Failing primary healthcare in Kano

Dosara Primary Health Care Centre, in Ungogo Local Council of Kano State, has been rendered helpless, hopeless and monumentally inefficient, due to lack of an effective, explicit primary healthcare policy in the state.

The facility established in 1977, was renovated in 2010, through the intervention of a development partner. Right now, it is one of the 1, 200 Primary Healthcare Centres (PHCs) in the state that are suffering as a result of unclear government policy regarding PHC.

Meant to serve about 8, 000 residents of the community, the now decrepit facility has no access road, and a trip to it by some of the locals, could take as much as two hours, as against the 40 minutes it should.

The staff residence, built alongside the facility, has since collapsed, forcing health workers posted to the facility to live outside the community, a situation that does not facilitate quick service delivery.

Patients from neighbouring communities like Malamawa, Hayin Rimaye, Dan Kunkuru, Zango, Adaraye, Inusawa, Kuriwa, Dauni, amongst others are some of those that equally use the facility.

According to members of the community, the Community Extension Worker there, Hajiya Zara, uses her vehicle to convey pregnant women to other hospitals when they are referred there.

However, for over five months, bats forced workers and visitors out of the facility to a block of classroom in the nearby Dosara Primary School. This block itself is in a terrible state, despite playing host to six beds.

In the same school, a classroom, which takes about 150 pupils, has also been collapsed to become a consulting room for pregnant women and other visitors. Here, mattresses are placed on bare floor, and drugs exposed owning to the very nature of the structure.

Some respondents said the last time the facility had drugs was during the previous administration, as part of the Drugs Revolving Fund (DRF). Drugs worth about N190, 000, was given to the facility.

Last year, three pregnant women died en route to other hospitals, where they were referred, to owing to lack of equipment at the facility. They all died before reaching where they were referred to due to poor access.

Investigation reveals that the state’s policy on primary healthcare was not explicit, neither is it articulate, a development, which causes hassles in healthcare delivery at that level.

Chairman of Dosara Development Association, Mutari Lawan, said stories of how pregnant women struggled to get medical attention in the community was aplenty.

According to him, “There is no single patent medicine store in our community. We take our sick relatives to the Murtala Muhammad Specialist Hospital, Sir Sanusi Hospital, or Bella Hospital, which are several kilometres away from here.”

“The only health official’s residence built alongside the health centre in Ungogo has since collapsed, leaving any health worker posted to live outside the community. This is a very discouraging situation.”

The Kano State Primary Healthcare Management Board has a total of 1, 200 Primary Health Centres it is catering for. In these centres, the board only takes care of the facilities, while the staff are placed on the shoulders of respective local councils, who pay their salaries and other benefits.

This is for the simple reason that the board was not designed to fully cater for the health facilities. Official files of staff members working in the 1, 200 health facilities are abandoned somewhere in containers as they do not have proper offices or stores within the premises of the board, situated along Zaria Road, in the Kano the metropolis. All staff files are kept or at best abandoned in containers.

The unpleasant situation playing out in the state is said to stem from the absence of a proper legislation backing the state’s primary healthcare policy.

A source close to the state House of Assembly revealed that there was a failed attempt in the past to review, and put in place, a proper primary healthcare policy.

Several attempts to get the Executive Secretary of the Board, Dr Nasir Mahmud, to shed light on conditions that have caused the agency to flounder in its service delivery have been unsuccessful.

But one thing is clear, and that is the fact that the board needs full autonomy in order for it to work diligently and without encumbrances.

Chairman of the Local Health Committee of the facility, Haruna Muhammad, lamented that, “To our dismay, the past local government chairman visited our facility more than five times, promising to do something about it. But look at it now. It is only when election comes that they come here cap in hand asking for our votes. This is very unfortunate.”

The Dosara PHC has only two unskilled traditional birth attendants on shift, called Talatuwa and Sabulu. Investigation shows that the state government has not sent any other skilled birth attendants to the centre. “Even if they were posted here, where will they stay? Muhammad asked rhetorically.

What still surprises many is the fact that 15 years after its establishment, the state Primary Healthcare Management Board, is not as autonomous as it
should be.

Since being established in 2012, it does not fully control healthcare facilities in the state.

With the increase in budgetary allocation for primary healthcare from N714, 022,969 in 2016, to N899, 554, 803 in the 2017 fiscal year, health facilities like that of Dosara Village are still suffering from lack of attention from concerned authorities, a situation made possible due to the unclear policy governing primary health care generally in the state.

In 2016, the approved budget for personnel cost was N80, 000, 000, which rose to N114, 507, 834 in the 2017 fiscal year. The overhead cost for 2016 was N37, 000, 000, and was increased to N137, 000, 000 in 2017.

In 2016, capital expenditure for the primary healthcare in the state was N597,022,969, the amount was increased to N648,046,969 in the 2017 fiscal year.

But with all these increments between 2016 and 2017, the people of Dosara community and its environs are still at a loss regarding the reasons they have continued to suffer. They are therefore, calling on development partners to kick-start the process of getting the state to put in place, a clear cut primary healthcare policy through effective legislation.