Primary health care delivery in Bayelsa: A monitors perspective

Nigeria holds the record of having the second infant/maternal mortality rates in the world. About one million Nigerian kids die each year from ailments that could be prevented by the adoption of basic hygiene practices and the administration of inexpensive medicine. Others include proper dietary habits, iodization of salt and the use of insecticide treated nets.
Grim as the introductory scenario may appear, current statistics on the matter also does not give hope for respite as it indicates that the death rate has climbed even higher. Attempts by the governments in Nigeria , International health organization and other well-meaning bodies to halt the onslaught could be liken to a drop of water in the ocean.
Many have pondered, what is the reason for this scenario? Why has the huge resources sunk into the health sector coupled with support from major health organizations in the world failed to failed to bring about a turn around of the situation? And what then is the responsibility of the individual in respect to this dire reality.
Perplexing as these questions may seem, the answers stare at us in the face. African countries with smaller resources have able to reduce infant/maternal mortality to the barest minimum. As it was done those countries all hands must be on deck in Nigeria , including the very rural vulnerables.
Once again, May 27th celebrated as the international day of the child provides a platform for deliberation by all stakeholders on issues which concern children in Nigeria as well as to provide answers to the quandary of maternal and infant fatalities. In the same vein, the week-long Integrated Maternal, Newborn and Child Health (IMNCH) intervention by the federal government and UNICEF coinciding with Children's Day celebration is again another opportunity to reinvigorate health care delivery in rural environs.
In Bayelsa state, the exercise offers a team of journalists who monitored it, an insight as to what may be major challenges that face a country that may very well not meet the Millennium Development Goals (MDG).
Nigeria has one of the finest care delivery system. On paper, brilliant health policies coupled with the best medical minds that should be the envy of Africa but this has not been translated into quality health care for her populace. A critical appraisal of this paradox would simply reveal that the problem had been brought about by a systemic collapse of the health sector. For instance in Bayelsa, media monitors of the IMNCH were greeted by the sight of derelict buildings that were used primary health care facilities. At a small community in Sagbama Local Government Area in Bayelsa, a local health worker who could hardly stomach his angst wonders why government would nothing to improve on the physical structure of the health facility that was built in 1922. This situation, he complains, inconvenience his duties alongside others working with him as they are been pressured to work in an environment limited in space, lacking in security and support staff.
“I have used my money to paint and renovate this place, the place is bushy I often use funds from my pocket to engage labourers”, he angrily told monitors at his one-room health facility.
The light of the primary care-giver's dilemma, it appears that there is little that can be done at the moment as he reveals that he has complained to his head of the department who may likely passes his complaint to another up the bureaucratic ladder. As one health worker told the team, “It is what we have that we will give”.
This also drags in the issue of non-availability of drugs at primary health care centres. Despite claims by government that health is top on its priority, a visit to rural health centres would negate the assertion. The issue of 'No Drugs' has been the cause of distrust between local care-givers and rural dwellers who upon gaining information of free treatment at their local clinics are often disappointed by its non-availability.
Governments must stop paying lip-service to the health sector even as it must stop using health programmes as a platform for gaining public support during elections. It should rather brainstorm on schemes that would bring about prompt payment for health workers, an issue that has been a major source of grumbling in the sector. For instance in some of the centres visited during the IMNCH week a good percentage of the workforce were either deliberately absent because of unpaid salaries or had excuse themselves from their duty post in order to collect a one month wage after three months.
Apart from addressing this issue, government should see it as its primary duty to provide incentives for health personnel in the course of carrying out their assignments. Also ancillary, government must deliberately embark on policies that would invigorate the economy of rural dwellers as malnutrition and vulnerability to diseases can not be divorced from poverty. The above also brings to fore the recent budget by the Bayelsa state government where the state's ministry of finance was given a far higher allocation than the ministry of health, commerce and industry.
Importantly, government must also address the issue of non- availability of drugs in primary and tertiary health institutions if it wants to be taken seriously. Companies and other corporate interests must not see the health sector as the responsibility of government alone but rather should collaborate with it, in sincerity and deep commitment. Prosperous members of the society should extend their charity beyond family and churches to assisting in health care delivery.
While it has been essential to pinpoint gaps in the system, it is also noteworthy to commend the First lady of Bayelsa state Mrs. Alayingi Sylva for her tremendous job in providing succor to Bayelsa kids through her many health care programmes. Her partnership with a visiting UNICEF team recently in Yenagoa should be pursued with vigor to produce positive results.
It would be out of courtesy not to mention the wife of Sagbama LGA Chairman, Mrs. Peremobowei Peretus and other primary health care-givers both in Sagbama and Akenfa-Epie, Yenagoa whose support, enthusiasm and dedication led to the success of the IMNCH in their direct constituencies.

By Theo Agidee
http://www.thephctelegraph.com/stories/June,%202010/0906feat_01.html