State Of Primary Health Centres In Delta

Margaret Ochenu, a 50-year-old health worker, often finds herself on the dark road from Issele-Azagba to Asaba at midnight, going home to her family after work. She finds herself on that road several times in a week, all in a day’s work at the comprehensive Health Centre.
Although the journey is not a lengthy one, about 20 minutes’ drive, the road like many in the state and the oil rich Niger Delta area, is unlit as there are no lights and accidents occur frequently in view of the dilapidated roads and equally rickety, commercial cars and buses that ply the route.
The lady, who is the official in charge of the health centre spoke with this reporter during a visit to assess the quality of services and state of facilities in the community. “The health centre is not big enough to accommodate the number of patients we have regularly. If you look outside now, you would see something that looks like a hut. That’s where we have antenatal and immunization and it is not supposed to be that way.”
Giving further insight into the dire condition of the centre, which is supposed to cater to thousands of community people, she explained also that, “We don’t have enough staff here. As the matron in charge here, I am supposed to sleep here especially, when I have a difficult delivery in the evenings. But, because we don’t have accommodation, I go to Asaba, even if it’s after midnight that I finish the delivery. I have to take that risk because there is no place for me to sleep. I can’t be sleeping with patients in the ward.

Beside the daily personal risks, Madam Ochenu and the few other staff face, the health centre lacks many basic facilities. This includes, furniture for patients awaiting attention by staff. Patients in various conditions of ill-health were seen seated on hard long benches. Ochenu said, “We need plastic chairs and ceiling fans. In short, we need a more conducive environment. Such as more spacious antenatal centre with necessary equipment and facilities like television. When patients come in they should feel relaxed.”
Madam Ochenu also drew attention to the paucity of critical personnel at the centre divulging that, “As I speak, I am the only qualified nurse working in this health centre. I have three volunteers and though they have been very helpful, we have little control over them. They can choose to stop work anytime they like because, they are not being paid by the government.”
The matron also complained about not having a Health Assistant, according to her, a volunteer has been acting as Health Assistant to her.

Primary Health Care was established essentially to bring health closer to the people in the community and through their full participation. It is meant to provide services to the majority of people based on need, without geographical, social or financial barriers.
Over the years these health centres have played a major role in the health delivery system and it is pertinent to note that many communities rely solely on these health centres for their medical needs.
According to available record, “Currently, the state of PHC system in Nigeria is shocking: only about 20 per cent of the 30,000 PHC facilities across Nigeria are fully functional. The rest of the PHC facilities cannot provide essential primary healthcare services” (www.ifeanyinsofor.com}.
There are 447 Primary Health Centres in Delta State and National Point recently visited some of these health facilities in Delta State to assess their state in line with what is playing out in the state primary health care system.

At Issele-Azagba in Aniocha South LGA of Delta State, Mrs Ochenu Margaret, who is the officer in charge of the Primary Health Centre, spoke to National Point on several issues and she also bared her mind on the challenges facing the centre. She complained about the small space, lack of adequate staff and even accommodation.
In her words: “It has been wonderful here if we put into consideration the inflow of patients both in antenatal, delivery and treatment.
“But the health centre is not big enough to accommodate the number of patients we are having. If you look outside now you would see something that looks like a hut. That is where we have antenatal and immunization and it is not supposed to be like that.
“The place does not have doors; no windows and no fans. So we are having some challenges there.
“We also don’t have enough staff here. As the matron in charge here, I am supposed to be sleeping here especially when I have a difficult delivery in the evenings. But because we don’t have accommodation, I go to Asaba even if it is after midnight I finish the delivery.
“I have to risk it because there is no place for me to sleep. I can’t be sleeping with the patients in the ward.
“Sometimes the person on night duty calls me after 11:00 pm that they are having challenges, I will have to enter the road by that time. It is just God that has been helping me all through.”

She said there is urgent need for staff accommodation even if the apartments are one bedroom apartments.
Madam Margaret also said the centre needs chairs as patients often sit on long benches during antenatal.
“We need plastic chairs and ceiling fans. In short, we need a more conducive environment such as more spacious antenatal centre with necessary equipment and facilities like television. When they come, they should feel relaxed,” the matron said.
She also complained about shortage of staff which she claimed has made the job very difficult for them at the Issele-Azagba Health Centre.
“As I speak, I am the only qualified nurse working in this health centre. I have three volunteers here and though they have been very helpful, there is little control we have over them. They can chose to stop work anytime they like because they’re not being paid by the government.”
She also complained about not having a Health Assistant. According to her, a volunteer has been acting as Health Assistant to her.
On power supply, the matron said the Centre has a power generator which they use to augment the electricity supply from the Benin Electricity Distribution Company, BEDC.
Asked if she had made official complaint to the authorities, she said the authorities were in the know of the situation.

“They do come here for supervision and they see all these things. Two persons came from Abuja yesterday. Last week, someone came from the Primary Health Care Agency. They do see patients standing and some sitting under the mango tree outside because of lack of enough space. In a month we always have between 25 and 30 deliveries in this Health Centre,” she explained.
Madam Margaret also said the centre needs more labour ward because there is only one Labour ward at the centre presently. She recounted that sometimes, they have more than one labour case at the same time and in such a case, it was always difficult for them to manage the situation as they always have to be moving the women in labour in and out which ought not to be.
“If we have more than one labour ward and we have two labour cases at the same time, we would keep them at separate wards and that makes it easier for us”.
The Matron revealed that there are about 10 beds for patients and more than 70 women came for antenatal that morning. She had to tell them to leave and come back the following week.
“I just dismissed the patients that came because of the strike embarked upon by the Labour (NLC/TUC). I asked them to come back next week Tuesday after the strike. If that happens and with the other set slated for that day, I will have more than 200 patients whereas the space is small.”
She further revealed that due to inflow of people into neighbouring Azagba-Ogwashi, the pressure on the Health Centre is on the rise due also to the fact that the services are being rendered free of charge to pregnant women and children of five years and below.
According to her, the community is also assisting. They are helping to mount a gate at the entrance of the centre and offering accommodation to student midwives. She explained that the student midwives would not have stayed but for the intervention of the community that provided them with accommodation.
Nzemeke Ruth: Patient
She spoke to National Point from the Labour Ward. She is waiting to be delivered and she said she had received excellent treatment from the Health Centre.
Ruth commended workers at the Issele-Azagba Primary Health Centre for trying their best at all times.
Volunteer
Emakpor Ifeanyi is a volunteer at the Issele-Azagba Primary Health Centre. She said she had been working with the Centre since 2015.
She revealed that patients rush to the centre now unlike in the past. Like the matron, Emakpor said the space and the staff strength are too small for the number of patients that throng the Centre daily.
She also asked for more delivery rooms because they sometimes have to contend with more than one patient in labour sometimes.
Primary Health Centre Ikpide-Irri in Isoko South LGA
The visit of National Point to Ikpide-Irri in Isoko South LGA was as a result of information received about the non-functional Primary Health Centre in the community.
When National Point visited, the centre was under lock and key and from the look of things, it has been a while the centre was opened for operation.
National Point went round the community to find out why the place was under lock and key. All efforts to speak with the officer-in-charge of the centre, Madam Lauretta was unsuccessful but information gathered threw more light on the situation.
A source, who spoke on account of anonymity revealed that the Madam Lauretta runs a chemist where she attends to patients instead of treating them at the centre.
From all indications around the Health Centre, government has equipped the centre with facilities but the attitude of the management was nothing to write home about.
Mrs Alice Eterigho (a school teacher), a native of Ikpide-Irri, agreed to talk to National Point after much persuasion.

She revealed that the nurses don’t come to duty and during emergency situations, people have to call them from their homes.
She appealed to the government to build residential quarters in the premises of the centre and employ more staff for the centre to function properly.
Rita Okiemute (Pregnant Woman): She is pregnant and physically challenged. It was her condition that drew the attention of National Point to find out how she is coping with the poor operation of the only Health Centre in the community.
She said she is a trader in the community and revealed that sometimes people go from Ikpide-Irri to Odi or Kaiama in Bayelsa State to seek medical attention as a result of the non- commitment of the staff of the Medical Centre in Ikpide-Irri community.
According to Madam Rita, the centre opens maybe once in two weeks, but she has never attended antenatal session at the primary health centre before.
Asked if she registered for antenatal, she remarked that she registered with a particular nurse but she has never attended the Health Centre before.
From our findings, people of the community are not aware of the role of a primary health centre. They assume that the operators of the health centre are doing them some favour by opening once in a while, unaware that the centre is there for their daily health attention.
A youth of the community, who volunteered information on condition of anonymity for security reasons, took a swipe at the elders of the community for not living up to their responsibilities as elders.
He expressed worries that the elders, who ought to check the officials of the Health Centre and make them sit up are pretending not to know that the officials of the Centre have abandoned their duties.
“If the youths of the community decide to act now, they will say we have started again. How can the only Health Centre in a community be locked every time? Sometimes we have to take our sick persons to other communities in Bayelsa State for medical attention,” he fumed.
Further investigation revealed that the OIC of the Primary Health Centre, Ikpide-Irri also operates a patent medicine store in the community where she treats patients.
Primary Health Centre, Emevor
Mrs Ogorugba Veronica is the assistant nursing officer of the centre in Emevor, Isoko North LGA.
When National Point visited the community Health Centre, the OIC was not around. As the second in command, Mrs Ogorugba spoke to National Point on various issues
She said the centre is well equipped but the centre is prone to flood anytime it rains while the accommodation for staff is not adequate.

She remarked that the centre needs foams, bed sheets, curtains, security men and gardeners.
Mrs Ogorugba, who spoke on behalf of the OIC of the centre, remarked that the community people are making good use of the Health Centre. According to her, the antenatal and immunization programmes of the Centre are well attended by the community women.
National Point observed that some beds were without foams and Mrs Ogorugba used the occasion to plead with the authorities to come to the aid of the Centre.
She also mentioned security concern, saying the centre needs fencing.
“There are so many entrances to the centre and even at night you hear people passing. We need fencing so that we know who is coming to the centre. It is good for our security and safety.”
Orife Anthonia, a pregnant woman came to the centre for antenatal and she also spoke to National Point.
Mrs Orife commended the workers of the centre for living up to expectations. She revealed that she and other pregnant women in the community attend the antenatal sessions regularly.
She pleaded for adequate drugs for infants and mothers in particular.
Umuagwu Primary Health Centre, Oshimili South LGA
The OIC of Umuagwu Primary Health Centre, Mrs Osayi Janet revealed that the centre operates 24 hours and as such, needs more hands.
“We need permanent staffs because most of the workers we have now are ad hoc staffs. Because of that, they keep looking for jobs elsewhere and their commitment is not entirely 100 percent.”
The OIC also revealed that over 20 deliveries by pregnant women are handled every month. She want the relevant authorities to come to the aid of the centre in order to enhance their performance for more effective service delivery.
Mrs Favour Obianuju Okubo (pregnant woman and a volunteer at the centre) revealed that she has been a casual staff of the centre for four years.
She appealed to the relevant authorities to make her and others in her situation permanent staff to ensure there are adequate staff in the health centre.
She described the maternity department of the centre as very good but appealed to the government for adequate drugs.
“We have antenatal programme every Wednesday. Just one session in a week and in that one session we attend to both the old and new mothers,” she concluded.
GANA Health Centre Sapele
In Sapele LGA, National Point visited the Gana Health Centre, located at Gana by Mission Road, grappling with a series of pressing issues that are hindering its ability to provide optimal healthcare services to the community.
The deputy matron of the health centre, Mrs. Odili Happy who shed light on the various challenges faced by the facility, emphasized the critical need for immediate attention and support.
First, she said the facility’s perimeter fence is in a state of disrepair, rendering it ineffective in ensuring the security and privacy of patients and staff. She also stressed the need to urgently address this issue to restore the centre’s integrity and safeguard those within its premises.
Additionally, she said the Health Centre is grappling with multiple infrastructure deficiencies. The ceiling fans have ceased functioning, resulting in uncomfortable conditions for both patients and healthcare professionals. She stressed that it is imperative that new fans be installed promptly to alleviate the stifling environment within the facility.
The shortage of suitable chairs further compounds the discomfort experienced by patients during their visits. The inadequate seating arrangements not only compromise their well-being but also hinders the overall efficiency of the healthcare delivery process.
Mrs Happy highlighted the urgent need for good-quality chairs to enhance the centre’s capacity to accommodate patients comfortably.
Also, the Gana Health Centre is currently facing issues with its solar power system. The unreliable solar panels are failing to provide consistent electricity, impeding various essential operations within the facility. A robust and efficient solar power system is urgently required to ensure uninterrupted power supply and maintain the smooth functioning of critical medical equipment.
One of the patients, Mrs. Edith Isiaka, expressed concern regarding the shortage of manpower at the facility. Insufficient staff numbers have resulted in prolonged waiting times, inadequate attention to patients, and an overwhelming burden on the existing healthcare workers.
Mrs Isiaka emphasized the necessity of recruiting additional health staff to meet the growing demand for medical services effectively.
Furthermore, the scarcity of hand gloves poses a significant risk to both patients and healthcare professionals during surgical procedures. The lack of this essential protective gear not only compromises patient safety but also undermines the well-being of medical staff. Urgent provisions must be made to ensure an adequate supply of hand gloves to facilitate safe surgical interventions.
Patients awaiting medical attention at the Gana Health Center also face discomfort due to the absence of air conditioning and television facilities. Mrs. Isiaka pointed out that these amenities would significantly enhance the waiting experience, provide much-needed comfort and distraction during often stressful and anxious moments.
Omiemiedi Primary Health Centre, Sapele
Meanwhile, at the Omiemiedi Primary Health Centre, situated on Omiemiedi Road in Sapele, similar challenges persist. Matron Ajamikoko Joy highlighted the pressing needs of the facility, urging prompt action to address them.
Expansion of the treatment, labour, and admission rooms is crucial to accommodate the increasing number of patients seeking medical care at the Omiemiedi Health Centre. The limited space currently available hampers the efficient delivery of healthcare services and compromises patients’ comfort and privacy.
In terms of infrastructure, the health centre relies solely on solar lighting, with no provision for alternative power sources. This dependence on solar energy severely restricts the availability of consistent and reliable lighting, while also hindering various medical procedures and compromising patient safety. Linking the facility to the electricity power supply grid is essential to ensure continuous and adequate power.
Furthermore, the malfunctioning fans at the Health Centre, coupled with the absence of working fans in the open building, exacerbate the already challenging conditions faced by patients and medical staff. Immediate replacement of these fans is imperative to provide a conducive environment for healing and care giving.
The availability of a suitable refrigerator is another critical requirement at the Omiemiedi Health Centre. The current solar-powered refrigerator fails to adequately cool essential medical supplies, posing risks to patients’ health. Provision of a reliable and efficient refrigerator is essential to ensure the safe storage of temperature-sensitive medications and vaccines.
Expanding the labour ward and staff quarters is essential to accommodate the growing number of nurses and facilitate efficient shift rotations. This expansion will not only enhance the working conditions for healthcare professionals but also contribute to improved patient outcomes.
Inadequate power supply at the facility poses significant risks during surgical procedures, as medical staff often resort to using their phone torches for illumination. This dangerous practice compromises the safety and success of surgical interventions. Ensuring a reliable power supply is therefore, crucial to eliminate such hazards and ensure optimal patient care.
To enhance the care provided to new born babies, the Omiemiedi Health Centre urgently requires more baby cots. The current shortage hampers the centre’s ability to provide proper care and accommodation for infants, necessitating immediate intervention to address this deficiency.
Finally, the availability of sufficient mattresses is crucial to patient comfort and well-being. Inadequate mattress supply compromises patient rest and recovery, posing challenges to the overall healing process. The provision of an adequate number of mattresses is essential to address this critical need.
Mrs. Grace Sagoh, a pregnant woman who frequents the Omiemiedi Health Centre, also highlighted the absence of television and air conditioning facilities. “There is no light, and the place is stuffy, though they are trying,” she said.
Contacted on the findings at the various health centres, the executive director, Delta State Primary Health Care Development Agency, Dr Yinkore Paul remarked that there was so much pressure on the health facilities due to population explosion in the face of inadequate staff.
He noted that there are 447 Primary Health Centres in the state with a population of about seven million people.
Dr Yinkore revealed that there are 22 medical doctors in the State Primary Health, 411 nurses, four pharmacists and no single laboratory.
“We don’t have laboratory services and it therefore means that no matter what they do in respect of primary health services that we render, diagnosis is still a problem. That means most of the diagnosis is just what I can call clinical diagnosis and not laboratory diagnosis. It will be difficult for us to make laboratory diagnosis.”
He, however, revealed that rehabilitation of existing health centres and building of new ones by the federal and state government is ongoing.
Dr Yinkore expressed optimism that things would get better in the Primary Health sector, especially under the administration of Governor Sheriff Oborevwori because, according to him, the governor has no tolerance for poor service and non-commitment to duty,.
The executive director added that the governor has promised to overhaul the health sector for effective delivery.