By Chidiebere Ugwu (Timesreporters Online)
This investigation is for the GENDER, THE AGENDA project of Gender Strategy Advancement International (GSAI) supported by the Wole Soyinka Centre for Investigative Journalism (WSCIJ) and the MacArthur Foundation.
The Primary Healthcare Centre in Karu village, the only one serving the community was a bit chaotic that Thursday morning, save the intervention of the elderly nurse Abigail, it would have turned into a physical fight between Aisha and Ochanya, both mothers who brought their babies for scheduled immunization.
Aisha accused Ochanya to have tried to jump the long queue, but the latter said she begged others who gave her permission as she was running late to work, the argument snowballed into a shouting match and almost resulted in a fight before the situation was arrested through the intervention of nurse Abigail, whom everybody respected very much for her old age.
When frayed nerves were calm, Timesreporters Online sort to know the reason behind Ochanya’s haste, which led to the unpleasant situation, and a few minutes chat with the mother of three, revealed the strengths and weaknesses of human resource situation at the primary health care level in Federal Capital Territory.
“Keeping appointments in this hospital always gives me a nightmare because you will spend almost a whole day waiting to take your turn. Can you imagine the number of people here being attended to by only one nurse? I have had issues in the past with my office because of this problem. I am a banker and it is difficult to convince my boss that getting your child a doze of immunization takes the whole day” Ochanya lamented, insisting she actually took permission from the other women.
Further investigations by Timesreporters Online revealed that Ochanya is not alone in this frustrating experience. A study of primary healthcare facilities across the six Area Councils in the Federal Capital Territory, including Abaji, Kuje, Gwagwalada, Bwari, Abuja Municipal Area Council (AMAC) and Kwali revealed not only inadequate staffing, but also poor maintenance of primary health care centers.
According to available information, there are 300 Primary Healthcare Centres in all the Area Councils.
The information obtained from the research published in the American Journal of Social and Management Sciences, states that there are 31 in Abaji Area Council, 49 in Kuje Area Council, 34 in Gwagwalada Area Council, 55 in Bwari Area Council, 86 in AMAC and 44 in Kwali Area Council.
However, overall, there were 45 community health officers, 35 nurses and 453 community health extension workers engaged in primary health care services of the FCT and also only 30 of the PHCs are said to be equipped to standard.
These represented 140.6%, 109.4% and 130.9% of the expected for the respective categories of health workers, which are required to staff the existing primary health care facilities.
Apparently, the numbers above show that there is not enough workers in the FCT primary healthcare facilities and the situation may have been exacerbated by the so called ‘japa syndrome’, resulting in several negative consequences such as witnessed at Karu village PHC by Ochanya.
Regrettably, the story is not different elsewhere in the nation’s capital city as many people encountered during the investigation had one negative experience or two to share.
At one of the PHC in Bwari Area Council, a woman, Maryam Aminu, said the shortage of staff put unbearable pressure on the workers to the extent that some of them become abusive under intense workload.
“I had an unforgettable experience of mistreatment during childbirth, when the nurse that attended to me resorted to verbal abuse, and even left me on my own under labour pain for an extended period.
“And when she came round to attend to me, it was with shouting, scolding, threatening during labour and delivery. You can image the trauma. Of course, I understood her situation, the work was too much for one person” she said
At the Kuje Area Council, a woman, simply identified as Mama Toys, a trader who sells articles for newly born just outside the hospital, confirmed that workers struggle to cope with healthcare service delivery at the primary health care facility.
“Obviously, there is a shortfall of doctors and nurses here. The crowd that seek the facility’s service far outweighs the workers. I’m not sure the doctor attends to everyone that comes to this hospital on a daily basis” said Mama Toys.
At the Gwagwalada axis, Deborah Nnaedozie, listed arrays of issues affecting service delivery in the PHCs within the area, saying that some patients may have to wait for hours or even days to receive medical attention due to a shortage of healthcare providers and resources.
Also, at one of the PHC at Dei Dei, Timesreporters Online accosted an octogenarian, Hassana Raymond, who said that in few of the facilities she had attended within the Bwari, Kubwa, Dutse, and Dei Dei axis, she observed barriers to the delivery of age-friendly services including the lack of recognition of older adults as a priority, high staff workload, administrative challenges, and mismatch with the needs of the aging patient population and existing resources and priorities.
The elderly Raymond said despite her age, she is always made to follow through the queues for her turn which takes hours before she is attended to, noting that there ought to be some sort of consideration for the elderly and the attendant weak bones.
“If you are looking at what needs to be improved. Tell President Tinubu to make it possible such that elderly people like us are attended to in the hospital with dispatch. I have been to the hospitals around here, Dutse, Kubwa, Dei Dei, and each time I spent almost the whole day waiting on queues. That’s is not fare. We are old and weak, no longer strong like the young people so we should receive some considerations. And you know, you don’t blame the staffs because you could see them always busy all the time. One person will attend to over a hundred people, if not more” she said.
But, unlike others, the PHC at Kurudu was virtually empty when our reporter visited at about 11.54 am Friday morning. A nurse who pleaded anonymity said it is what they met on ground, she said that unlike Karu where you have many patients attending the hospital, nurses in Kurudu have to organize a sensitization drive from time to time to persuade residents to make use of the facility.
Asked what they do when electricity goes off, she said nothing other than wait for light.
We have been talking to the authorities to make these necessary things available but nothing has happened yet.
“You know in Karu PHC there is a solar installation, but this place has nothing like that. Even the people that the facility is provided for are not willing to take advantage of it.
Last week, we were at the Mai Angwa, the village chief’s Palace for sensitization , women were called and asked why they don’t patronize the place. The reason some of them gave will make you laugh. They said they cannot afford antenatal care. To tell you the level of redundancy they wanted to make this facility. When I got posted here the Commercial bike that I entered carried me past the hospital, we asked several people just outside that gate but they could not direct us. That will tell you that most people around did not even know what this facility was meant for”, she said.
Aside apparent shortfall in workforce or maldistribution of health workers, many of the PHC centers in Abuja, are reportedly in a poor state, which hampers the delivery of quality healthcare services to the population, especially women and children in hard-to-reach communities.
A recent research conducted by Tap Nitiative for Citizens Development and Dataphyte had shed light on the urgent need for intervention in Abuja’s primary healthcare system.
The research, which encompassed 30 healthcare centres across the Federal Capital Territory, revealed several critical issues that require immediate attention.
One of the alarming findings in the research is that a staggering 18 primary healthcare centres (PHCs) out of the assessed 30 had no medical officers available.
This shortage of medical personnel significantly hampers the provision of essential healthcare services to the local population, compromising their well-being and access to quality care.
Moreover, 21 PHCs did not have pharmacy technicians, 14 PHCs lacked health record technicians, and 12 PHCs did not have medical laboratories, with only one having an account clerk.
These deficiencies further exacerbate the challenges faced by healthcare centres and hinder their ability to deliver comprehensive care.
Additionally, the research highlighted a concerning perception among 7.5 per cent of respondents that hospital officials are engaged in unwholesome practices such as given priorities to patients who always give cash rewards.
These sharp practices in healthcare not only erodes public trust but also diverts precious resources away from patient care, exacerbating the already strained healthcare system.
Another troubling discovery was that a staggering 81 per cent of individuals who utilized primary healthcare services in Abuja did not receive proper receipts for their treatments.
PHC system is an essential aspect of healthcare delivery, being the first point of contact for individuals seeking medical attention, hence the need to urgently find a solution to improve the system.
Alhaji Rabiu Ibrahim, a retired director in the katsina State Ministry of Health, attributed the prevailing situation of PHCs in Abuja, to lack of motivational factors such as low wages, poor working conditions, lack of supervision, and lack of equipment and infrastructural facilities particularly in rural areas.
According to Ibrahim, this often manifests in dysfunctional health systems and poor health status indicators, advocating a concerted effort towards repositioning the system for optimal performance.
However, all hopes are not lost for the prospect of revamping the PHCs in Abuja. Going by recent promise by the Minister of the Federal Capital Territory (FCT), Mr Nyesom Wike, the PHC system may witness a complete turnaround for the better before the end of the administration of President Ahmed Bola Tinubu.
Wike said plans are underway to improve the quality of health services in the federal capital, when the executive members of the FCT Chapter of the Association of Resident Doctors, led by the President, Dr Rahman Olayinka, visited him recently.
He explained that the FCT Administration would ensure necessary provisions in the 2024 budget to improve quality of services in health facilities in the FCT.
“The services at the moment are not encouraging. It is unfortunate.
“I was thinking that since FCT is a capital city it will have the best health facilities, but from what I am told, there is nothing to write home about, but be assured it will be the best.
“We will bring the health system to a standard that everybody will be happy,” he said.
