Overstretched facilities: Health care in need of lifeline

ADEOLA OTEMADE reports on why health care facilities in the country, especially government hospitals need more attention from the government and private organisations.

With a population of nearly 200 million, Nigeria is the most populous country in Africa, but it still struggles to offer its people access to quality medical facilities which is one of the basic needs of an average citizen. According to an online report, government expenditure on health is considerably slimmer than what comes from private contributions, with a difference of billions of naira.

Currently, about 3.9 percent of Nigeria’s Gross Domestic Product is invested in the health sector, which is considerably below the average spending on healthcare among the Organisation for Economic Cooperation and Development (OECD) countries, which are mostly European, North and South American and Asia-Pacific nations some of whom are not really better than Nigeria economically. Typically, Nigerians usually have to pay for health care out-of-pocket even as the medicines are sometimes expensive and difficult to afford. In 2019, on the average, healthcare made up six percent of Nigerian household spending, with higher figures in rural areas than in urban zones.

 

Lamentations Galore…

In 2020, the health sector received a capital spending allocation of N46 billion which was just N2 billion lower than the country’s allocation for education; it was N4.15 billion lower than the capital wexpenditure allocation for health in 2019 which was N50.15 billion.

Across the country, doctors, nurses and the average patient alike have continued to bemoan the fallen standard at government hospitals with many avoidable deaths being recorded daily, thereby painting a deplorable condition in the health sector.

A mother of one, Mrs Grace Akinyemi, a teacher,  recounted her ordeal to Sunday Tribune, of what she went through when she gave birth to her son at the State hospital Adeoyo at Yemetu, in Ibadan. According to her, she gave birth to her son through a caesarian section, but her mother-in-law looking closely at the baby noticed that he had jaundice.

“My mother-in-law called on one of the nurses that my baby had jaundice, but she was told that the hospital does not have the medical equipment to take care of him. We were asked to go for a Bilirubin blood test to check for the level of the jaundice, which was six as of when we checked. We were asked to go home. The medical personnel also said that it (jaundice) might reduce on its own, but my mother-in-law didn’t want to take chances knowing how dangerous it might be.

“From there we went to University College Hospital, Ibadan, where we were told that there was no light to run the bili light (phototherapy) for the baby and no bed space for us to be admitted. With each passing moment being wasted, the bilirubin keeps increasing; by the time we ran another test, it had increased. Out of our fears and worries, we went to Catholic Hospital Oluyoro where we were later admitted, but we soon left in annoyance. My baby was only placed under the bili light for four hours; all through, while we were there at night, the generator was not used. We slept in the dark with my baby.

“When my mother-in-law came the following day and she found out that my baby was not exposed to the light, and one of the nurses was suggesting that we go for a blood transfusion, my mother-in-law left in annoyance and we went home. We later used a private hospital where we were well attended to, although we paid quite heavily, but the life of my son was saved.

“While we were at Oluyoro, I met a woman who lamented that she lost a child to jaundice, and her third child was going through blood transfusion and that his jaundice had risen to 18. Even if the child survived it, he might not be the same again as he might not grow normally,” she narrated.

Fisayo Adelakun, a banker also corroborated Grace’s story, noting that though government hospitals are accessible to people, but the services are poorly-rendered.

“General Hospitals in Nigeria are just there; though they are functioning, but they are not well-equipped. I have been there a couple of times, and I was attended to. I just feel the things available there are just the basics, such as malaria drugs and what have you. I don’t think they have enough drugs as such.

“The government hospitals are accessible to the common man in Nigeria and I’ve been there on occasions for medical care. The issue is: are the services available okay? Or are the tools and equipment needed for excellent service delivery provided for the health workers?

“Most of them are usually short-staffed, with the workers there giving accounts of the last recruitment process which took place over a decade ago. Most, also, have no necessary equipment but have to improvise or use their own resources just to be able to save lives as they’ve been neglected by the government.

“From my experiences too, most government hospitals have well trained staff but aren’t just equipped enough to save lives as they should. They are also poorly funded. What about modern medical facilities? Zero: You’ll see lanterns for lighting the hospital or wards; nurses buying gloves themselves or you could just be told they don’t have oxygen, as essential as it is,” Adelakun said.

However, the experience of Akinwale Adeyemo, a photographer, in accessing healthcare facilities had been quite different. For him, accessing healthcare in his neighbourhood has been easy and has proven quite useful. He even described the services rendered as amazing.

“The healthcare in my neighbourhood is useful. It has proved to be useful to everyone who registered there (at the Primary health care centre). Whenever I visit a government hospital, I get drugs for free but there are times I would be referred to pharmacies and that is if the prescribed drug is not available at the hospital. And this situation is very rare. There has never been a time I did not have access to healthcare in my neighbourhood,” he stated.

A matron at the Maternal and Child Facility, Omi Adio, Ibadan, Mrs Lydia Adesiyan, corroborated this. She, however, said that though hospitals are managed well by government, there is room for improvement.

“Our hospitals are faring well, but government needs to improve and do better, and focus more on the health sector in Nigeria. We (medical personnel) are just caretakers; we are placed here to take care of patients that come in for treatment.

“We make do with the drugs we are provided with, and sometimes when we do not have a particular drug, we refer them (patients) to a pharmacy. We all know the population we have in Nigeria, and for these drugs or medical equipment to go round adequately, governments needs to pump more funds into the health sector, and the people in charge should adequately use the money,” MrsAdesiyan said.

Also speaking with Sunday Tribune, Adufe Tolami, a nurse at the Lagos Island Maternity Hospital, said medical instruments are quite sufficiently supplied at her hospital, and she can only speak for herself and where she works. According to her, drugs are supplied in tons, which are easily accessed by patients at the hospitals pharmacy.

“Medical equipment are sufficiently supplied at my hospital, I don’t know for others. Equipment are accessible to patients directly since they are the consumers. Drugs are being supplied in tons, so every patient has the chance to purchase them in the hospital pharmacy and use them. My hospital is more reasonable (cost wise) than many private hospitals. It is one of the hospitals used for student practicals in Lagos State. So, I think it will be quite different from some other general hospitals,” Tolami said.

Availability of drugs and equipment, according to Dr Moyo Maitanmi, a medical doctor at the Federal Neuro-Psychiatric Hospital, Lagos, is not the problem but maintenance.

“Medical equipment are available for patients, drugs are made available as well,” he said, adding, “but where the problem lies is the maintenance of these equipment.”

According to him, much pressure have not been placed on equipment; drugs are made available, and medications are supplied in bulk, but the challenges facing the health sector today is based on poor maintenance of the equipment.

“There is not much pressure on this equipment as patients are well-catered for. Drugs are also readily available. Medications which are most used are the ones supplied in bulk and they are also affordable. Furthermore, the authenticities of the medications are guaranteed as various pharmaceutical companies lobby to get slots to supply the hospital. Thus, only the best is picked. When quality drops, the pharmaceutical company is usually replaced. Medication is usually available all year round. Where a particular brand is unavailable, the next most suitable brand may be prescribed.

“Also equipment are accessible as required, but where the drawback lies in the area of maintenance where such equipment are usually old, not serviced regularly, misused and thus prone to breakdown. In terms of medication, they are available and affordable, all year round with different brands to choose from. Most patients, who source their own medication, do so of their own volition. Special cases may only arise during periods of industrial action,” Dr. Maitanmi said.

However the Chief Medical Officer, General Hospital, Rabah, Sokoto State, Doctor Olubankole Adegoju, has a different narrative, as he claimed that medical equipment are limited, despite availability of drugs.

According to him, “They (equipment) are limited. There are some tests and treatments that patients have to do elsewhere. The ones that are available are affordable and accessible. Drugs are available and enough to go round, though the challenges most patients face are financial issues.

“The government procures them (equipment) as when due. When they get old, they bring new ones. There are some equipment that we don’t have at the state hospitals that are available at federal hospitals, because the manpower to manage them at the state level is not available.

However, despite government allocation to the health sector, the situation may not get better due to rapid growth in population which will continue to overstretch whatever allocations may be available. In addition, the health sector lacks the manpower to run it due to constant brain-drain that the country currently experiences. If this situation continues, the poor state of the country’s health sector may not improve even in the nearest future.

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