By Abdullahi D. Hassan
Yelwa Zangam is a gridlocked, rural area located in Jos North Local Government, Plateau State, North-Central, Nigeria. It has an estimated population of over 10,000 inhabitants and its nearest villages. The hinterland is just 21 minutes’ drive from the University of Jos, main campus. Most of the people are agrarian farmers and living below a minimal income.
Nigeria operates a three tier system of government, consist the federal, the state and the local government. Similarly, the Nigerian health system functions along such relations. Primary health care is at the local government stage, Secondary health care is managed by the state and the tertiary health system by maintained by the Federal.
Primary Health care is known for intervening, caring and controlling communicable diseases and non-communicable diseases, taking care of antenatal and post-natal, observing child growth, dispensing vaccines to children and Health Education and Community Mobilization.
According to the National Primary Health Care Development Agency (NPHCDA), a body oversees, coordinates and regulates the standard of Primary Health Care in Nigeria. The minimum infrastructural requirements for such a health centre; are as follows; a least 13 rooms in good condition with functional doors and netted windows, separated female and male words toilets, water supply (borehole), electricity (or alternative source of power), sanitary waste collection spot, waste disposal site and staff accommodation. However, it has a staff station, two consulting rooms, two delivery rooms (labour rooms), maternity sections, and a laboratory and the building must be fenced.
The United Nations, Refugee Agency (UNCHR) stated in its ‘Emergency Handbook the primary healthcare workforce is composed of a wide range of health professionals, including medical doctors, nurses, midwives, clinical officers or physician assistants, laboratory technicians, pharmacists, community health workers, managerial and supporting staff.
Yelwan Zangam’s Primary Health care began 31 years ago and was built by the local government in 2001 through direct allocations from federation funds. Global Alliance for Vaccine and Immunization, an international organisation under a sub-body ‘GAVI FUNDS’ partnered with the National Primary Health Care Development Agency (NPHCDA) for the renovating the centre in 2011.
Now, the unfenced facility faced a series of challenges; a leak roofing with only 6 rooms apart from the labour room, unkempt rooms in shambles conditions, single working toilets, no water supply, shortage of mattresses, obsolete medical equipment, dearth of medical personnel and constants insufficiency of drugs supply problems. Since its existence, the hospital has not been connected to an electric power source.
Fali Emmanuel John is a Health Officer in primary health care. He narrates a dire condition “We are facing a lot of problems in maintaining the hospital. Firstly, non-availability of electricity and solar systems for the storage of children’s vaccines, even if there is electricity. It’s compulsory to have a solar system. Due to power instability in Nigeria, so that we can render vaccination daily. Lack of electricity is a big setback to the community and the hospital. Secondly, our personnel need staff quarters. Primary health care is established for 24-hour services. Definitely, staff accommodation should be within the vicinity”.
He reiterates “The community starts building a staff quarters. But they are overstrained. The building is uncompleted”.
Mr. John lamented “The hospital is supposed to have 10 to 20 medical staff. According to medical ethics, working hours range from three shifts; morning, afternoon and evening (night). The deficiency of personnel here is too bad. We only have 3 medical doctors. Sometimes 1 medical doctor works for 24 hours, which is unprofessional and painful to us”.
“Issues concerning drugs, the government are making a little effort. We urged for more. Before the community donated money for drugs and other essentials”, he added.
Fauziya Musa Abdullahi is a nursing mother, who visits the hospital often for antenatal services and delivers her 6-month son to primary health care. She expresses “The most difficulty, women encounter is during night hours. For example, if a woman came to give birth. On certain occasions, there is no doctor available”.
She added “Sometimes, drugs are not available. It’s for patients to buy from the city. During, my last admission here. I wait for a long moment. Before drugs, injections and intravenous drips were bought. If authorities get involved and provide drugs in a hospital. It will be good for the patient to have treatment in any given situation”.
Usman Garba Danladi, an assistant sectary to the community and for years among the people work in progress of Yelwa Zangam community, says “For now, a local agency, Plateau State Contributory Health Care Management Agency (PLASCHEMA), supplies drugs”.
He shared “30 years ago, local government authority grants a fund under a scheme ‘REVOLVING FUNDS’, it was used to supply drugs and other necessary items. The drugs were sold to patients at affordable prices”.
“Financial challenges for buying drugs. Some patients run away with complicated health issues”, he cried out.
Nigeria’s highest court, on 11 July passed a judgement for local government to have full autonomy. Henceforth, the allocation from the federation account is to be funded directly into the local government, not through the state government ‘Joint account’. Mr. Danladi chip in “I am dreamt for local government to be independent. In the past, primary health care was managed from local government funds, not state government. Certainly, with this development electricity will be installed, more workforce and enough drugs to the patients and the facility will be improved”.
Mr John remarks “I am grateful to Almighty God for the Supreme Court’s verdict to allow local government to use their money for local affairs. Local government autonomy is a great success to health sectors”.
Abdullahi D. Hassan writes from Jos in Plateau State and can be reached via +234 803 323 7977.