A survey carried out by a national daily exposing the neglect and rot in the primary healthcare sub-sector is a sad commentary which the states and the local government councils should feel sick about.
The investigation further exposed the two tiers of government as not only irresponsive to the health needs and challenges of their people but also insensitive to their responsibilities.
According to the report, virtually all the primary healthcare destinations all over the country have been reduced to mere consulting clinics in places where medical personnel are found. In most places, no doctors are available, while nurses and other auxiliary staff are in short supply. Besides the dearth of personnel, medications and other services are never provided.
In terms of infrastructure, most of the centres are in a dilapidated state and lacking basic facilities to handle minor cases prevalent in the rural communities. Some healthcare centres have been forced to shut down altogether owing to poor funding or lack of it. The primary healthcare centres are supposed to be the first medical laager to the grassroots.
Curiously, most of the states have primary healthcare boards but it is an irony that under their watch, most of the centres are anything but medical facilities.
As a result of this gross neglect of the sub-sector, the rural populace is left at the mercy of quacks masquerading as medical personnel and traditional medicine practitioners in the rural areas.
Sometime ago, declaration of a state of emergency on public health in relation to maternal and child deaths occurring at the primary healthcare centres was announced by no other than the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr. Fasal Shuaib. This was because pregnant women and children have been the major victims of the pathetic state of the sub-sector.
He had lamented the appalling health statistics in the country, especially in the area of maternal and child mortality rate, noting that there was the need to reduce maternal and child care challenges through investigating deaths of women related to childbirth and provision of toll-free numbers for Nigerians to supply information to raise the sense of accountability for preventable deaths.
He was particularly enthused by the assurance indicated by the 36 states of the federation and the Federal Capital Territory (FCT), Abuja, to buy into the initiative to achieve its purpose. However, a few months down the road, the assurance has remained a mirage and the scourge is ravaging the sub-sector unhindered.
On the whole, the healthcare policy even of the federal government has not been citizen-friendly and does not favour the average Nigerian who depends on the public hospitals and clinics to access medicare. Besides, owing to congestion in the public healthcare destinations that are functional, deplorable service delivery and high charges, many have surrendered their fate to patent medicine dealers, hospital/clinic attendants masquerading as midwives in their neighbourhoods and quack healthcare givers.
Worse still, many take refuge in self-medication or settle for traditional medicines hawked around the streets. Others, driven by poverty and ignorance, prefer to go to prayer houses for solutions to ailments that require medical attention.
At the root of this general neglect are mismanagement of resources, systemic corruption, insensitivity and greed on the part of government officials. In a situation where local government councils which are the driver of the sub-sector are financially emasculated through the instrumentality of the controversial joint accounts, nothing positive should be expected. A glaring instance gained national attention in 2019 when the Zamfara state chapter of the Association of Local Governments of Nigeria (ALGON) raised an alarm over the disbursement of N5m as a June allocation to each local government council for primary healthcare services. The Zamfara experience is not peculiar to that state alone.
The report is a wake-up call for government at all levels, especially under the Tinubu administration, to give the health sector the attention it deserves. It has become increasingly imperative to bring healthcare delivery to the doorstep of the average Nigerian at affordable cost. Successive administrations have failed in this respect. It is this state of affairs that has led to the migration of our medical personnel to foreign countries where they enjoy good pay, conducive working environments and state-of-the-art facilities to work with.
