Two years after the Federal Government promised to revitalise 10,000 primary healthcare centres across the country, many states have said they are still awaiting the central government’s intervention.
The Federal Government had, in 2017, begun the National Primary Healthcare Revitalisation Initiative with the aim of resuscitating over 10,000 health centres across the country.
During the inauguration of the Model Primary Health Care Centre, Kuchigoro in Abuja, the immediate past Minister of Health, Prof Isaac Adewole, had said the target of the scheme was to have at least, a functional health care centre in each ward in the country.
He added that the scheme would be executed through the National Primary Health Care Development Agency.
But stakeholders in different states, including the Nigerian Medical Association branches and chapters of the National Association of Nigerian Nurses and Midwives, told The PUNCH that they had yet to see the impact of the Federal Government’s programme.
The associations and many state governments also said not a single primary healthcare centre had been rehabilitated in their states.
But the NPCDA said the programme had not been abandoned, noting that N5.8bn had been released for the revitalisation project.
FG yet to start work on any PHC – Gombe secretary
The acting Secretary of the Gombe State Primary Health Care Agency, Ali Dadinkowa, in an interview with The PUNCH, said the state had sent a list of 114 PHCs to the Federal Government, stating that the central government had yet to start work on any of them.
“We were asked to send across the list of our health centres, but work has yet to start. The state enjoys a donor support from the Bill and Melinda Gate Foundation, which cuts across about 57 facilities,” Dadinkowa said.
A visit by one of our correspondents to some of the PHCs in the state indicated that the Federal Government’s intervention was needed to make health care accessible to the people through the centres.
At the Kundulum Primary Health Centre, Akko Local Government Area on Friday, there were only two health workers on duty.
One of the workers, Abubakar Aliyu, who is a community health extension worker, said, “There are about 32 settlements that use this facility and on a daily basis we see 30 to 50 patients. We don’t have medical doctors here.”
He said although nine people were employed, two of them, who were women, had never reported for work at the centre.
The PHC, which serves 32 communities of about 20,000 people, has six beds, “a maternity ward with one isolation room and delivery room.”
But Dadinkowa said, “Ideally in the state, each ward should have a primary health centre. We have 114 wards in Gombe State, but there are some without adequate equipment. So roughly, about 110 are functional.
“We have an agreement with the Bill and Melinda Gate Foundation and they are currently working in 57 health facilities. They engage in staff training and equipping.”
Some PHCs now churches in A’Ibom — NANNM chairman
In Akwa Ibom State, the Chairman of the NANNM, Patrick Odu, said some of the health centres promised by the Federal Government for revitalisation were not working.
Odu, in an interview with The PUNCH, said some of them had either been converted to church premises or had long been abandoned.
Odu said, “The primary health centres you are talking about are not working. The one in the Oron Local Government Area has been converted to a church. The last time I passed through the area, it was one church that was operating there.
“The one in the Urue-Offong/Oruko Local Government Area has long been abandoned in the bush. They are scattered and I cannot give you details of how they are in the state.”
He, however, said that the state government’s primary health centres were working in almost all the 31 local government areas of the state except a few with a few managerial and manpower issues.
We are not involved — Kwara PHCDA
On his part, the Executive Secretary of the Kwara State Primary Health Care Development Agency, Dr Abimbola Folorunsho, who stated that the state had over 400 PHCs, added that the state was not involved in the revitalisation of 10,000 PHCs promised by the Federal Government.
However, a nurse in a primary health centre in Kwara State, Femi Agbede, who is the National Chairman of the Forum for Local Government Nurses and Midwives, said none of the primary health centres in the country was functional.
Also, the Kwara State chairman of the NANNM, Joseph Adekanye, said primary health care in the state was poorly funded and inadequately staffed, stating that they were not provided with drugs and equipment such as thermometer, among others.
FG hasn’t touched any Lagos PHC – Medical Guild, NMA
In the same vein, the Chairman, Medical Guild, Lagos, Dr Babajide Saheed, in an interview with one of our correspondents, said he was not aware of any intervention from the Federal Government at any of the primary health centres in the state.
“They have not touched any primary health centre in Lagos State since that declaration in 2017. The only revitalisation I’m aware of is the one that has been done by the Lagos State Primary Health Care Board,” Saheed said.
A source in the Lagos State Ministry of Health, who spoke on condition of anonymity, said out of the over 300 PHCs in Lagos, about 291 were functional.
The Publicity Secretary of the NMA, Lagos, Dr Moruf Abdulasam, said he was not also aware of any Federal Government’s intervention in any PHC in the state.
But the Permanent Secretary, Lagos State Primary Health Care Board, Dr Tayo Lawal, in an interview with one of our correspondents, said, “The Federal Government is doing a lot of things. What they are doing mostly is within the basic health care provision fund. One per cent of the consolidated revenue will be given to health care.”
No FG intervention in Bauchi PHCs – Nurses’ union
In Bauchi, the Chairman of the NANNM, Ibrahim Maikudi, told one of our correspondents in a telephone interview that there was no Federal Government intervention in the primary health centres in the state.
He said the state had 323 PHCs across the 20 LGAs.
Maikudi said, “On the issue of revitalisation, all the efforts at improving the primary health centres in the state are from the Bauchi State Government. It was the immediate past administration in collaboration with some donor partners and non-governmental organisations, which funded the entire programme for the revitalisation of the PHCs. There has been no intervention from the Federal Government to these PHCs in the state.”
Plateau still waiting for FG – Officer
In Plateau State, investigations showed that the 952 government-owned PHCs had yet to feel the impact of the Federal Government’s revitalisation programme.
An official of the board, who spoke with our correspondent in Jos on condition of anonymity, confirmed the development.
She said, “We were excited when we heard of the FG’s promise to revitalise 10,000 health centres in the country but here in Plateau State, we are still waiting for them. They have not done anything. The truth is that there is nothing on the ground to show the revitalisation at the health centres which they promised about two years ago.”
She lamented that in the past four years, the state had continued to perform below average in its assessment of the functionality of its 952 PHCs in the 17 LGAs of the state.
The state Coordinator, NPHCA, Mr Ifeanyi Ohanu, when contacted by our correspondent in Jos, refused to comment on the progress so far made by the Federal Government to revitalise some of the health centres.
Also, the Imo State Government said the Federal Government was not renovating any PHC in the state.
The Special Adviser on Media to the governor, Steve Osuji, in an interview with one of our correspondents on Saturday, said, “Although our administration is new, to the best of my knowledge, there is no such thing in Imo State. “The health centre that is functional in my community was built by the Catholic Church”
States should address workers shortage – Oyo coordinator
But his counterpart in Oyo State, Mr Steve Akinrinade, said the Federal Government had renovated about 120 out of the proposed revitalisation of 10,000 healthcare centres nationwide.
In an interview with The PUNCH in Ibadan, Akinrinade said, “We have started. We are not building new facilities but it is the existing ones that we want to make functional in terms of equipment, personnel, drugs and all those things.
“It is too costly to build new facilities. We are doing it in collaboration with states as our partners. As of now, I know we have done about 110 or 120 facilities across the country.”
Asked to confirm how many of such interventions had been done in the state (Oyo), Akinrinade said, “We have done like four or five centres. The only problem we have is manpower which is the responsibility of the state government. The Federal Government cannot supply manpower to states.”
In Ogun State, both the NMA and the NANNM said there were a lot of health centres that were either not functioning or had been abandoned in the state.
The Chairman of the NMA, Dr Ismail Lawal, said, “Basically, the primary health care (centre) is the bedrock of all health facilities in the country. Basic equipment and materials must be available in the primary health centres.”
The NANNM chairman in the state, Mrs Rosaline Solarin, said the plan of the Federal Government would afford many people, who had been deprived of health care, to have access to health care.
I don’t know the number of renovated PHCs – Osun officer
When contacted, the Supervisor for Works and Health in Osun State, Mr Remi Omowaiye, said, “The Federal Government started its own (renovation of health centres) before our own. I don’t know the number of (health centres for rehabilitation) given to Osun. We are moving at different speeds.”
Omowaiye said the state government wanted to make at least one PHC functional in each ward to make health services more accessible to the people.
But the Chairman of the National Association of Government General Medical and Dental Practitioners in the state, Dr Olufemi Oroge, stated, “The rot in the primary health care is as a result of systematic neglect. Now, people who are well exposed don’t bother patronising the PHCs.
The Executive Secretary of the Sokoto State PHCDA, Alhaji Abdullahi Room, admitted that some of the facilities were functional, while some were not.
We haven’t seen FG’s revitalisation – C’River
The immediate past Director-General of the Cross River State PHCDA, Dr Betta Edu, told The PUNCH correspondent in Calabar that there were 1,060 PHCs in the state.
She said, “They (the Federal Government) said they were going to revitalise 10,000 primary health centres but we have not seen them.”
FG has started fulfilling its pledge — Adamawa PHCDA
However, the Executive Chairman of the Adamawa State PHCDA, Dr Batulu Mohammed, confirmed to one of our correspondents in Yola that the FG had started the revitalisation of some PHCs in the state.
He said, “This is something that has been ongoing. As I talk to you now, there are renovations of some primary health care clinics going on in Fufore and elsewhere. The interventions have been on and off in the state.
“Even two months ago, the Federal Government sent a mail to all of us (at the states) to give them an updated list of all health facilities in our domains, whether they are renovated by the government or partners.
“They also requested us to furnish them with those that have not been upgraded for intervention and this has been going on. The aim is to have at least one health centre in each ward that is fully functional.”
No budget for the revitalisation programme —Ex-minister
When one of our correspondents approached the Federal Ministry of Health to know the stage of the implementation of the project and what was budgeted for it, the Director, Media and Public Relations at the ministry, Boade Akinola, who had been transferred out of the ministry, through a text message said the NPHCDA would be in the best position to supply the information.
However, the immediate past health minister, Adewole, told one of our correspondents that there was no particular budget for the implementation of the project.
He explained that the cost of implementation at the beginning was to be sourced from donors, partners’ contributions and largely from part of the N51bn budgeted for the implementation of the Basic Health Care Provision Fund.
He said, “No direct Federal Government budgetary funding was earmarked for the project. We relied on donors and partners’ support. At the last count in April 2019, we had close to 5,000 completed health care centres. The implementation of the Basic Health Care Provision Fund will ensure funding for all the 10,000 public health care centres.”
Earlier in November 2018, the Executive Secretary of the NPHCDA, Dr Faisal Shuaib, said through the revitalisation programme of the FG, about 4,000 basic health care centres across the nation had been refurbished, promising that more would be done in 2019.
On Friday, a statement from the NPHCDA sent exclusively to The PUNCH, said the project had not been abandoned and that more PHCs would be done. The statement added that so far, 15 states had benefited while 119 additional facilities had reached 76 per cent completion.
The agency added, “So far, N5.8bn has been released to the NPHCDA (from the N51bn from the Basic Health Care Provision Fund) and the funds have been disbursed to 15 states. They are Niger, Abia, Osun, Kaduna, Kano, Delta, Anambra, Edo, Nasarawa, Ebonyi, Benue, Adamawa, Kwara, Plateau, Bayelsa and the FCT.
“Additional 119 new health facilities have been awarded under the 2018 appropriation with 76 per cent completion rate.”
Within a three-year period, covering 2017 to 2019, the Federal Government allocated N63.01bn to the NPHCDA. The amount is contained in the approved Federal Government budget for each of the three year period. An analysis of the budget document, as obtained from the Budget Office of the Federation, shows that out of the N63.08bn, the sum of N56.37bn is allocated to capital projects.
The N56.37bn is about 89.36 per cent of the total amount allocated in the three-year period.
Further analysis shows that the balance of N6.7bn is allocated for recurrent expenditure. This is about 10.64 per cent of the total amount.
The budget document stated that out of the N63.08bn, N19.21bn was allocated for primary health care in 2017 made up of N17.07bn for capital projects while N2.14tn was budgeted for the recurrent programme.
For the 2018 fiscal period, N25.44bn was budgeted for the agency out of which N23.3bn was for capital expenditure while recurrent expenditure was allocated N2.13bn.
Further analysis showed that in 2019, N18.43bn was allocated for primary health care. Out of this amount, N16bn was budgeted for capital projects while recurrent the expenditure got N2.43bn.
Olufemi Atoyebi, Ifeanyi Onuba, Dayo Ojerinde, Chima Azubuike, Patrick Odey, Tunde Oyekola, Armstrong Bakam, Tunji Bosun, James Abraham, Ademola Babalola, Ada Wodu, Bola Bamigbola, Hindi Livinus, Chidiebube Okeoma and Adeniyi Olugbemi