, an official at the centre in Asata told
our reporter on condition of anonymity to avoid victimisation.
“Though this facility looks very small, a lot of people
visit here on a daily basis. But because of lack of funds, people have been
suffering severely to the extent that some of our staff cannot even afford
transportation fares to come to work on daily basis.
“We don’t have enough staff in the centre; we lack adequate
manpower”, the official stated.
“We are supposed to have cleaners, night watchmen and care
takers, but we don’t have any. The building is too small and not conducive at
all. As you can see, all the nets and windows are gone.
“The issue of light (lack of electricity supply) has been on
for a long time. For over a year, we had no light at all; not even for a day.
When there was no light, we just used our torch lights or phone light. That’s
the only option. There is a standby generator but it has been faulty for a long
time.
“Considering the fact that we run two shifts, both morning
and night, light is needed. So recently, we borrowed money to fix the light. We
need light to preserve our vaccines and to take (birth) deliveries at night.
So, we went to good spirited Nigerians to lend us money. We are still owing
that money up till now.
“Despite all these challenges, women prefer having their
babies here. In a month, we have between 17 and 20 deliveries”.
Asked what she expected from the federal government’s
revitalization scheme, the official eagerly unfurled her shopping list.
“We want the Federal Government to expand this building for
us as this is a centre that serves so many people. Expansion and equipping of
this building will make it more conducive and friendly for both the workers and
the patients.
“We have only five rooms and OPD (Out Patient Department)
here. If the government can put up five more rooms, it will be good for
everyone.
“We also call on them to train our staff. We need to be
updated of recent discoveries, to enhance our knowledge on how to handle
certain health issues. If the staff here can be updated, especially in child
bearing, it will help us work better”.
Other members of staff joined in to remind her of the lack
of ambulance or any vehicle that can be used in cases of emergency. She stated
that patients who needed to be transported to other locations either use “Keke”
(tricycle) or get a taxi.
At the Primary Health Centre, Kuduru in the Bwari Area
Council of Abuja, it was discovered that there has never been any form of power
supply in the past four years since the centre started operating.
“We have never had light or water in the centre” said an
official who also prefers not to be named.
The centre was commissioned in May 2011 and started
operation in 2013.
“In all these years, we have never had light or water. We
buy water on a regular basis from Mai ruwa (water vendor)”.
Asked how the centre operates at night without light, the
official said “We run only one shift daily. We resume 8 a.m. and close by 4 or
5 p.m., depending on the day’s work.
“When there is a delivery and the labour room is dark, we
make use of rechargeable lamp. That’s the only option since we do not have a
standby generator.
“The residents already know our plight and the reasons we
close early, so when there is a case of delivery after that time, they go to
other health clinics”.
At the Primary Health care centre in Dutse Makaranta also in
the Bwari Area council of the Federal Capital Territory, the story was like a
recap of the earlier ones in this report.
Except that light is not a primary challenge in the
facility, as a standby generator is available. The building, however is
dilapidated and would almost not pass for a place where people receive
treatment and are delivered of babies.
“As you can see madam, the building is too old and not
conducive at all”, said one of the nurses on duty.
“We usually have large number of patients every day, so we
need the building to be renovated to ease our work and keep the environment
neat”.
At the Primary Health Care Centre in Idu Karmo also in the
FCT, however, power supply is expectedly a big problem.
But, according to a source, the staff contributed money to
purchase a solar facility which now provides power at the centre.
“Once there is no light, and since we do not have a standby
generator, we use the solar. We bought the solar because of the innocent
patients that visits the clinic on daily basis. We cannot continue to wait for
the government”, a worker at the centre explained.
Many Nigerians who have to use the primary health care
centres across the country will be eager to see what the 2017 Budget, which was
passed by the National Assembly on Thursday, has for the centres within the
revitalization scheme of the President Buhari administration.
The National Primary Health Care Development Agency, NPHCDA,
is a parastatal of Nigeria’s Federal Ministry of Health with policy and
oversight roles on PHC implementation at the state and local government levels
in Nigeria. Allocation proposed for the agency by the federal government in the
2017 Budget is over N19 billion (N19,212,923,655) including cost of
rehabilitating some of the PHCs.
Africa Center for Clin Gov
Research & Patient Safety
@ HRI West Africa Group - HRI WA
Consultants in Clinical Governance Implementation
Publisher: Health and Medical Journals
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Cross River State, Nigeria
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