How lack of amenities sabotages healthcare delivery in Lagos

By Chioma Obinna

Incredible, you would say!  But it is an unquestionable fact. Kerosene, petrol,matches and nylon bags have become major requirements for expectant mothers before delivery in Lagos. Ordinarily, demand for these items, particularly kerosene is quite odd.

But given the poor power supply in the country, what alternative does a health centre in a rural community have to keep delivered mothers warm before they are discharged?
This explains why health centres in Alimosho Local Government, a suburb of Lagos are now adding half gallon of kerosene to the list of requirements expectant mothers must submit before delivery.

A visit to some other health centres revealed that in addition to the power problem, chronic shortage of medical personnel is another challenge. These inadequacies continue to affect effective delivery of healthcare services.

The LGA, home to about two million people and one of the largest local governments in Lagos State, can only boast of two PHCs. Worse still, Alimosho has one of highest maternal mortality rates in the state. A 2008 NDHS Report shows that it had about 900 deaths per 100,000 live births.

Mobilising the women One of the centres visited include Orisunbare Primary Healthcare Centre where LACSOP, PATHS 2 and other Civil Society Organisations have taken pains of training what they described as “Ward Health Committee”’ to strengthen the centres as well as mobilse the women.

The Ward Health Committee members which comprise community leaders and non indigenes were trained by PATHS2 to support the effort of the LGA in ensuring adequate health service delivery especially services aimed at reducing maternal and child mortality through community efforts. They advocate to the LGA on behalf of the community people and hold quarterly community forums to address health issues experienced at the PHC.

The Chairman of the Ward Health Committee, Orisunbare Health Centre, Alhaja Hafsat Adebisi confirmed to Good Health Weekly that before they were trained the health centre was not rendering antenatal and immunisation services due to the state of the health centre. She said since the establishment of the Committee, there has been improvement.

“Through this Committee, we have raised money to install ceiling fans in the centre. Mothers used to feel uncomfortable bringing their babies because of the heat. We want residents to know that there is a functional health centre in the area.
Training

“We were trained in March this year on how to mobilse people to our PHC and to make sure it is functioning. We used to go to our CDA meetings to talk to them. We involve the traditional birth attendants and meet Baales to advise them on the need to encourage the women to visit the centre.”
Orisunbare PHC was established in 2008 to serve about 50,000 people. The health centre which initially was running an 8-hour healthcare delivery services was upgraded to a 24-hour service in June, 2014. Since then, the number of patients at the centre has increased, yet just one medical doctor, Youth Corps member, is serving about 250 patients daily at the Centre.

A Local Technical Assistant, with PATHS2 and, Member, Lagos State Civil Society Partnership, Chinyere Nkire said they mobilise community members to make use of the health centre and also work with community leaders to simplify concept that may seem worrisome to residents.

It was gathered that the kerosene is for boiling hot water when they need it in preparing tea or bathing their babies. One Mrs. Oladimeji who delivered a year ago at Merian Health Centre, recounted her experience.

“It is common practice in Lagos PHCs, not just Alimosho. I delivered last year at Merian health centre, I was asked to bring five litres of fuel and kerosene. My husband paid about N1, 500 for the two items,” Oladimeji stated.

The Officer in –charge, Orisubanre, PHC, Mrs. Giwa Folake noted that the centre began 24 hour services in July this year and diversified into ante natal care, child delivery, immunisation, out patients and family planning cares.

“I was posted here in May 2014 and I noticed that the place was not in good condition. Now they have employed about six non pensionable nurses and laboratory technicians and since then we have been having 24 hours. We started with three antenatal cases as at last report in September we have 68.

Today, we have 40 antenatal cases. Ante natal registration and delivery are free. Initially we did not have delivery couch but with the help of PATHS 2, we have a delivery couch and some little instruments that we are using now.

They only pay for their drugs and laboratory tests. But today, we just got a letter that they will be paying N2, 000 after delivery. We only refer operation cases and have referred two cases since we started.”

At Alabata PHC, Akowonjo, in Alimosho Local Government Area, the situation was not different as patients lamented the congestion.

Complaints Most of the women complained that each time they visit the centre; they spend the whole day waiting to be attended to. When asked why they cannot leave or go to other centres, they said, the only alternative which is Alimosho General Hospital is no better as congestion remains the order of the day.

In a chat, the Chief Matron, Alabata PHC, Mrs. Grace Okpadotun said no fewer than 250 patients are seen daily and the Centre extended its services to Isheri due to lack of space. Okpadotun, who identified lack of space for operations in the health centre as a major problem affecting effective services, said: “The number of patients that come here daily is overwhelming but we are managing to attend to them the best way we can.”

Asked why the centre includes kerosene to its list even when the Lagos State Government has made available free Mama’s kit for delivery, she said: “We only do that due to epileptic power supply. The kerosene is used to boil water for their bath until they are discharged.”

Medical Officer’s response
Responding to state of health centres under his care, the Medical Officer for Health, Alimosho LGA, Dr. Kayode Odufunwa, denied knowledge of the mandatory kerosene requirement, saying government was not aware either, however lamented poor funding, epileptic power supply and lack of space among the key challenges facing effective delivery of healthcare services.

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