Absence of PHCs, their conditions affect healthcare delivery


    The Primary Healthcare Centre (PHC) is the basic structural and functional unit of the public health services in developing countries such as Nigeria.

    Primary Health Care is founded on the interconnecting principles of equity, access, empowerment, community self-determination and intersectoral collaboration. It encompasses an understanding of the social, environmental, economic, cultural and political determinants of health.

    The PHCs are to provide medical care, maternal-child health including family planning, safe water supply and basic sanitation, prevent and control locally endemic diseases, collect and report vital statistics and education about health.

    PHCs are also for national health programmes, as well as for referral services.

    Given the enormity of the roles of PHCs, the absence of it or its malfunction will greatly affect healthcare delivery in the country.

    A check by the News Agency of Nigeria (NAN), therefore, seeks to find out the state of the centres across the country, and their functionality toward improving the health status of citizens, especially at the grassroots.

    In Kaduna State, the Deputy Director, Primary Healthcare Development Agency, Ibrahim Hamza-Ikara, said the government has upgraded PHCs so as to offer best services and encourage patronage to residents
    He said “the standard is good and people are now patronising the facilities.”According to him, the state government has modernised and equipped 255 PHCs and 23 comprehensive healthcare centres to expand access to healthcare. 

    He told NAN that equipment and staff were increased to ensure effective health delivery at the grassroots.

    Hamza-Ikara added that the agency had trained over 8,000 community health volunteers and conducted adequate mobilisation to encourage patronage of the facilities.

    In Sokoto State, PHCs are being patronised by patients, with some operating 24-hour services.A resident of Gagi, Malam Ilyasu Bello, said the PHC in the area is offering general services, including antenatal and post natal care. 

    At Kalambaina area, one of the residents, Danladi Kaka, told NAN that the PHC there is more like a General Hospital, as the staff work 24 hours daily.

    At Dange PHC, one Alhaji Dan’azumi Saraki, said people of the area are being taken care of at the facility, and referred to general hospital when absolutely necessary.

    Meanwhile, Kebbi Government in collaboration with some partners, is renovating and equipping 225 PHCs to enhance access to healthcare services at the grassroots.

    Malam Yahaya Sarki, the Special Adviser to Gov. Atiku Bagudu on Media, told NAN in Birnin Kebbi that the government introduced measures to encourage residents to patronise hospitals.”The state government entered into partnership with the state chapter of the National Union of Road Transport Workers to convey pregnant women and children in rural areas to PHCs for delivery. 

    “The scheme was launched in October 2017 and is still functional,” the governor’s aide said.

    Also, the Executive Secretary, Kebbi State Primary Healthcare Development Agency, Dr Abubakar Ka’oje, said “the state government is taking measures to bring healthcare under one roof to ensure proper coordination by pooling money from local governments to support PHCs.

    He also said that the state government rolled out the State Emergency Maternal and Child Health Coordination Centre, and renovated PHCs.

    Ka’oje explained that about 76 centres had so far been renovated out of the 225 PHCs in the state.

    The state Commissioner for Health, Alhaji Jafar Mohammad, said the government would soon accredit 86 primary and 12 secondary healthcare facilities for the state contributory healthcare scheme.

    At Takalau PHC in Birnin Kebbi, one of the renovated primary health centres, a Community Health Extension Worker, Rukayya Shehu, informed NAN that the 15-bed centre attend to at least 20 pregnant women daily for Antenatal Care (ANC) and five for Post Natal care.

    “Actually, the patronage is good here, women come for ANC, delivery and even post natal because they believe that here we have skilled health providers.

    “We conduct ANC on Tuesdays and Wednesdays, featuring health talk on ANC, exclusive breastfeeding, nutrition, child-spacing and HIV/AIDS counselling,” she said.

    She, however, said that the centre lacked fencing, adequate drugs and beds, as well as cold store, furniture and other facilities like blood pressure apparatus.

    Zainab Faruk, a 25- year-old mother who attends the health facility for post natal, said she had her baby at home, but had to go to hospital after the child developed some complications.

    NAN reports that although the state of many Primary Healthcare centres in Kano had improved, not many residents patronise them.

    In Zamfara, the Commissioner for Health, Alhaji Yahaya Kanoma said “the state government will soon establish functional and modern PHCs in each of the 147 wards of the state.

    “As I am speaking now, many have been completed and equipped with modern health care facilities.”

    However, the  Executive Director, Niger Primary Healthcare Development Agency, Dr Ibrahim Dangana, said the state has 1,320 healthcare facilities.
    Dangana said that each local government has a focal facility the community depends on.
    “The Primary Healthcare Development Agency has three main categories of health facilities namely the Primary Healthcare Centres,  Healthcare Clinics and the Health Post.
    “We  hope to improve the state of the facilities by improving the infrastructure and re-equipping them” he said
    He stated that the agency would continue to create awareness about the facility through the media.
    The executive director stressed the need for patients to visit hospitals for proper diagnosis of their ailments and for proper treatment.
    However, Mr Nambol Daniel, the Chairman, Plateau House of Assembly Committee on Health, says the state does not have Primary Health Care Centres but posts and clinics.

    He described the situation as unfortunate, while rating the health care services of the posts and clinics as poor.

    He told NAN that “primary healthcare centres are the facilities that should provide basic health services at the community level, but Plateau does not have any.

    “What we have are Primary Health Care Posts and Clinics, but ideally, what we are supposed to have are Primary Health Care Centres because they are more advanced.

    “At the post, you have a minimum package service such as the treatment of malaria, pneumonia, diarrhoea, ante natal services and routine immunisation.

    “The clinic offers increased services and should have a nurse, a pharmacist and a medical lab scientist.

    “The Primary Health Care Centre, which is the most advanced, is supposed to have a medical doctor and services like Cesarean Section, appendectomy, liver function test and so on; sadly, even some general hospitals don’t have medical doctors.”

    The chairman said that in the 532 state and federal wards, the state has just over 1000 health posts and clinics, with only 400 functioning. 

    He regretted that the 400 still did not have adequate personnel, equipment, infrastructure and health commodities, among others.

    “We have over a thousand primary health care posts and clinics but just about 400 are functional, not really functioning as they should.

    “Personnel are grossly inadequate, COVID-19 exposed the lack of personnel on ground, the infrastructure are dilapidated, availability and accessibility of health commodities a  problem. 

    “There are some drugs that are not supposed to be kept in a room temperature but because there are no refrigerators in these centres, they are stored inappropriately,” he said.

    The lawmaker scored primary health care service in the state at three over 10, stating it as grossly below standard. (NAN)

    Nov 16 2020 @ 8:05 GMT

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