FCT Primary Health Care Centres: Health Facilities Or Death Traps?

FCT Primary Health Care Centres:  Health Facilities Or Death Traps?

By Ebiere Eruemulor

Despite being established to address pressing health needs at the grassroots level, Primary Healthcare Centres in the nation’s capital have become a shadow of themselves, in some cases even threatening the lives of patients.

Mutiu is a commercial taxi driver who lives within the Abuja Municipal Area Council, AMAC, Lugbe to be precise. Recently, Mutiu’s sister visited him but while in his house she became ill. He rushed her to the primary health care centre located at Lugbe Village, because that was close to his house. The nurse on duty then asked what was wrong with Mutiu’s sister and she mentioned headache, body pain and general weakness. The nurse then said his sister needed to take a test to ascertain what her problem was.  Mutiu agreed and then rushed to the pay point and paid for the test. They called her into the laboratory, took her blood specimen, conducted a test and came out after 20minutes with the test result.  At that point, Mutiu asked if they could see the doctor but was told that the doctor was not around, that they could see the matron on duty with the test results and possibly get a prescription; they did that without waste of time.

The matron studied the test results and said the patient was suffering from malaria and typhoid fever so she prescribed drugs but on getting to the PHC’s pharmacy, drugs were not available, meaning they must buy outside and Mutiu took his sister away, bought the drugs and went home.

Days after the treatment had commenced, Mutiu noticed that his sister’s health was deteriorating.  He then rushed his visiting sister to Maitama General Hospital where she saw a medical doctor who conducted an investigation and found out that her blood level (pcv) was low.  She had no trace of malaria and typhoid.

Thank God Mutiu’s sister narrowly escaped death through wrong medication but how many people are or will be so lucky?  Madam Helen almost lost her life last week also due to wrong treatment at a primary health centre in her neighbourhood, until her husband rushed her to Asokoro General Hospital.

The Primary Health Centre, PHC, is the basic structural and functional unit of the public health services in developing countries and it is established to provide accessible, affordable, available and timely healthcare to the people in accordance with the Alma Ata agreement and declaration of 1978 by the member nations of the World Health Organisation, WHO, of which Nigeria is a signatory.

Nigeria as a nation acknowledges all the eight pillars of primary health care on paper but in the Federal Capital Territory Abuja today, this agreement has not yet translated into the highly desired adequate medical treatment in these health centres for those who need it.

If the Federal Capital Territory Abuja, the seat of power, the nation’s capital city is still experiencing such challenges, what would the state and local government areas look like? It is also unfortunate to note that this instability has been with us and remained the same after several regimes of government came in, paid lip service, use it as a campaign tool and left without effecting the needed change.

Challenges in the primary health care service delivery in Nigeria are obvious. A visit to these centres will discourage anyone seeking medical attention; some of the structures have been taken over by either petty traders or other agencies.

When AljazirahNigeria visited Lugbe PHC, we noticed that the sign post is snowed-under by petty traders and other sign boards. The access gate to the centre is completely taken over by other activities that it will keep you wondering if this is a medical facility or a market.

That of Nyanya, located close to Karu abattoir has been besieged by military men who have made that place their abode while on duty but behind that centre is a haven for drug addicts and criminals.

More than 200 primary health centres were created to ensure prompt attention to sick persons in the local communities. It ought to be the first point of call before going to the general hospital but the PHCs in Abuja are not well equipped to meet the high demands of the people in those communities.  The doctors posted to these centres are hardly on ground to attend to patients.

Most leaders do not show the needed political will to change the situation in the health care system. The local health programmes like immunisation and polio eradication take place only with the help and donations from international agencies. Government’s commitment to this cause is certainly a key element in the decentralisation of health services, which can improve primary health care service delivery in the FCT and the country at large.

In conclusion, PHC policy in Nigeria can be strengthened through the implementation of the Abuja Declaration, thereby increasing domestic resources for health and improved budgetary allocation for the management of PHC.  Recall that In April 2001, the African Union countries met and pledged to set a target of allocating at least 15% of their annual budget to improve the health sector and urged donor countries to scale up support. Years later, only one African country reached this target. Twenty-six countries had increased the proportion of government expenditures allocated to health and 11 had reduced it. In the remaining nine countries there was no obvious trend up or down. Current donor spending varies dramatically.

Governments should redirect resources for health care from curative services to preventive services in order to improve PHC infrastructures, encourage the migration of health workers from urban areas to rural areas, and provide acceptable level of health-care services for all, thereby reducing the gross inequality in health status of the people.

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