Our correspondent visited Gama Primary Healthcare Centre (PHC) located in Gama Ward in Nasarawa Local Government Area of Kano State, one of the over 300 revitalised PHCs in the state under the 2023 FG/NPHCDA programme, and reports on how the revitalisation project transformed service delivery as well as other challenges faced at the Gama PHC.
When Hafsat Sani (not real name) was brought to Gama Primary Healthcare Centre (PHC) in her last stage of labour to deliver her baby, she met two other women in the labour room, as such she has to wait before she could get entry into the delivery room.
Therefore, Hafsat was asked to wait at the labour room’s reception because at the Gama PHC, women in labour must queue to use the facility’s sole delivery bed.
As such, whenever multiple expectant mothers arrive at the PHC for delivery at the same time, they have to join a queue before they can get access to the labour room and deliver their babies.
A midwife working at the Gama PHC told Daily Trust that, “In the event of multiple birth deliveries, we have to rush and wash the bed to attend to the next woman in the queue.
“There is only one bed in the labour room, so in the event of multiple deliveries in the labour room, we have to improvise, whereby an observation bed is used to receive the delivery. And at least seven women delivered in the facility daily.”
After waiting for over an hour, the midwives rushed to wash the delivery bed to attend to Hafsat who was next on the queue.
Gama Gabas PHC, located in Gama Ward in Nasarawa Local Government Area of Kano State, was among the over 300 PHCs in Kano State that were revitalised under the programme spearheaded by the Federal Ministry of Health and the National Primary Health Care Development Agency (NPHCDA).
The upgrades focus on infrastructure, equipping health workers, and securing a reliable power and water supply.
It was gathered that the revitalisation has brought changes in the electricity and water supply, and staff productivity. A development that increased patients’ influx to the facility for healthcare services.
As such, when Mariya Umar’s son complained of a stomach ache, she brought him to the facility, and the health workers attended to him within a short time and prescribed drugs for him.
However, Daily Trust learnt that despite the revitalisation, Gama PHCs still battle a dearth of skilled health workers and basic equipment to function optimally and serve the large population surrounding the facility.
It was gathered that the health facility is one of the three major PHCs in Gama ward that are providing health services to about 30,000 people.
Our correspondent reports that despite the large number of people it serves, there is not a single medical doctor in the facility. The facility relies on nurses, midwives, CHEWs and other health technicians.
Deputy In-Charge of the PHC, Malam Danladi Muhammad, told Daily Trust that the facility was renovated about two years ago.
But according to him, even before the renovation, it was in relatively good condition.
“It was constructed in 2015 by a lawmaker representing the area. So, it was relatively in good condition before the renovation. Basically, there is not much difference between before and after the renovation.
No new building was added in the facility; the contractor just applied new paint, some floor work in some areas, and replaced the roofing in the maternity and ANC wards with an aluminium roof. He also changed some doors and locks,” he said.
Malam Muhammad stated that the 40-bed PHC provides 24-hour services in the areas of Antenatal Care, Delivery, Pharmacy services, Routine Immunisation (RI), Family Planning (FP), Accident and Emergency, Laboratory service, Out-Patient Department (OPD) and the Kano State Contributory Health Care Management Agency (KSCHMA) under the BHCPF.
However, he said despite running a 24-hour service, the PHC lacks some basic facilities that function optimally. For instance, there is a blood bank; however, the health workers can only screen, and the patients have to find a donor.
“The scanning machine and some of the equipment are not working. Sometimes patients have to visit private laboratories before they can get a test or scanning, which are often very expensive.
“Also, the solar system is not covering the whole hospital, thereby resorting to rationalising the gadgets to avoid breakdown of the solar system. But there is adequate water supply, with a dedicated borehole,” he said.
Malam Muhammad also lamented that only 24 staff work in the facility as permanent staff. But over 100 others work as temporary staff, receiving a meagre monthly allowance which hardly covers their transport fare.
He added that the PHC needs at least 30 more staff to work effectively.
He said, “Each of the units needs at least five more staff to run the shifts effectively as a 24-hour facility.
“There is no single permanent staff in the A/E units of the hospital, even though about 15 staff run the unit, but none of them is a permanent staff. At least 10 dedicated staff are required to work at the A/E.
“The GOPD alone receives at least 20 new patients daily. While the facility in general receives a minimum of 200 patients daily who visit for different types of ailments and diseases.”
He, however, added that despite the shortage of staff, the maternity unit is doing its best to provide good services to pregnant women. “We always refer expectant mothers with complicated cases to a secondary facility to avoid complications.”
The deputy In-charge further stated that blood transfusion cannot be conducted in the facility. “We can only screen or conduct tests in our laboratories.
“But drugs are available and affordable, and there is no issue of drug stockout; patients can get their drugs within the hospital,” Muhammad explained.
He, however, added that, “despite these challenges, we are doing our best to run the PHC effectively; a patient can be attended to, get his or her prescribed drug and leave the hospital within one hour.”
PHC Management not contacted before renovation
The PHC management said they were not contacted before the contractor carried out the renovation.
“We were not contacted when he came to start the project. The contractor just came with a letter and told us he was directed to renovate the facility. But there is nothing we can do about it because he just came, did what he did, and left.
“There was no provision of new beds, bedsheets, or other equipment in the work he carried out. As such, we are still using the equipment that was provided when the hospital was commissioned 11 years ago.
“Had we been contacted for our input, we would have told him that the facility needs a security post, because we experience security breaches from time to time. Miscreants sometimes used to break and steal drugs and other valuable equipment,” Muhammad complained.
Government to employ, post more health workers to PHCs
Speaking on the staff shortages, the Director General of the Kano State Primary Health Care Management Board (KSPHCMB), Professor Salisu Ahmed Ibrahim, said they have a plan to employ more health workers to be posted to the PHCS.
He said, “Presently, Governor Abba Kabir Yusuf has approved the employment of 2,500 medical healthcare personnel across all the cadres, which includes doctors, pharmacists, nurses, CHEW, JCHEW, laboratory and pharmacy technicians.”
“However, there is another plan to revitalise other PHCs and equip them with modern equipment to provide qualitative healthcare to our people. Already the proposal has been submitted to the governor, and we are waiting for his approval,” he explained.
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