Nigeria lower legislative chamber, the House of Representatives, has asked the Federal Government to declare a state of emergency in the health sector. The chamber claimed that only 20 percent of Primary Health Centers (PHC) are functional in the country. A member of the house remarked that the health centers in rural areas lacked adequate facilities and staff. The lawmakers also requested the government to allocate an adequate budget to the health sector in 2024.
According to the member, who was representing Mushin Federal Constituency II of Lagos State, Fayinka Oluwatoyin, Nigeria has about 39,983 hospitals and clinics as of 2020. Of these, the primary healthcare centers accounted for about 34,000, which is 86 percent. Media investigations revealed that 72 percent of the budgets allocated to the health sector were spent on salaries and running offices in 11 years. Data from the Budget Office of the Federation showed that the Federal Government allocated N3.5 trillion (N3,545,594,778,327) to the sector within the period.
Many reports revealed how centers have been short-staffed.
Of the fund, the Federal Ministry of Health received N2.9 trillion for recurrent expenditures (N2,905,050,442,117) and N640 billion (N640,544,336,209) for capital expenditures. Recurrent expenditures refer to funds used to pay salaries, train employees and run offices. Capital expenditures are spent on physical projects, namely building new offices, equipping them, and making other procurement. The ministry’s capital budget for the period stood at nearly 19 percent of its total budget (18.06).
There have been many reports on how inadequate manpower has hindered the smooth running of PHCs in some states in Nigeria. In November 2022, the International Centre for Investigative Reporting (ICIR) investigated many PHCs in Nassarawa. They discovered that many of the centers did not have nurses until the government recruited some nurses and midwives, there were less than 20 nurses and 30 midwives in over 700 government-owned primary health centers in the state. The shortage of trained midwives and nurses cripples services and threatens the state’s Basic Health Care Provision Fund (BHCPF), launched in 2021, and other services at the PHCs. It also prevents the state from achieving the Federal government’s Midwives Service Scheme (MSS) targets.
Anambra State was running over 630 centers with just 150 personnel.
Again, the ICIR investigated centers in Anambra. Journalists discovered that the state was running over 630 PHCs with only 150 nurses and midwives. For instance, a public health nurse and officer-in-charge of one of the health centers in Anambra East Local Government Area of the state said that she supervised two other employees – a laboratory technician and a midwife – engaged under the revived Midwives Service Scheme (MSS), courtesy the Basic Health Care Provision Fund (BHCPF). Despite the deployment of the young midwife, she still felt overburdened with the workload at the facility. She said that she could not leave the facility. “Even when I go home on weekends, calls keep coming for my attention. It’s too demanding.”
Anambra State, though seen as the best in terms of maternal mortality in the South-East region, had lost 20 pregnant women to various birth-related complications between January and June 2022. The development was hinged on the fact that a good number of women still patronized quacks for ante-natal and child delivery. A consultant community physician at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Dr. Chinomnso Nnebu, advised residents against patronizing prayer houses for antenatal care. With Dr. Nnebu’s warning, many citizens of the state believe that the pitiable conditions of most primary health centers could not cater for them, especially in the five selected local government areas, leaving the locals with no option but to embrace other alternatives.
Lawmakers urged the health ministry to intervene.
Meanwhile, the motion moved by the Chamber was titled, “Need for the National Primary Healthcare Development Agency to collaborate with relevant health agencies in States and Local Governments to ensure the functionality of Primary Healthcare Centres.” Honourable Oluwatoyin said the lack of medical equipment, drugs, qualified personnel, power supply, beds, and road networks had increased the death toll in healthcare centers. He added that federal and state health ministries’ inaccurate representation of primary healthcare centers hindered proper budgeting and access to quality healthcare in rural areas, leading to premature death. In its resolutions, the House of Reps urged the Ministry of Health to encourage states to initiate and revive primary healthcare programs capable of making the PHCs more functional, provide quality and affordable drugs for the masses and encourage stakeholders in all government tiers to establish a task force to tackle all forms of malpractices at the PHCs.