Primary healthcare centers are the closest and most accessible healthcare facilities for every community. Though primary healthcare centers have certain health complications, they are the first point of call for many residents in need of health services, especially in rural areas and in emergency cases.
Bearing in mind the extreme importance and role of primary healthcare centers, it is ideal that primary healthcare centers are properly equipped with medical supplies, healthcare equipment and workers, in line with the global standard practice, to enable effective and efficient service delivery.
But a visit to Amansea Health Post in Amaowelle Village, in the Awka North Local Government Area of Anambra State was rather a dramatic and heartbreaking experience.
Though located less than two kilometers from Amansea Junction along Enugu-Onitsha expressway, the first three residents of the village including commercial bike riders approached by our reporter for directions to the health post neither knew about it nor how to get to the health facility.
“I know the place, sir. But many people don’t know about it because it is not really working. Most people go to the other health centers in a village across the main road. It is actually farther than this one but that one is working,” one middle-aged motorbike rider said as he approached the reporter who was already looking frustrated and confused, having asked three residents for directions to the health facility without success.
Another confusion overwhelmed the reporter when the motorbike rider, rather than taking him to a place that could pass for a health facility, took him to a residential building surrounded by overgrown grasses.
Mistaken for being a small chemist, the reporter walked up to two women, one of whom was pregnant. The women were seated in the front room of the two-room rented apartment, dressed casually. When asked for the health post, the reporter was told that he was in the right place.
One of the women who later identified herself as a Community Health Extension worker and the only health worker available at the time of the visit lamented that the health facility lacked virtually everything needed for healthcare service delivery.
It was observed that one of the two bedrooms served as a ward while the health post had a total of four beds, out of which, one was completely damaged while one, though being used, was no longer in good condition.
SaharaReporters confirmed that the health post had no bandages, gloves, personal protective equipment, injection ample, methylated spirit, disinfectant, blood pressure apparatus, weighing scale, drip, oxygen gas for patients, stretcher, drip stand and scissors.
“We don’t have anything here. Our blood pressure apparatus is not working. There are not enough drugs here. We buy syringes that we use to attend to a few people that come here because the people that come here are not even many,” the health worker who spoke under the condition of anonymity lamented.
She added, “Even our kerosene that we have here is not working. We don’t have a restroom at all let alone being clean and functional. We don’t have an ambulance, in fact, we have not referred anyone to larger hospitals in the past one year.”
When asked about the total number of health workers assigned to the health post, she said three, but she was the only person on duty when our reporter visited the facility. She added that they buy water from the neighbouring compound as they do not have any source of water supply at the health post.
Asked if the staff members of the health post were satisfied with their working conditions, she said, “No, how can we be satisfied with a place like this? Imagine our kerosene stove is not even working. We don’t have many things to work with here. Sometimes we just come and stay here because we have no option. People hardly come here. They prefer going to other health centers. Some of the materials we use, my head buys them.”
The staff of the health post lamented that the non-availability of the needed medical supplies and equipment has become the major hindrance to their effective service delivery. They further revealed that annually, only about 50 persons and a few more visit the health post for medical services. She said that the health post required urgent intervention including moving it to a permanent site where they had land in the community.
She also called for the provision of adequate medics and other equipment including labour ward equipment, fans, personal protective equipment, beds, a standby power generator, and more workers including at least a doctor and a nurse.
More Health centers Visited, Similar, Worse Conditions Observed
While it could be acknowledged that the state and federal governments and some donor agencies have tried to salvage the situation of primary health care centers in Anambra state, unfortunately, many primary health care centers in the state greatly lag in medical supplies, health care equipment and health care workers.
Whereas one of the major primary roles of primary health care centers is to refer patients with health complications, especially in times of emergency, to larger hospitals, the investigation showed that only one out of 16 primary health care centers visited across at least five local government areas in Anambra had a partially malfunctioning tricycle, popularly known as Keke Napep as an ambulance.
Shortage of medical supplies, equipment and health care workers has become a cause for concern in many primary health care centers in the state as some PHCs do not have labour wards, let alone have equipment, necessary medicines and personnel for child delivery.
These shortages of medical supplies, healthcare equipment and health workers have greatly affected effective and efficient service delivery in many primary healthcare centers in the state.
Visits to 15 other primary health centers and health posts across the state showed that shortage of medical equipment and drugs seems to have become a norm in the state as all the facilities recorded shortage of drugs, labour ward equipment, and other medical supplies, which in turn speak volume of what to expect at the health facilities.
At Community Reproductive Referral Health center, Akwaeze located at AYC Hall in Umuideke Village, Anaocha Local Government Area of the state, it was observed that the health center, despite recording a large number of people visiting the health center for medical services, it has only one ward, seven beds, no pharmacy, no bandages, GV Ink, Methylated spirit, disinfectant, Oxygen Gas for patients and stretcher, while one of the health workers in charge of maternity said other medical supplies available were not sufficient.
With at least six communities depending on the primary health center for medical services, a staff member of the center told SaharaReporters that the health facility recorded an estimated 100 persons visiting it for medical services annually, adding that the health center had recorded at least two deaths in the recent past.
The staff member whose identity was not disclosed for fear of victimization said, “We would have been rendering great services here but there are many things we don’t have. We need a generator, refrigerator, fans, functional pharmacy, at least a doctor, more health workers, and this place needs annual fumigation because there are a lot of Mosquitoes and it disturbs us and patients.”
In the same vein, Aguluzigbo Primary Health center located at Ifite Aguluzigbo, near St Patrick Catholic Church, was filled with damaged tables, chairs, doors and hospital beds, with no pharmacy. The health center is inside a community hall with three wards partitioned with plywood and it was already falling apart.
Despite having recorded at least eight referrals to larger hospitals in the past year due to complications of the patients’ health challenges, the health center had no ambulance to hasten the movement of patients.
The health center also had no weighing scale, oxygen gas for patients, personal protective equipment for staff, stretcher, gloves, boots, no restrooms, while our reporter was told that it had been over 10 years since a health worker was last recruited at the facility.
It was learnt that there was no regular training for the four workers managing the health center, out of whom, two were Community Health Extension workers.
At Adazi-Nnuku Community Reproductive Referral Health center in Umudiana Village, Anaocha Local Government Area of the state, there were damaged doors, windows, hospital beds and leaky roofs.
Just like most of the health facilities visited, with at least eight communities relying on it, the health center which a midwife said had not been renovated for the past 10 years, had no bandages, personal protective equipment, GV Ink, oxygen gas for patients, stretcher, drip stand, suction machine, sterilizer, Forcep, delivery table and clean and functional restrooms.
Our reporter was told that the health center had a functional ambulance but there was no ambulance on the hospital premises nor was there any confirmation that it was on duty outside the health center at the time of the visit to the facility.
Amid the medical supplies and equipment shortages, the midwife said that the health center records at least 480 visits annually for medical services.
The midwife lamented, “We need one small and one big generator, more workers, urgent renovation, changing of loofah windows. We also need increased pay and incentives.”
Nkpologwu Model Primary Health center located opposite the library in Isiorji Village in Aguata Local Government Area had damaged doors, windows, hospital beds, tables, chairs, leaky roofs and damaged medical records, it had no syringes and scissors, yet, a Community Health Extension worker who was met at the facility said the hospital recorded about 3,000 persons visiting it for medical services annually.
She said the health center urgently needed more staff members, equipped laboratory, borehole, tables and chairs, urgent fixing of the leaky roofs, provision of placenta pit, hospital beds and mattresses, provision of Sphygmomanometer, delivery coach and bedpan, episiotomy equipment and delivery kits, among others.
Visits to Oye Achina Primary Health center near Oye Achina Roundabout in the Aguata Local Government Area, Amesi Primary Health center beside Ascon Hall, Amuwo in the Aguata council area, Ora-Eri Primary Health center in Umunriofia, opposite St Mary’s Catholic Church in Aguata LGA, Ikenga Primary Health center, near Ikenga Market in the Aguata council area, Queen of the Rosary Clinic, inside Queen of the Rosary College, Oguta Road, Onitsha in Onitsha North Local Government Area and Abakpu Health Clinic, near Oye Market, Abakpu village in the Oyi Local Government Area, all presented similar or worse conditions.
Similar shortages and pitiable conditions were observed at St Stephen Primary Health Care center using a room inside Brothers of St Stephen Chaplaincy Catholic Church, Nkwelle Ezunaka in Oyi LGA. The health facility did not have even functional blood pressure apparatus, beds or drip stands.
At Recreation Health Post inside Gatehouse in Recreation Club, Bridge Head 2, Housing Estate, Onitsha in Onitsha South LGA, St Barnabas Health Post inside St Barnabas Anglican Church, Emordi Street, Onitsha in Onitsha South LGA, and Sokoto Road Health Post inside a tailoring shop at No. 69 Bida Road, Odoakpu, Onitsha in Onitsha South LGA, the level of shortage of medical equipment, drugs and staff is also alarming.
The Danger Has Ripple Effects On State, National Health System – Expert
A Community Health Expert, Dr. Ikechukwu Joshua, a medical expert in Ebonyi State said that shortage of medical supplies, equipment, and staff at primary health centers can have significant implications on the government and the general public.
He said, “Shortages can hinder the government’s ability to respond effectively to public health crises, such as disease outbreaks or natural disasters, potentially leading to an overwhelmed healthcare system and inadequate emergency preparedness.
“Shortages of healthcare equipment and medical supplies and staff at the primary health care level may lead to increased healthcare expenditure for the government, as it may need to allocate additional funds to procure necessary supplies and equipment, hire more staff, or address the consequences of compromised patient care.
“Persistent shortages can lead to public outcry and political backlash, negatively impacting the government’s reputation and credibility in addressing healthcare needs.
“It can affect societal well-being, leading to decreased access to essential healthcare services, reduced productivity due to illness, and an overall decline in public health outcomes.
“It may exacerbate healthcare disparities and inequalities, particularly in underserved communities, leading to unequal access to quality healthcare services.
“Addressing the dangers posed by shortages requires the government to prioritize healthcare infrastructure, resource allocation, and workforce planning to ensure the sustainable delivery of essential healthcare services to the population.”
Efforts made by SaharaReporters to reach the Anambra State Commissioner for Health, Dr. Afam Obisike, on its findings on the state of primary health centers in the state and to find out what the government could do to salvage the situation, were not successful.
He did not answer calls from the reporter nor reply to the message sent to his mobile line.
This story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science.
