In 2016, the International Center for Investigative Reporting (ICIR) released a report estimating that about 2Billion Naira (US$5.6 million) has been spent on Primary Healthcare Centers (PHCs) lying idle across Nigeria.
The report featured a number of photographs of some of the newly built PHC structures in Nigeria overtaken by weed and grasses higher than their fences. But these are only a few examples of about 24,000 PHCs not functional in the country. According to the minister only of health, Isaac Adewole, only 20 per cent of Nigeria’s 30,000 PHCs are functioning.
Bako PHC, a Performance-Based Financing health facility under the World Bank assisted Nigeria State Health Investment Project (NSHIP) in Adamawa State, could have been one of the failed PHCs but is lucky to remain functional. Community members, having no alternative have taken over responsibility where government has failed. For about five months till date, salaries of the health workers in the facility remain unpaid but the workers are quite dedicated.
For a small center catering to about a population of 13, 000 people, and more than 40 average free childbirth delivery conducted every month, drugs are highly subsidized at almost no gain, but a consultation fee for non-community members is charged, which costs between N700 – 800 (US $2).
If there is any need, we contribute or task the wealthy in the community
Every month, community representatives under the association called Result Based Financing (RBF) which functions as a cooperative, meet to discuss solutions to either renovate the infrastructure or supply commodities, equipment to the center based on their immediate needs.
“If there is any need, we contribute or task the wealthy in the community,” says the Secretary of the RBF, Jibrilla Abdulrahman, he noted that the indigent committee members also source and sensitise the less privilege in need the community about the free medical services available at the center.
Coping without Doctors
Malaria, typhoid, diarrhoea are the most common illness affecting children in the community, while the adults are mostly diagnosed of hypertension, according to the reports which also showed that women, and children are the highest beneficiaries .
When I asked Ibrahim Abdulkadir, the Facility Manager, if there were registered nurse or doctor at the center, he shook his head and said, “We are all just health workers, walahi. But one doctor from FMC visits us during the weekend, he is a volunteer.”
When the situation is beyond their control, he tells me, they refer the patients to the Federal Medical Center, Yola for immediate attention.
The small center has a maternal ward, which had only one bed, until a student from a private university in Adamawa State, and the Community members jointly expanded the space enough to fit in another two extra beds.
Jibrilla Abdulrahman pleading with government, sought assistance to expand and fully equip the health care center, which is the only facility serving the Bako community.
The Bako PHC was neatly kept, with patients outside waiting to be attended to. They had their own laboratory and a full stock of drugs, all thanks to communal effort.
The only recorded death in the center was a six-year-old who died of Malaria this year.
Reporting by Nelly Ating; Editing by Adewunmi Emoruwa. [Please credit Machaha (machaha.com), a Gatefield Impact, social change project focused on the Sustainable Development Goals]
