BY AHMED TUKUR LAFIA
Rural women are considered vulnerable species in their environment particularly with regards to conflict of crisis situations and the weakness can be made worse owing to lack of essential services that include health care that is considered crucial and vital in the daily life.
Some of the identified vulnerable women include pregnant women that need regular Health medical attention and care among other things.
In Nasarawa state, the story is not different from other rural settlements in most parts of the country as women form part of the working population that include farming and trading in their respective villages thus the need for them to have access to health care services when the need arises.
In many of the rural communities, most pregnant women are left at their mercy as they trek long distance before they can have access to Health facility that will attend to their needs. This ugly development was mainly due to the lack of health facilities in most of the remote areas and the inability of local population to access transportation for the people to get to functioning primary healthcare centers.
However, with the Establishment of the Primary Health Care Agency in Nasarawa State, the story brought about positive change that is seen as many as a welcome development as more women and children now have easy access to facilities to address their health challenges.
But that was not without challenges that have to do with manpower, service delivery, equipment, drugs and other essential services to address the EVER GROWING population in the state
Presently, Nasarawa State has about 770 Primary Health Care centers spread all over the state that requires a huge number of skilled staff to meet the desired quality of services.
But with support from World Bank and other donor agencies, the State Government resources is now being complemented with a view to address the patient’s needs. On note too is the other initiatives of the agency like the ‘Decentralized Facility Financing (DFF), Performance Base Financing (PBF), that are targeted at improving and assisting in addressing some of the challenges.
While health facilities on DFF, plan their schedule of activities and get financial support from the state Primary Health Care Agency, those on PBF are supported base on services rendered. In the PB, the number of services offered by each PHC will be purchased by the state agency through the NSHIP PROJECT and in turn the PHC is expected to use the proceed in developing the PHC because of the autonomy granted the facility.
In addition, the Bill and Melinda Gate Foundation, seeing the success of the NSHIP programme in the state, equally initiated a project called Mainstreaming Performance Base Financing (PBF) in the state to sustain the project while addressing three key areas such as government structure, performance management, and financial management
A Memorandum of Understanding (MoU), was signed with the state government after which funds were released in tranches following a detailed and approved work plan with none of the releases meant for structural upgrade as it is expected to be the state government’s responsibility. Instead, the fund is expected to build capacity and the system for sustainability.
A visit to Wulko, a small village of about 15 kilometers from Akwanga Local Government Area of Nasarawa state, with less than one thousand population but rich inn agriculture owing to its rocky nature, indicate that the inhabitants are mostly Eggon by tribe and proud farmers that have lived for many years close to nature. The village has a learning environment that houses both Primary and secondary schools as well as a Primary Health Care Centre with about six personnel that attend to an average of over 10 to 40 patients on weekly bases.
The structure housing the health centre was before now in a dilapidated state in addition to having lack of functional facilities to address the need of patients that are mostly pregnant women.
Mrs. Asabe John, a mother of five children, treks for about seven kilometers from a neighboring Ayaga village before she can access the Wulko Medical facility which is deemed close to her, yet get disappointed for lack of proper services and medical attention before now.
The people of the village have before now lost hope of having qualitative and quantitative access to health owing to the epileptic or near zero health services in the village
However, Mrs. Deborah Elisha, who took her child for immunization at the Wulko Health Centre, said that the services presently being rendered by the clinic has improved tremendously, adding that availability of drugs has increased while Patients – Staff of the Clinic relations has improved with quality services.
Elisha also said that the story of shortage of drugs has also disappeared and now a thing of the past just as equipment for anti-natal and family planning have been increased.
According to her; “The staff members are very friendly these days, and quality of Services has improved because before now, you have to wait for them to go and buy drugs, but now it’s available while the number of staff has also increased”.
“I have been coming to this clinic for the past four years but now the services are better. That is why you see me coming here for immunization with my child”
Another patient, Mrs. Janet Awayi, who visited the clinic for Ante-Natal, said that she has stopped going to Akwanga General Hospital since the Clinic started offering 24 hour services.
According to Awayi, she now visits the clinic on weekly bases for Ante-Natal services while calling on government to expand the structure of the Clinic to accommodate more patients.
The head of the Clinic Mrs. Patricia Benjamin said during a chat that the number of patients visiting the facility has increased by over hundred percent just as drugs are usually stocked in the hospital.
Mrs. Benjamin explained that the clinic has a drug revolving scheme that assist the facility to increase its services to patients and also deliver other essential services to patients.
In her words; “After the intervention by Bill and Melinda Gate Foundation, the number of patients accessing our facility has increased at the out-patient department from 40 to 100.
“Women accessing Ante-Natal care has increased. Before now, we used to carry out Ante-Natal care on monthly bases but presently, we are doing Ante-Natal on weekly bases. Through the assistance of Bill Gate, we have increased our staff strength to offer more services.”
A visit to the clinic however showed that the facility clinic is yet to get a medical doctor as it is still being run by a Chief Health Officer (CHO), who attends to patients. This is just as a look at the facility further showed that ante-Natal section has been renovated with needed drugs in stock for patients. Similarly, there is a functional borehole that is now servicing the clinic.
Similarly, at the Out-Patient unit, patients were seen waiting to be attendant to by a health personnel.
A stakeholder in the village, Mr. James Manger said that it was after the intervention of Bill and Melinda Gate Foundation that more patients started accessing the clinic especially women and children.
Also at the new Market Primary Health Care Centre, Lafia, that operates DFF programme, over 7500 patients accessed the facility between January
and November 2019 with about 674 of the patients attending Ante-Natal monthly.
The head of the new market PHC, Hajara Haruna Abubakar explained that access to the facility is on the increase on daily owing to the Decentralized Facility Financing (DFF) that gave access to more service delivery and drugs.
Overall, most of the 770 Primary Health Centres need more qualified Health personnel especially medical doctors.
The state Primary Health Care Agencies is presently collaborating with tertiary health institutions in the state to assist with doctors to oversee the PHC close to them indicating that there is a desirable need to employ doctors to man the PHC in the near future.
Tertiary Health Care institutions such as Dalhatu Specialist Hospital, Lafia, Federal Medical Centre, Keffi, and other general hospitals across the state are strengthening the relationship with Primary Health Care Development Agency to ensure the issue of human resources for health is over.
