Despite government’s efforts and its investment to ensure sound healthcare delivery system in the State of Osun, the complaints of lackadaisical attitude against health workers across the state are on the high side and seem to have been causing setback in the sector. FRANCIS EZEDIUNO and SIKIRU OBARAYESE consider the factors that have been causing issues in the healthcare delivery system of recent.
The primary health care centre is a grassroots approach to provide health care services to communities. In Nigeria, it was established through the launching of the Primary Health Care plan in the National Policy of 1988 as the cornerstone of the Nigerian health system as part of efforts to improve equity in access and utilization of basic health care.
It was intended to: improve the collection and monitoring of health data in Nigeria; ensure the availability of essential drugs in all areas of the country; guarantee the implementation of an Expanded Programme on Immunization (EPI) across the country; boost the promotion of health awareness; aid the development of the national family health programme and improve nutrition standards throughout the country.
In 1992, the National Primary Health Care Development Agency (NPHCDA) was established to ensure that the PHC agenda is continued and sustained.
In Osun State, the case of health care delivery has been declining of recent. This is so not because the government has failed to do the needful, but because there are issues of absence of medical personnel at work, lack of enough medical equipments, consumables, shabby services by personnel, lack of courtesy from health and record workers, corruption like referral of patients to private health centres, referral of patients to private pharmacies for purchase of drugs and consumables, unauthorized sales of medical consumables within the premises of health centres, refusal to attend to patients unless they have patronised those selling the consumables.
There have been myriad of complaints emanating from patients who throng the healthcare facilities at the primary, secondary and tertiary levels with particular emphasis on the Primary Healthcare Centers (PHCs).
Patients to these facilities often complain that the services that they get are often below standards and lacks professional etiquettes.
Today, the impact of the lackadaisical attitude of health care providers in Government hospitals in Osun is particularly weary.
Investigations have shown that the issue of carelessness on the part of medical workers especially nurses has been turned to a normal practice in the system, particularly in rural communities.
Complaints such as poor attitude of medical personnel to work, shabby services by personnel, lack of courtesy from health and record workers, referral of patients to private health centres, referral of patients to private pharmacies for purchase of drugs and consumables, among other complaints.
There was insider information last year about sharp practices perpetrated at the Primary Health Centre, Oke-Bale, Osogbo.
Most of the healthcare centres located within urban areas, especially in Osogbo and Olorunda are not often not culpable of the suspected sharp practices, probably because of their locations within the state capital, but the same cannot be said to be obtainable in centres that are in rural areas.
In these centres, it was gathered from the locals that health workers might visit once in a while, drugs and consumables are hard to come by, a condition which has made patients to seek medical attention outside the communities or alternative therapy.
This is the situation in areas like Kajola village, Oke-Bode, Prince, Osin, Inisha in Atakumosa West Local Government and some other villages in the state, where villagers alleged health workers of idleness at work.
Villagers of Prince Village, Abebeyun lamented on the state of the health centre in the area, saying the villagers will always go to neighboring village, which is Oke-Bode maternity for treatment. A villager, Ayo Daramola said; “I have been living in this village for about 30 years, the maternity was functioning before, it was not like this, until the health workers suddenly decided to be ignoring their jobs. They are always absent and our people here are not patronizing the place again. The lackadaisical attitude of the health workers has pursued our people to Oke-Bode healthcare centre.”
A pregnant woman, Ifeoluwa Alex, said she did not bother to register for ante-natal at her village because “the nurses at the maternity might lock the place for a week, and moreso, the nurses are not sleeping at the maternity when they come around”.
At Inisha primary healthcare centre, a villager said, “I only see a nurse there, I hardly see other workers at the place. So, we don’t bother ourselves to go to the maternity if we have emergency such as snake bite or scorpion bite”.
A villager, Pa Asaolu Isaac while speaking on the state of the health centre stressed; “when government fail to manage its properties, the workers will do it as they like. Since the government has fails to inspect its properties; the health workers may decide to do the job how they like. I can only blame government for this”.
On getting to Prince Village, this medium met a nurse, Mrs Olokun Lydia who hinted that there are only essential drugs in the maternity which are malaria drugs and some other drugs, just as he complained that the vicinity was not being properly maintained.
Another typical example is the PHC serving Yekemi, Aye Kooka and Aroko villages in Ife South Local Government Area of the state, which has been overrun by weeds.
Villagers who are mostly farmers revealed that since the centre was built, it has never been utilised which means that it has been hope dashed for the people in these communities.
They also claim that no health personnel had ever visited the facility even though the community had offered to take care of all expenses of a health personnel if stationed in the area.
In order to meet this shortfall and take care of their health challenges, community members have engaged the services of private health practitioners who come to their villages, render health services and get paid for these services. Those who cannot afford this arrangement resort to alternative means, that is, they patronise local healers and make do with herbs and give birth to their babies in faith based homes or make use of traditional birth attendants within the neighboring Garage-Olode axis.
At the Comprehensive Health Centre, Oba-Ile, the story is still the same. Complaints range from lack of doctors, furnishing and equipment, shortage of drugs and medical consumables.
The situations have forced patients to patronise both traditional and private health practitioners.
The state Commissioner for Health, Dr, Rafiu Isamotu on being notified of the development promised that prompt action would be taken to find out the truth in the allegation and if so, prompt punitive action would be meted out to the culprit(s) and solutions would be proffered to ensure such do not repeat itself again.
The Executive Secretary of the State of Osun primary Health Care Development Board, Dr. Kayode Ogunniyi stated that all the 332 PHCs in the state were operating optimally, wondering why the attitude of medical workers would be frustrating the government’s efforts.
He said that drugs worth N50 million has just been purchased by the administration of Ogbeni Rauf Aregbesola and that the allegations certainly did not occur recently, saying, there would be an investigation into the matter.
“With the availability of drugs, drugs dispensing would resume in earnest and improvement of services rendered from personnel would be visible.
“Drugs and services from health practitioners are somehow related and cannot be divorced. Where there are no drugs in a health facility, it would mean that the facility would only consult and cannot treat but with drugs available, consulting which is the services and treatment would go hand in cap.
“The N50 million drugs are now available for distribution to all the 332 PHCs in the state but there is an instruction to wait till the end of this week before the distribution mode of the drugs because the state government had created the Osun Health Insurance Agency to implement the Osun Health Insurance Scheme.
“In essence, these drugs cannot be free anymore because the insurance scheme means that a 5% margin purchase price would be imposed on patients at the point of dispensing.
“This is standard practice as there is no free health anywhere and with the introduction of health insurance, it is hope that affordable health care will be available for all without bias. Before implementing the 5% margin purchase price, the approval of Mr. Governor has to be sought.
Dr. Ogunniyi urged that if there is any reported case of indiscipline and sharp practices, the identity of such personnel should be revealed and action would be taken to deal with such cases.
The Permanent Secretary of the State of Osun Hospital Management Board, Isaac Olaluwoye in his assessment said that the government has its own part of the blame, stressing that the management of the whole situation from the government side was faulty.
He said, based upon the outsourcing scheme, the state government was supposed to be servicing the service providers and the outsourcing pharmacies were supposed to be responsible for the paid drugs while government on its part was supposed to be responsible for the free drugs by re-imbursing them.
Though, provision of prompt and adequate services cannot be divorced from drugs supply, but how do one address the complaints of patients who throng these health facilities and how can their confidence be restored in a system that is currently suffering a reputation crisis due to the absence of trained personnel, where the personnel are available, they are not working and where they are working, there are no adequate drugs to go round.
This is is critical issue that must be addressed as quickly as possible to restore sanity in the system.
