Osun State’s primary healthcare system has made notable strides in recent years, with 64 out of 69 surveyed Primary Healthcare Centres (PHCs) undergoing renovation within the last decade. However, three facilities remain in a state of disrepair, having never been renovated, and half of the PHCs experience at least one of eight identified building failures. This highlights the need for regular maintenance to prevent infrastructure deterioration and ensure safe and effective healthcare delivery.
The state’s PHCs demonstrate a relatively high level of preparedness to handle patient loads, with 64 boasting consulting rooms and bed availability. This suggests that most facilities are equipped to handle a moderate patient load and provide essential care services. However, significant gaps persist in basic amenities and waste disposal infrastructure, with only 18 out of 69 PHCs possessing clean and functional restrooms. Waste disposal methods are often unsafe, and water sources are primarily reliant on boreholes and underground wells.
Medical equipment and supply shortages are a major concern, with only one PHC possessing a functional ambulance and half of the surveyed facilities lacking at least 16 out of 18 identified medical supplies. This includes critical shortages of oxygen, personal protective equipment (PPE), and essential labor ward equipment. The scarcity of vital medical equipment and supplies across the state’s PHCs is alarming and critically undermines emergency response capabilities and overall healthcare delivery.
The disparity between assigned and active health workers in Osun is a significant 41.19%, with 47 of the PHCs lacking doctors on weekends. This shortfall in healthcare personnel affects service delivery, especially during weekends. Work condition satisfaction is also low, with only seven PHCs reporting satisfaction, and limited opportunities exist for staff training and development. The absence of formal mechanisms for addressing staff grievances and recognizing their efforts is a concern, with only 11 out of 69 PHCs having such systems in place.
While 49 PHCs operate on weekends, the staff strength is varied, and the minimum expected staff strength is not met. This could impact patient care quality, particularly during weekends. The staffing composition includes 148 Community Health Extension Workers (CHEWs), 46 nurses/midwives, 22 health assistants/support, 19 pharmacy technicians, 15 doctors, 7 community health officers, and 56 others. This indicates a reliance on a diverse but potentially insufficiently skilled workforce for weekend operations.
The average daily usage per PHC is 11 patients, with 511 communities relying on the surveyed PHCs, reflecting substantial community reliance on these facilities. However, a concerning 41% of patients struggle with affordability, highlighting significant barriers to accessing healthcare and raising concerns about patient throughput and the financial burden on the community.
No estimated mortalities have been reported in the last five years, and 261 referrals were made over the last year, primarily due to special cases and severe delivery/labour. This suggests the PHCs’ capability to manage common ailments but potential limitations in handling more complex cases. The referral patterns and reasons highlight critical gaps in PHC capabilities and the need for improved facilities to handle complex cases locally, reducing the reliance on referral services.
Treatment quality and immunization services in Osun are generally positive but uneven across facilities. The quality of treatment is rated as excellent to good in 32 PHCs and poor to very poor in 17 PHCs, while immunisation services are rated excellent to good in 62 PHCs and poor to very poor in seven PHCs. Overall, 47 PHCs received excellent or good general ratings, whereas 22 received fair or very poor ratings. These findings align with the National Primary Healthcare Development Agency’s (2020) report highlighting the need for quality improvement initiatives in PHCs nationwide.
In light of these findings, it is clear that Osun State’s primary healthcare system faces significant challenges that threaten the delivery of safe and effective healthcare services. Urgent attention and investment are needed to address these gaps and ensure that residents have access to quality healthcare services. The state government must prioritize renovation and maintenance of its PHCs, focusing on the three dilapidated facilities and addressing the identified building failures. Additionally, addressing medical equipment and supply shortages, staffing disparities, and staff support are crucial to improving the health outcomes of Osun’s residents.
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