Raymond Osho, on a recent tour of Primary Health Centers across Ogun State, uncovered a distressing reality plaguing its residents. What he witnessed painted a grim picture of inadequate healthcare facilities, particularly affecting women and children in numerous communities.
The scarcity of accessible healthcare services has exacerbated their plight, leaving them vulnerable to preventable health risks and crises. As Raymond delves deeper into his investigation, the stories emerging from these areas reveal a pressing need for urgent intervention to address the healthcare disparities plaguing Ogun State
“I was at the health centre for three days during labour. Throughout the three days, I went through hell. We couldn’t get drugs, there was no light.
“We had to go miles to get drugs because the hospital has no drugs. Gave birth to my other two children at the same health centre and it was the same experience.
“It was a moment of horror”,this was the pathetic experience of a 34-year-old Olusoga Rasheedat, a resident of Ebute-Igboro in Yewa North Local Government area of Ogun state.
Rasheedat narrated her harrowing experience during her period of childbirth after sue was rushed to a nearby primary health center in the community.
A family source who was with the mother of three told this reporter that Rasheedat found herself in a facility that lacks essential drugs, adequate lighting, and other crucial resources necessary for a safe delivery.
It was discovered that lack of essential medication forces residents of the community to endure the grueling journey of miles in search of basic drugs and even proper care.
The absence of electricity further exacerbated the dire situation, plunging the facility into darkness and rendering it incapable of providing adequate medical care.
Worried by the situation, Mr. Yinusa Bankole the Chairman, Ebute-Igbooro CDA wondered why the state government has lingered in rehabilitating the health facility. Through his capacity, Yinusa had written politicians to intervene, seeking for renovation and donation of equipment but his effort yielded no result.
“A few weeks ago, I took my child to the health center for treatment, only to discover that it lacks essential equipment and even windows. Recently, when I sent some engineers for inspection, we found out that the ceilings are in a deteriorating condition.
The estimated cost for fixing the ceilings was exorbitant, leaving me in a situation where I couldn’t afford the necessary repairs.
“It is concerning that an aluminum pan is being used to cover the window at the health center. Action needs to be taken by the government to address this issue.
While we acknowledge the role of the government, there are also actions that we as citizens can take to improve the situation. It is worth noting that the last renovation of the facility took place during the tenure of former governor Olusegun Osoba.”
…Same Reality Different Communities
Similar to Ebute-Igboro, the primary health care centres in Lakiri and Ode-Omi communities in Odeda Local Government and Ogun Waterside Local Government respectively are in the same condition.
The deplorable condition of Lakiri Health Centre in Odeda Local Government which has been abandoned for over a decade is disturbing. Built over 50 years ago, the once-vibrant health centre that served over 150 communities now lies in ruins, its facilities overrun by goats and rams.
The health centre’s demise has exposed community members to grave health risks, resulting in the loss of numerous lives.
“This Lakiri health centre had been in existence over 50 years ago. The last time it was functional was 10 years ago.
One of the issues that really contributed to the total shutdown of this health centre is that when nurses stopped coming to attend to patients perhaps due to the distance.
“This health centre used to be the major centre where people from neighbouring communities come for treatment,” said Adebayo Adisa, Lakiri community leader.
Another community member, Adebayo Noimot said “When I gave birth to my first child here, this health centre was still in good condition but today it is totally down. We now travel to the Federal Medical Centre in Abeokuta for treatment. We need help.
The feeling of neglect and abandonment continues to overshadow the residents of Ode-Omi community, as several appeal to the Ogun state government to intervene on the dead state of their Ode-Omi health centre continues to fall on deaf ears.
Ode-Omi shares the same peninsula with lekki in Lagos State and it is the only coastal area that Ogun has, unfortunately, the town is naturally isolated from the rest of Ogun State due to lack of access or motorable road.
A community member, Babatunde Idris said “As big as this place (health centre) is, there are no facilities there. The nurses and patients sleep on the same bed and this can cause a spread of diseases. This facility is just empty, no equipment.
This is very unfortunate so we are calling on the state government to do something as soon as possible. To get medical care is a big challenge. For how long are we going to continue like this?
“We are not saying that the government is not trying but this is about life. We are really suffering here”.
… Between Life And Death: The Agony Of Childbirth In Ode-omi
Mrs. Kudirat Adedayo in the Ode-Omi community shared the distressing experience of her daughter’s near-fatal childbirth ordeal at the community’s primary health centre where there was no ambulance or speed boat.
Her daughter’s life hung in the balance due to the centre’s inadequate facilities and personnel. The pregnant daughter of Mrs Adedayo was in labour for over an hour, and even after delivering the baby, she began bleeding profusely because the placenta didn’t come out, an incident that almost claimed her life.
“When we are pregnant and we are approaching delivery, we are always in fear. Because we know that the experience will be between life and death as a result of the condition of our health centre.
We don’t have enough health workers in the facility. One day, my daughter came here to deliver a baby, she was in labour for over one hour.
“After she narrowly gave birth to the child, the placenta did not come out so blood began gushing out of her. We were referred to a standard hospital, far away. We left this village around 3:00 am with a good Samaritan’s car and we got there by 6:00 am.
“We gave her six cans of evaporated milk to drink for her to stay alive. If not for God’s intervention, she would have died. If it is that we have all the necessary things in this health centre, such wouldn’t have happened.
Ode-omi And Its Economic Potentials
The untapped economic promise of Ode-Omi within Ogun State is a tale of immense potential overshadowed by neglect from the state authorities.
Nestled between the sea and lagoon, Ode-Omi possesses a unique advantage that has not been recognized and nurtured by the government.
Regrettably, this lack of attention has led to an enticing proposition by neighboring Lagos State for Ode-Omi to join its fold, drawing on the riches that such a location could bring. Of course, the health facility in Ode-Omi would be fixed if it joins Lagos state.
“Despite this tempting proposal, the resilient we are still holding fast to the legacy and heritage of our forefathers, choosing to remain in Ogun State rather than forsake our roots, even in the face of adversity and uncertainty” One of the community leaders, Chief Wasiu Hassan affirmed.
Ogun Govt Promised To Rehabilitate PHCs
Contrary to the ugly narrative in these communities, the Ogun state government claimed that it had invested massively in renovating and equipping PHCs with qualified health personnel in the state and introducing tricycle ambulances, among other facilities.
In January 2024, the Ogun state government pledged to rehabilitate 472 Primary Healthcare Centers (PHCs) in Governor Dapo Abiodun’s second tenure to consolidate the administration’s gain in the health sector.
According to the Commissioner for Health, Dr Tomi Coker, at least 100 PHCs were rehabilitated during the first term of the governor and promised that the stride would be sustained during the governor’s second term in office.
During a retreat organised for the management in the Ministries, Departments and Agencies and health facilities in 2024, Coker said “His Excellency invested in ambulances and supported the formulation of a policy, where we had a guideline of referral methods from the traditional birth attendants to the PHCs to secondary facilities and then the tertiary.
“From our findings, after six months, we realised that we have existing resources in the system to deliver better healthcare services and saw a 40 per cent increase in referrals from PHCs to secondary facilities,”
Poor Primary Health Care System Contributing To Early Death In The Rural Areas – Experts
A Community Health Extension Worker, Gbemisola Olaleye speaks about the danger of lack of health centers in a community. According to her, communities without health centers risk the spread of communicable diseases, and early death.
“If there is no PHC in a community, there will be no immunisation in such a community which can translate to high risk of communicable disease. Death rate will increase. The community members will result in unsafe practices that are injurious to their health.
“Lack of PHC is also contributing to early death in affected communities due to lack of equipment and drugs. If a primary health centre lacks manpower, drugs and equipment that health workers can work with, this can lead to early death in such a community.
For example, in a community where a farmer is beaten by a snake while working on his farm, or injured by cutlass when the person is rushed to a primary health centre, even if there is somebody there to attend to him, if there are no drugs or equipment, the victim will die. So, if the primary health centre is not sound in terms of manpower and drugs, it can contribute to early death”, she said.
A Senior Registrar, Community Medicine and Primary Care Department, FMC, Dr Omolola Akinmolayan described primary healthcare as the foundation of a country’s healthcare system, which provides a range of healthcare services to help people stay healthy. Akinmolayan stressed the possible risk of lack of primary healthcare centre in a community to include; high cost of care and poor health outcome.
“Poor primary health systems contribute to early death in the rural areas due to challenges like poor manpower, and poor infrastructure. Some of the challenges faced by rural communities are limited access to health care and this is because they may need to travel long distances to reach healthcare facilities. Other challenges are poor health information from low health literacy level and inadequate manpower.
Challenges Of PHCs In Nigeria
According to the World Health Organisation (WHO), some of the key challenges facing primary health care in Nigeria include inadequate funding, insufficient healthcare infrastructure, and a shortage of healthcare workers.
Despite these challenges, the Nigerian government has made efforts to strengthen primary health care, including the development of a comprehensive national health policy and the expansion of primary health care services to all local government areas.
As part of the innovative drive towards transforming primary healthcare delivery in Nigeria, the World Health Organization (WHO) officially signed a Memorandum of Understanding (MOU) with the Private Sector Health Alliance of Nigeria (PSHAN) under the “Adopt-A-Healthcare Facility Program (ADHFP)”.
The partnership between WHO and PSHAN signifies the collaborative effort to accelerate financing and access to quality primary health care delivery for improved health outcomes in Nigeria as the foundation for Universal Health Care Coverage (UHC) and health security.
It comes at a time when the Coordinating Minister of Health and Social Welfare is rolling out implementation of the Health Sector Renewal Investment Program (HSRIP) and the innovative Sector Wide Approach (SWAp) in collaboration with the States, and development partners.
WHO is helping member countries to reorient their health systems towards PHC as a key means towards achieving UHC, SDG3 and health security. Health systems should be fit for people, fit for context and fit for purpose.
Health system strengthening involves strengthening of health governance and financing; the health workforce; gender, equity and rights; information systems; quality and patient safety; maternal, newborn, child and adolescent health through to healthy ageing; sexual and reproductive health; medicines and medical supplies; emergency preparedness, response and recovery; work on communicable and non-communicable diseases, among others.
Foundation’s Intervention
A nonprofit organisation in Ogun state, Wellness Africa Foundation (WAF), with the support of Nigeria Youths Future Funds and Leap Africa began a community sensitization and stakeholder’s engagement in 2024 to galvanise the support of state and non-state actors to revamp and strengthen Primary Health Centres in Ogun State.
The organisation focuses on advocacy for reforms in health and agriculture sectors through awareness creation and strategic engagements with key stakeholders to amplify the voices of marginalized communities.
Our findings show that the organisation is taking measures to advocate the rehabilitation of abandoned primary health facilities in the 20 local government areas of the state. For instance, the NGO began its media campaign on the renovation of Ogun PHCs using the print, electronic and the social media. The Organisation had also written several letters to the state Ministry of Health by the approval of leaders of the affected communities.
… The Way Forward
Akintunde Akinmolayan, the Executive Director of Wellness Africa Foundation, believes that one of the ways forward is community support for the state government to enhance healthcare services in the affected communities.
He stressed that the government alone cannot renovate the dilapidated health facilities and that community support is also necessary to refurbish them. For instance, Akinmolayan said, people from those communities who study medicine, nursing would prefer to travel out of Nigeria to practice the profession, this he argued that it reduces the number of medical personnel in the various health centres.
He said “We are urging community members to support the health centres through initiatives such as reaching out to indigenous sons and daughters in diaspora for support, encouraging your daughters to enroll for the community midwifery program at the Ogun State School of Nursing to cushion the dearth of health workers. We are also calling for community collaboration to pull resources together for these health centres”.
“The government is investing in hiring more doctors and nurses for our hospitals, but unfortunately, many of these personnel leave the country after just a few years, or months. This raises a critical question: what can the government do to address this brain drain?
“As stakeholders, we must acknowledge the truth. Are there not instances where people have stolen equipment and sold it, without facing consequences from the community. This is unacceptable, especially since the equipment was provided by the state government.
“When women spend around N6,000 to transport themselves to a distant hospital for a scan, imagine if they pooled their resources together – they could have achieved something significant for their local health center. However, many times, we show less concern because we view it as ‘government property’, rather than taking ownership and responsibility for our community’s healthcare needs.”
We Will Start Renovating PHCs – Ogun
To end the ugly narrative, the Ogun State Government has disclosed that it is embarking on the revitalisation of 75 Primary Health Care centres across the state’s 20 local government areas.
The state says it will execute the project through partnership with World Bank, noting that the PHCs would greatly increase access to quality healthcare for rural and underserved populations.
“This initiative aligns with the governor’s mission to ensure the wellness and well-being of all citizens by providing accessible healthcare services, especially for those in remote areas,” he stated.
“Poor primary health systems contribute to early deaths in rural areas due to challenges like poor manpower and poor infrastructure.
Some of the challenges faced by rural communities include limited access to healthcare, often requiring them to travel long distances to reach healthcare facilities.
Other challenges include poor health information due to low health literacy levels and inadequate manpower.”
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