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Equipping healthcare centres for better service delivery

By Kayode Crown
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It’s not enough to build health facilities, they would be mere shells without adequate staffing. But the staff would be largely handicapped, unable to carry out even the basic duties, relying mainly on guess work to the detriment of the people of the community they are supposed to serve, if they lack the required medical equipment.

The experience would be extremely frustrating not just for the patients but also the staff. The staff, because what they have spent many years in school to learn, they are unable to practice to help the people who troop into the centres, and for the patients, their hope of adequate medical attention dissolves into thin air as their very lives may be at risk, helpless in the hands of the medical personnel, who are as helpless as they are. With ailments are wrongly diagnosed because of the dearth of the needed equipment, drugs and wrongly used and the burden of morbidity becomes greater.

The primary health care (PHC) facilities are the closest to the people, but one which has suffered neglect over the years.

To highlight how vital those health facilities are, the Minister for Health, Professor Isaac Adewole, recently declared from his professional point of view that 80 percent of health problems in Nigeria could be solved at the Primary health care level of the health system if adequate attention is given to service delivery at the State and Local Government levels with the facilities properly funded and managed.

He expressed the Federal Government’s commitment to ensure they are one well-funded and that PHC is functional in each L.G.A. in Nigeria.

It seems that getting it right at the level of the PHCs has the potential to radically transform the health sector in Nigeria which would go a long way to increasing the life expectancy in Nigeria, which is presently 54.5years and we are ranked 177 out of 183 countries profiled (WHO, 2015).

It’s been a sad tale in this country of primary healthcare centres lacking the essential tools to perform some of its roles. Without the right diagnostic tools, treating patients becomes hit and miss, like looking for a needle in a hay sack. It will be pure trial and error.

What hope is there for the health sector, which is in such a bad shape? No wonder we have one of the lowest life expectancy in the world with how we have allowed our primary healthcare to suffer for a long time.

Recently, the Ondo State government took delivery of medical equipment and deployed them to the eighteen local governments, as it keyed into the All Progressives Congress-led Federal Government’s policy to intervene at that level of health care in the country.

The equipments include 18 Microscopes, 18 Bench Centrifuges, 18 improved counting chambers, 18 Micro-Haematocentrifuge, 18 Micro-Haematocrit readers, 36 Glucometers and Strips, 18 Widal test Kits, 18 Oxygen Concentrators (with inbuilt inverters), 18 Oxygen Face Masks and Laboratory Reagents of various types.

These constitute some of the basic needs for a primary healthcare facility to enable it serve the people effectively, consisting mainly of diagnostic tools, without which an health care center would not be worth the sign board on which it has its name. Diagnosis is thereby taken beyond guess work and the medical personnel can carry out their assignments with joy.

At the event where the equipments were distributed to the 18 local government (one primary healthcare centre each), the Ondo State Governor, Arakunrin Oluwarotimi Akeredolu, (SAN), revealed that the distribution of the equipment is the first step towards the fulfillment of the Federal Government policy that has to do with the adequate equipment of the states’ primary healthcare centres. The policy is tagged Millennium Service Package (MSP) pillar of the Primary Healthcare Under One Roof (PHCUOR).

The target is that at least one unit of a well-equipped, standardised and functional laboratory is available in each of the 18 Local Government Areas of the state.

The governor said: “One striking feature of some of the multimillion naira worth of equipment, is that proper cognizance was taken of the infrastructural profile of our communities.

“For instance, for the reason that a number of these communities where our Primary Healthcare facilities are located do not have sufficient and regular power supply, we ensured that Oxygen Concentrators that were procured are those with in-built Uninterrupted Power supply (UPS).

“This will ensure prolonged usage of the equipment to deliver oxygen to persons needing it, especially children with acute severe respiratory distress which has claimed the lives of many of our children less than five years old.

“When our administration came on board in 2017, we made a pledge to the good people of our state, that we shall steadily improve the health of our people by providing the enabling environment and necessary working tools for our teeming health workers at all levels of care.

“Today, I’m glad that in less than two years, the potential of our Primary Healthcare system is being boosted with these equipment being commissioned today.

“It is my hope that this equipment will be promptly distributed and installed in the facilities for which they are earmarked so that our people can begin to feel the impact of government in our healthcare system.

“It is also my expectation that requisite training will be organised for the relevant health workers who shall man this equipment.”

He pointed out the benefit of the diagnostic tools for pregnant women, saying that their blood profile can be quickly determined for early and decisive intervention in the pregnancy to adequately care of both the woman and the unborn child.

He mentioned HIV screening, blood grouping and cross-matching, routine antenatal investigation as some of the uses of the medical gadgets and kits.

He noted that that the provision of Oxygen Concentrators and their accessories with enable the health facilities to provide oxygen therapy when needed.

Arakunrin Akeredolu assured that in the nearest future, subsequent phases of equipment and facilities upgrade be targeted at the other Primary Healthcare facilities till each is able to meet the criteria for proper classification, according to the MSP guideline.

Commissioner for Health, Dr. Wahab Adegbenro on his own, said: “Our objective then is still the same as now and that is to enrich the quality of care available to the good people of Ondo State.

“How can we accurately make diagnosis in the absence of essential laboratory utensils in our Primary healthcare facilities? How can we effectively treat diseases at the primary level without requisite medical equipment?”

Not only has the equipment being delivered to the local governments, the medical staff have also been trained to handle them.

This is a very important part of the whole process. Because, what is the use of the medical equipment worth millions of naira, if the medical staff are not adequately trained to handle them?

There are tales of equipment bought for untold millions of naira, allowed to gather dust and become damaged after long term disuse.

What began as a very good policy initiative and idea ends in rot and huge amount of money going down the drain.

At the training workshop which began on September 26 to prepare staff of the health centres in the 18local governments to use the new medical equipment, the diagnostic tools and respiratory aid, the Commissioner for Health said that the staff must handle the equipment well to guarantee the right result.

It is clear that the wrong understanding of an equipment can lead to wrong use and therefore wrong diagnosis, and what was supposed to be a force for good results in evil, completely defeating the initial purpose.

Dr Adegbenro clearly told the medical laboratory officers that the Government is bent on improving the health sector and it is their responsibility to use the equipment well.

The Executive Secretary, Ondo State Primary Health Care Board (OSPHCDB), Dr. Francis Akanbiemu added that the focus of government is to ensure that cases which are to be attended to at the primary healthcare level are done and not transferred to other health tertiary institutions like the General Hospitals, adding pressure to them.

All these is because the government is determined to get a good return on its healthcare investment, which is meant to translate into better health status of the citizens, with reduced mortality and morbidity.

Apart from the specified medical equipment given to the local governments, in a recent trip to the United States of America, the governor’s was able secure N2.1billion ($6m) worth of medical facilities from a Non Profit organisation to further strengthen the health sector in the state.

As reported by NAN, who interviewed the Ondo State governor in Atlanta, Akeredolu said, “I went there (MedShare) myself and found out that everything they’re going to ship down is new and a lot of our colleagues have benefitted from this; nobody has ever mentioned it.

“I mean what I got from Nell (Diallo), the Vice Chairman of MedShare, is that initially she got the 19 states in the north to come and they all came and bought into it.

“Babangida (former governor Aliyu) bought into it in Niger State.

“Today, Bayelsa is doing a lot because it got people to sponsor them; Bayelsa is doing a lot of shipment.

“I now said if this be the case and we never knew and not only that, the Federal Government of Nigeria has bought into it.

“When we got into their storage facility, we saw a lot of packages ready to go to National Hospital, a lot are going to Bayelsa.

“And I was saying ‘wow, wow’ so we are missing out of these?

“I said to them immediately, we are going to order for about 20 container loads to start with.”

According to NAN, “The module for receiving the container load of $300,000 worth of medical supplies and equipment involves the sponsorship of $25,000 for shipping logistics. The governor said the bargain was too good and that the state government would source for funds immediately to pay the $500,000 for shipping logistics for all the 20 containers.”

Arakunrin Akeredolu said: “We will raise funds to make sure that we are able to pay for it so that we can equip our hospitals with necessary facilities, which have been lacking for long.

“So my understanding with MedShare is for us to start with 20 container loads for now and then we proceed until we get to 50 (container loads).

“If we’re able to do that, then I’m sure all the medical equipment needs for all our hospitals in Ondo State, we will have covered it because everything we need, they’re all there.

“Anyway, things that are not there (MedShare), the idea is for us to let them know and they will source it and send to us too. So this is a good idea.”

MedShare is described as a Medical Surplus Recovery Organisation that collects and distributes surplus medical products to qualified healthcare facilities in medically-underserved communities around the world on an on-going basis.

While praising the Ondo State government for securing such a deal, the Ondo State Chairman of Associations of Professional Bodies in Nigeria, Prince Adeyinka Adedire, emphasised the need for the training and retraining of qualified and licensed health workers that will handle the equipment.

Prince Adedire, who is a leader in Association of Medical Laboratory Scientists of Nigeria (AMLSN) in the state, harped, according to reports, on the need for a well planned and managed maintenance programme that will keep the medical equipment reliable, safe and available at all times for diagnostic procedures, therapy, treatment and monitoring of patients.

On Sunday, Special Focus spoke with the Ondo State Commissioner for Health, Dr Adegbenro on the phone, and he revealed that the medical equipment from MedShare are already on their way to Ondo State and we would soon witness a radical change in the health sector going by the zeal with which the Governor is pursuing the matter.

It means the story of their procurement was not about scoring cheap political points, but the Ondo State Governor has put a good measure of political will behind it to see to it’s fruition and transform the health sector in the State.

Adegbenro said in the telephone chat: “The equipment are on their way. Everything has been taken care.

“Medical equipments are supposed to be duty free. We have applied for the import duty waver and we are waiting for its approval.

“When we have the approval in place, and the equipment eventually arrive, we will easily clear them and we won’t need to pay for custom duties. They are already on their way.”

Owena Press Limited (Publisher of The Hope Newspaper), Akure

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