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Some residents of Kogi and Nasarawa States have called on their state governments to prioritise primary healthcare service delivery.
The residents told the News Agency of Nigeria (NAN) that most of the Primary Healthcare Centres (PHCs) lacked sufficient health workers to serve the people.
Nasarawa
Juliana Oka, a mother and resident in Koroduma, Karu Local Government Area of Nasarawa state, said the PHC in Koroduma was very functional, but more health workers were needed, given the influx of people seeking healthcare services in the area.
“They are trying their best. The cost of treatment and medication is affordable compared to other health facilities.
“However, the staff are always overwhelmed, especially during immunisation and antenatal sessions,” Mrs Oka said.
In Lafia, Maimuna Aliyu and Rekiya Shuaibu, both nursing mothers, said they and their families access health service at the Sabon-pegi PHC, saying it is closest to their residences.
They also appealed to the state government to employ more health workers in the area, as more people were accessing the facility.
Similarly, Emmanuel Yohanna, a casual health worker at PHC, Akalekwu, and Helen Douglas, another casual worker at PHC Akunza Migili, all in Obi Local Government Area of the state, also narrated inadequate manpower.
Mr Yohanna noted that only two of them worked at the facility and they worked throughout the day, including weekends, which he said was stressful.
Ms Douglas, on her part, said that apart from understaffing of PHCs, some residents preferred alternative medication for treatment of their ailments in the rural community due to the harsh economic realities.
Nasarawa official speaks
Stephen Sasetu, the director, Research and Statistics, Nasarawa State Primary Healthcare Development Agency (NSPHCDA), said the challenges facing primary healthcare delivery were surmountable.
He attributed the challenge of understaffing of PHCs to the growing population in the state.
Mr Sasetu, however, said the state had remained consistent among states in the country in terms of healthcare service delivery and would continue to sustain the tempo.
He said there were no fewer than 780 functional PHCs in the state, offering healthcare services at different levels.
“We have Primary Health Posts which cater to about 500 patients, Primary Health Clinics handle 2,000 patients, while the Primary Health Centre is designed to serve about 12,000 residents,” he said.
Kogi
From Kogi, Ibrahim Nasiru, a lecturer with the Department of Political Science, Prince Abubakar Audu University (PAAU), Anyigba, applauded the government’s policy of ensuring that the PHCs are primarily at the local government areas or the grassroots mainly to serve the rural populace.
But he expressed worry over their condition and services, saying “It is very pathetic in the sense that what the people expect from the government is not what they are getting”.
“Despite government huge investments and what the partners, like World Health Organisation (WHO), World Bank, UNICEF and others are putting up, the people don’t feel much of its impact,” he said.
Other major challenges, according to him, include “lack of roads, water and electricity.”
“These are hampering the accessibility of some of these facilities in the rural areas.
“In some of the PHCs, there are not enough equipment or facilities to do simple malaria or typhoid tests. Most times you see people going far outside the immediate communities to carry out such tests. So there’s a lot to be done.
“In fact, that’s the more reason why the mortality rate is very high, particularly the childbirth mortality rate in the rural areas. This is supposed to be the responsibility of these PHCs to control,” he said.
On what should be done to address some of these challenges, the don urged the government to make available more facilities in the PHCs to replace obsolete ones.
Mr Nasiru also said that the training of personnel that would make use of those facilities should be paramount just as they should make sure drugs are available to cater for the rural poor when they fall ill.
“Again, a situation where a healthcare worker is being paid a salary on percentage is not encouraging nor healthy for the success of the service in the state.
“The health workers must be motivated to work through the provision of good salaries and other welfare packages, moreso that they have sacrificed to stay in the rural areas to serve the people and government.
“I am of the belief that with such pragmatic steps, there will be an improvement in the PHC services, which will go a long way in attracting more patronage from the people,” the lecturer noted.
Mixed feelings
Also speaking, a mother of three children, Memuna Adejoh, expressed gratitude to the government for setting up the PHCs in the rural areas.
Mrs Adejoh, who is a petty trader in Ofu Local Government Area of Kogi State, said she and her family members had been patronising the centre in their community.
“My family patronises the PHC in our community very well. The only challenge is that sometimes we have to go to town to buy some drugs that they don’t have, which is a huge challenge for us.
“But then, their services are affordable compared to the private hospitals, where we are charged thousands of Naira to get simple malaria drugs or tests.
“How we wish that government should post qualified doctors to the PHCs to help diagnose our health challenges and treat us at affordable rates,” she stated.
Kogi official speaks
However, Abubakar Yakubu, the executive director, Kogi Primary Health Care Development Agency (KPHCDA), disclosed that 838 PHCs are operating across the 21 local government areas of the state as of 2018, based on the facility assessment conducted by the agency.
The director said that because the government wanted the PHCs to serve the people of the rural areas effectively, it gave them a very robust investment in recent times through the support from partners and the state through the Healthcare Provision Fund.
“On their operations, immunisation, intrusion and maternal and child health, social mobilisation and health education are the primary work they do.
“When we surveyed in 2018, over 70 per cent of the facilitates were functional and could manage patients. Graciously, these facilities have recently been upgraded.
“We are aware that when the facility is not where the population of the people are in rural communities, the facility might not be patronised.
“For people to move for a very long distance before accessing a healthcare facility is not good at all. Again, they might not want to do that.
“So, we try hard to ensure that the facilities are located within the dense communities. Their accessibility is very key just as the healthcare workers even though we have problems with human resources, which is a challenge for the smooth running of the PHCs.
“To address that, we recently employed over 80 community health workers and midwives in order to augment the already existing health personnel.
“Primarily PHCs are supposed to be run by these personnel but in the high volume areas, doctors might be required because anything above the community health workers and midwives are to be referred to the doctors within the vicinity as quickly as possible.
“For us here in Kogi, human resources is very much a challenge but we are doing our best to see how we can mitigate it.
“Funding is another challenge but it is because of that that the PHCDAF is helping in earmarking funds to us to see how the PHCs could be revitalised to bring them to a good level that anybody could access healthcare services.
READ ALSO: Why demand for primary health care services is low in Nigeria -Official
“The good news is that the federal government is planning to increase that fund within the shortest possible time. This PHCDAF fund that I talked about is to help us equip the PHCs with facilities and drugs for effective service delivery.
“Part of the fund is meant to procure drugs for the use of the PHCs. The state government has always ensured that there are drugs available to be dispensed to the patients.
“We believe that with this ongoing effort, it will go down well to solve some of the challenges being faced by PHCs across the state,” Mr Yakubu said.
(NAN)
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