But they are hardly maintained, a recent report suggests. According to the National Baseline Survey, 98% of PHCs nationwide are all poorly equipped and understaffed. About 40% are model PHCs while 30% are PHC clinics. The outcome of investigation into the state of the health facilities by the National Agency for Combating Acquired Immune Deficiency Syndrome (NACA) recently further painted a dismal picture of the condition in rural areas. The survey drew particular attention to the poor facilities at the PHC in Chibiri, a settlement of Kuje Area Council in the Federal Capital Territory (FCT).
That little or nothing has been done overtime to sustain a project that is vital to the health sector at the grassroots level is indeed lamentable. The PHCs were introduced to focus on preventive measures, especially to check potential serious public health challenges in rural areas where facilities for tackling deadly ailments are lacking. The immunization of children against child killer diseases and the use of traditional birth attendants to curtail the rate of maternal mortality were part of PHC routines, and these greatly contributed to the success of the regular immunization scheme at the initial stage. However, today it is a different story, because local government councils that should sustain the programme have neglected this role.
Consequently, the PHCs, built nationwide with huge resources, have been abandoned due to a vague definition of their ownership. Apart from being ill-equipped and understaffed, the structures are dilapidated while others are located far away from the communities that are supposed to benefit from their services. The few personnel manning some of the centres cannot perform their duties well because they are not properly trained. For example, in one Edo State local government area with 13 PHCs, only one is covered by a medical doctor, the other centres are taken care of by community health workers who are strictly not as qualified as registered nurses and matrons. To worsen the situation, access roads to these facilities may be by foot. Pregnant women who need the services of these centres most are often excluded, with unpleasant consequences. In some communities in the far north, donkeys are the transport system of choice to reach the centres. For any meaningful headway to be made in reducing maternal mortality, these health centres have to be made easily be accessible, while traditional birth attendants should be continuously trained to fill the gap wherever health workers are insufficient.
The local governments must give priority attention to both the physical and mental wellbeing of people at the grassroots level; that is their primary duty. Facilities and the required personnel should be provided at these centres. An effective scheme to supply drugs to these centres is essential, even if on a cost-recovery level to ensure not only availability but affordability of drugs. There is also the need for the local government councils to create awareness about the location of PHCs as well as how these can be accessed. Considering the likelihood of increased risk of serious endemics affecting the rural communities, more treatment centres are required for the provision of information on their epidemiology and treatment.
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