Hi all, I would like to know from you esteemed people on Nairaland what the major problems with our primary health care system are in Nigeria.Thanks all!!!!!

If I begin, there will be no end,

Lack of facilities
Lack of Training for the Doctors (they will never be compared to British medical doctors)
Lack of common and basic training especially Nurses!!
Lack of empathy
Lack of funding
Lack of hygiene
Lack of GOD GIVEN COMMON SENSE & INTELLIGENCE in the GOVERNMENT among those blood sucking hungry BASTARDS who are Governors!!
Lack of Electricity, how person go operate when light no dey? U go use Lamp how person go do X-ray when NEPA no fit show?

Need I go on? The question started with problems with Primary health care abi? But in order to solve that issue other underlying MAJOR issues MUST rear its Ugly head first,

God Dey sha, 9ja go better,

Having the primary basic necessity in Nigeria is crucial to our survival in all part.
Electricity is a major part of this problem, if that can be solved, then I think things will start picking up gradually.
More so, there are no hospitals with the proper equipment for the sick, and if there are, how many Nigerians can afford to pay for a good quality health care service?

The no1 problem is about medical facilities. Can you imagine a clinic without ECG, a clinic with ancient sphyg, miserable thermometers, ancient dental tools, poor electricity, inadequate water supply, degraded laboratory tools, miserable surgical room with no difference from a carpenter's workshop.
If any one ask you the cause of all these, tell it's the GOVERNMENT

people corruption is our major problen,solve that and every other Ees will fall into place.Education,Eletricity,Employment E.tc

Primary Health Care according to WHO is essential heath care based on practical, scientifically sound and socially acceptable methods and technology made universally available to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self determination.
The Four essential components are

Universal coverage
By ensuring sufficient supply of medicines and services; removing financial barriers to access and ensuring social health protection
People Centered care
By transforming traditional healthcare delivery models (specialist, procedure or hospital-based) into people-centered primary care networks
Inclusive leadership
By shifting from conventional "command-and-control" approaches, increasing participation of all stakeholders and moving from supply-led to demand-led policies and programmes
Health in all policies
By ensuring that all relevant sectors (e.g. labor, environment, education) factor health into their agendas

With this information in mind then one can look critically at the primary health care in Nigeria and try to understand what its problems as a form of healthcare delivery method are.
As someone who has had cause to use the primary health care facilities in Nigeria in the past, I will say that to the common man the primary health care had been a great help in the area of pre-natal and post natal care, immunization, and prevention and treatment of some very common ailments.
However I do believe there are problems with primary health care in Nigeria if one look at what the four essential components are for a Primary health care according to WHO . Below is what I think these are from my own observation.


Lack of enough publicity
Most people don’t know these healthcare centers are there. This limits their patronage. 

Poor or no community buy-in the running of the health care centers
Our politicians think health care is only the buildings and facilities. In a country where a lot people are still illiterates the importance of community buy in cannot be over emphasized. This effectively has not made it easy for primary health care in Nigeria to be “People-Centered”

Lack of adequate number of personnel to man these centers
This could be blamed on brain drain from Africa of medical personnel to the Western Nations.

RRRAAA:

Hi all, I would like to know from you esteemed people on Nairaland what the major problems with our primary health care system are in Nigeria.Thanks all!!!!!

Poster, there is no primary health care in Nigeria, that is a figment of our imaginations, okay? What we have are a farce named government hospitals.

^^I don't understand

bad roads

1. Lack of mission

2. Patient and faculties right and responsibility

3. Ethics and morals

4. Updated technology

5. Education [Both public and employee education]

6. Ratio of healthcare workers to patients

7. Sanitary issues

8. Provision of accurate diet for the patients while they're being hospitalized.

9. GOSSIPing amongst employees

CarlosVent:

bad roads

CarlosVent:

bad roads

LMAO!
I had to laugh at this spurious statement,   

Lady Dee:

LMAO!
I had to laugh at this sppurious statement,

Can you plz enlighten me?

Wrong quote FLGaters, sorry hun

they can summarised like this:

Not accessible - in terms of distance to communities and bad road leading to the centre where you have pregnant women climbing donkeys to access services, imagine that you are in labour and have to climb a donkey to get to the centre.

Not affordable-in terms of drugs and services LGA are suppose to collaborate with the community for drug revolving scheme which is never done leaving the Health worker with the choice of buying the drugs and selling for their profits.

Not available- this can be in terms of trained personnel and facilities.

PLEASE NOTE THAT IN MOST NORTHERN STATES WHERE IAM MORE FAMILIAR WITH, DOCTORS AND NURSES/MIDWIVES ARE NOT SENT TO PHCs. ONLY CHEWS

simple as A B C


government willpower!!!!

all other vices are a derivative of it

i just finished serving in a primary health care center in Edo state so i feel I'm a better position to describe some problems associated with primary health care services as it relates to Nigeria. please note that services that are obtainable in a health care center vary from location to location.

in a local government area with 13 primary health care centers,i was the only doctor covering just one of the centers.the other centers were covered by CHEW,who were not as qualified as a licensed registered nurse, and matrons, some of whom visit the centers that they are supposed to cover one or twice a week.

in a period of eleven months, i had electricity supply that could be added up to 4 months.i had no hope of laboratory investigation services in any form.i usually had to send the patients to a near by town which is 30 - 40 minutes away on bike. availability of an ambulance is a joke;patient could wait for a cab that visits the location once every two hours. most times i had to buy and transport fuel to the centre in order to run my generator for two hours every day.

immunization covered is more than average with adequate supply of materials.the main problem is getting the villagers to come and take the free immunization. in regards to health-care, i was in serious competition with a chemist (not a pharmacist) and a native doctor. you would be amazed that while we are in the 21st century, some people still maintain some health views that predate the colonial era.

i have lost count of number of times i have had to deliver a pregnant woman with torch and lantern. yet we have to keep the cost as low as possible or else the woman would deliver at home or at the farm. telling a woman to do at least one ultra sound scan doing pregnancy is as good as telling her to stop attending ante-natal clinic.

the problem with primary health care centers is not just in the establishment of structures, provision of equipments and laboratory facilities and adequate staffing but also in improving and increasing orientation in the utilization of health-care services. a number of states have started free medical health-care provision, i feel such an approach be implemented at the basic level of health care would  be benificial.

Lady Dee:

Wrong quote FLGaters, sorry hun

No prob

Leopantro:

i just finished serving in a primary health care center in Edo state so i feel I'm a better position to describe some problems associated with primary health care services as it relates to Nigeria. please note that services that are obtainable in a health care center vary from location to location.

in a local government area with 13 primary health care centers,i was the only doctor covering just one of the centers.the other centers were covered by CHEW,who were not as qualified as a licensed registered nurse, and matrons, some of whom visit the centers that they are supposed to cover one or twice a week.

in a period of eleven months, i had electricity supply that could be added up to 4 months.i had no hope of laboratory investigation services in any form.i usually had to send the patients to a near by town which is 30 - 40 minutes away on bike. availability of an ambulance is a joke;patient could wait for a cab that visits the location once every two hours. most times i had to buy and transport fuel to the centre in order to run my generator for two hours every day.

immunization covered is more than average with adequate supply of materials.the main problem is getting the villagers to come and take the free immunization. in regards to health-care, i was in serious competition with a chemist (not a pharmacist) and a native doctor. you would be amazed that while we are in the 21st century, some people still maintain some health views that predate the colonial era.

i have lost count of number of times i have had to deliver a pregnant woman with torch and lantern. yet we have to keep the cost as low as possible or else the woman would deliver at home or at the farm. telling a woman to do at least one ultra sound scan doing pregnancy is as good as telling her to stop attending ante-natal clinic.

the problem with primary health care centers is not just in the establishment of structures, provision of equipments and laboratory facilities and adequate staffing but also in improving and increasing orientation in the utilization of health-care services. a number of states have started free medical health-care provision, i feel such an approach be implemented at the basic level of health care would  be benificial.

This is too SAD!


Have you ever had to let someone go [die]? Because of one of the problems you listed?

.

there are various ways of looking at this problem as it is hydra headed.however a few points need to be buttressed.
the problem is not just a lack of facilities, several states have good facilites in LGAs.the problem is maintenance.some of these facilities are abandoned minutes after commissioning.
another problem is staffing.the stories of health centers with one or no doctor abound.you see scenarios where five health centers are run by one doctor.where there are doctors, the government ignores there welfare.two years ago, a state in the south made so much fanfare of building several health care centres.these centres were equipped to the hilt but the NYSC doctors were not paid for 12 calender months.most of them quietly abandoned the PHC centres for PP in the cities.
it makes no sense building primary health care centres, equipping them and not staffing them properly.
you find cases where people queue for long hours to see the doctor,especially since it is free, they go back home frustrated and disappointed.

It is always the standard practice to blame the elites when something goes wrong.In contributing to this topic I am going to do so in the context of an experience I had at the Igando general Hospital which is close to my house.We were excited when the Lagos State Govt came up with the project but I was constrained to go there only on sunday 20 june very early in the morning.My baby of one and half years old was vomitting and stooling and we were advised that it was a very delicate situation for a baby.At the hopital they were reluctant to attend to us they said it was a sunday and that only emergency cases would be attended to .Upon my insistence a registration card was issued but the one to be given to the doctor was witheld on the ground that this will only be released when the doctor gives a go ahead.In the middle of all these patients were subject to all kinds of abuses by the nurses and attendants.A recourse to a senior nurse on duty was equally fruitless.As this was going on an elderly man was brought in Kombi bus and he was unable to come out of the bus.He was in that bus for about 30 min before a female doctor came.Her attention was drawn to the man in the bus and her response was that she cannot enter the rain.An umbrella was provided and she looked into the bus and directed that the man must be brought out.this was done and the man was placed on one of the wooden benches where she barely examined him and left for her office.Next I saw the man being evacuated for help elsewhere.Thereafter I walked up to her and greeted her but she ignored me.I was incensed because I am a professional and the fact that I was in the hospital did not give any body cause to be uncivilised to me.I therefore entered her consulting room where she was chatting with some nurses and reststed that I had delicate problem on my hands and requested for help or some form of first aid.The doctors response was that she did night that it is the doctor who would resume later that would attend to us.It took me over one hour to get this response.There were a lot of people in that predicament and they were just waiting helplessly.We were force to rush the baby to a private hopital where she was admitted immediately and was discharged after 2 days.
On another occasion I had rushed an elderly diabetic woman who was about to enter coma on account of low blood sugar to the emergency unit of LASUTH Earlie in the year at about 2am.The nurses were fine but the doctor on duty was annoyed to have been roused from his sleep .Instead of attending to us he stated by saying that he cannot attend to the woman as he had no space in the hospital.I pleaded that he stabilised the woman till morning when we can take her to another hospital but he refused.It was only when I left the woman in his office and threatened that if anything happened to her that I would deal with him that made him come to our aid
This situation is common and unless the medical personell begin to learn the basics of customer service with the patients as their primary focus that change can come.There is need to weed all unsuitable personell otherwise the poor masses will continue to suffer.I intend to take up the Igando case with the State Commissioner for health

ronkyzee1:

It is always the standard practice to blame the elites when something goes wrong.In contributing to this topic I am going to do so in the context of an experience I had at the Igando general Hospital which is close to my house.We were excited when the Lagos State Govt came up with the project but I was constrained to go there only on sunday 20 june very early in the morning.My baby of one and half years old was vomitting and stooling and we were advised that it was a very delicate situation for a baby.At the hopital they were reluctant to attend to us they said it was a sunday and that only emergency cases would be attended to .Upon my insistence a registration card was issued but the one to be given to the doctor was witheld on the ground that this will only be released when the doctor gives a go ahead.In the middle of all these patients were subject to all kinds of abuses by the nurses and attendants.A recourse to a senior nurse on duty was equally fruitless.As this was going on an elderly man was brought in Kombi bus and he was unable to come out of the bus.He was in that bus for about 30 min before a female doctor came.Her attention was drawn to the man in the bus and her response was that she cannot enter the rain.An umbrella was provided and she looked into the bus and directed that the man must be brought out.this was done and the man was placed on one of the wooden benches where she barely examined him and left for her office.Next I saw the man being evacuated for help elsewhere.Thereafter I walked up to her and greeted her but she ignored me.I was incensed because I am a professional and the fact that I was in the hospital did not give any body cause to be uncivilised to me.I therefore entered her consulting room where she was chatting with some nurses and reststed that I had delicate problem on my hands and requested for help or some form of first aid.The doctors response was that she did night that it is the doctor who would resume later that would attend to us.It took me over one hour to get this response.There were a lot of people in that predicament and they were just waiting helplessly.We were force to rush the baby to a private hopital where she was admitted immediately and was discharged after 2 days.
On another occasion I had rushed an elderly diabetic woman who was about to enter coma on account of low blood sugar to the emergency unit of LASUTH Earlie in the year at about 2am.The nurses were fine but the doctor on duty was annoyed to have been roused from his sleep .Instead of attending to us he stated by saying that he cannot attend to the woman as he had no space in the hospital.I pleaded that he stabilised the woman till morning when we can take her to another hospital but he refused.It was only when I left the woman in his office and threatened that if anything happened to her that I would deal with him that made him come to our aid
This situation is common and unless the medical personell begin to learn the basics of customer service with the patients as their primary focus that change can come.There is need to weed all unsuitable personell otherwise the poor masses will continue to suffer.I intend to take up the Igando case with the State Commissioner for health

Your experience just butresses the fact that we dont have a properly run primary health care system in Nigeria.
The cases you mentioned are PHC cases and shouldn't ideally have ended up in a hospital.
I feel your pains anyway, theres a lot of rot in that country and its so saddening.

i just finished serving in a primary health care center in Edo state so i feel I'm a better position to describe some problems associated with primary health care services as it relates to Nigeria. please note that services that are obtainable in a health care center vary from location to location.

in a local government area with 13 primary health care centers,i was the only doctor covering just one of the centers.the other centers were covered by CHEW,who were not as qualified as a licensed registered nurse, and matrons, some of whom visit the centers that they are supposed to cover one or twice a week.

in a period of eleven months, i had electricity supply that could be added up to 4 months.i had no hope of laboratory investigation services in any form.i usually had to send the patients to a near by town which is 30 - 40 minutes away on bike. availability of an ambulance is a joke;patient could wait for a cab that visits the location once every two hours. most times i had to buy and transport fuel to the centre in order to run my generator for two hours every day.

immunization covered is more than average with adequate supply of materials.the main problem is getting the villagers to come and take the free immunization. in regards to health-care, i was in serious competition with a chemist (not a pharmacist) and a native doctor. you would be amazed that while we are in the 21st century, some people still maintain some health views that predate the colonial era.

i have lost count of number of times i have had to deliver a pregnant woman with torch and lantern. yet we have to keep the cost as low as possible or else the woman would deliver at home or at the farm. telling a woman to do at least one ultra sound scan doing pregnancy is as good as telling her to stop attending ante-natal clinic.

the problem with primary health care centers is not just in the establishment of structures, provision of equipments and laboratory facilities and adequate staffing but also in improving and increasing orientation in the utilization of health-care services. a number of states have started free medical health-care provision, i feel such an approach be implemented at the basic level of health care would be benificial.

tanks for the heads up


very enlightening

its a multi systematic problem
- No health insurance scheme THAT WORKS in Nigeria.
im at work as we speak at a Private hospital, and this lady came in, very ill, definately needs admission and a couple of preliminary tests, she does not have money to pay, i had to start analysing the intravenous drugs and everything i had prescribed to find a combination she could afford, even with that she said she could not pay the grand sum of 3k! of course admission was out of it for her and she had to go home. ( i have a policy of not paying wiv my own money for patients except its a child). its very pitiable and it frustrates the hell out of doctors when u know u can do more but are constrained by lack of infrastructure, basic stuff that is taken for granted in other countries. its a shame.

primary health care is not the only problem in nigeria, when the virus called corruption enters into any country it will affect every part of our economy, the way we are complaining about primary health care is the same way every other sector of our economy is complaining,

we have to change this country by starting from where we are and doing what we can do any where we find ourselves, even though we know the government has to take a lot of the blame, there are still cases where acts of selfless service can go on and change lives

in the last set of NYSC that just passed out, a doctor won a national award because of his selfless service to nigerians in kogi state, this doctor built six wards with his own money, he bought many medical equipment for those wards,

imagine 100 nigerians just in kogi state, thinking like that, you could imagine the impact they would make, i am happy that we have reached the point where we complain about the services rendered by the government, it means we will soon get tired of complaining and start acting

It's not all government government government.
After all there are people working in the 'government' health care sector. Nothing GEJ or any other president does will change anything, until the health care practitioners themselves change.

Like all other professionals, health care practitioners in Nigeria are mostly lazy and greedy. Like other professionals, they have a terrible attitude to their work. Unfortunately, they are dealing with human care, so the impact is more severe. If you want to blame government, just go to any of the highbrow private hospitals and check out the terrible attitude of the staff.

Olikoye Ransome Kuti, whom we all believe was the best ever health minister, said this after he left office. 'My greatest regret is not being able to pursue the various reforms I had in mind. Most of the health care workers in Nigeria are only interested in what they can get, and their current positions, rather than how to move the health sector forward.'. Need I say more?

the major problem is lack of commitment
poor political will
lack of workers commitment
lack of incentive to workers in rural areas
lack of proper monitoring

omoabike: Primary Health Care according to WHO is essential heath care based on practical, scientifically sound and socially acceptable methods and technology made universally available to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self determination.
The Four essential components are

Universal coverage
By ensuring sufficient supply of medicines and services; removing financial barriers to access and ensuring social health protection
People Centered care
By transforming traditional healthcare delivery models (specialist, procedure or hospital-based) into people-centered primary care networks
Inclusive leadership
By shifting from conventional "command-and-control" approaches, increasing participation of all stakeholders and moving from supply-led to demand-led policies and programmes
Health in all policies
By ensuring that all relevant sectors (e.g. labor, environment, education) factor health into their agendas

With this information in mind then one can look critically at the primary health care in Nigeria and try to understand what its problems as a form of healthcare delivery method are.
As someone who has had cause to use the primary health care facilities in Nigeria in the past, I will say that to the common man the primary health care had been a great help in the area of pre-natal and post natal care, immunization, and prevention and treatment of some very common ailments.
However I do believe there are problems with primary health care in Nigeria if one look at what the four essential components are for a Primary health care according to WHO . Below is what I think these are from my own observation.


Lack of enough publicity
Most people don’t know these healthcare centers are there. This limits their patronage. 

Poor or no community buy-in the running of the health care centers
Our politicians think health care is only the buildings and facilities. In a country where a lot people are still illiterates the importance of community buy in cannot be over emphasized. This effectively has not made it easy for primary health care in Nigeria to be “People-Centered”

Lack of adequate number of personnel to man these centers
This could be blamed on brain drain from Africa of medical personnel to the Western Nations.

You have summarized the subject matter. Your contribution should be carefully studied by stakeholders.

Thank God 4google,nairaland & the op 4dis post my assignment is completed.

omoabike:
Primary Health Care according to WHO is essential heath care based on practical, scientifically sound and socially acceptable methods and technology made universally available to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self determination.
The Four essential components are

Universal coverage
By ensuring sufficient supply of medicines and services; removing financial barriers to access and ensuring social health protection
People Centered care
By transforming traditional healthcare delivery models (specialist, procedure or hospital-based) into people-centered primary care networks
Inclusive leadership
By shifting from conventional "command-and-control" approaches, increasing participation of all stakeholders and moving from supply-led to demand-led policies and programmes
Health in all policies
By ensuring that all relevant sectors (e.g. labor, environment, education) factor health into their agendas

With this information in mind then one can look critically at the primary health care in Nigeria and try to understand what its problems as a form of healthcare delivery method are.
As someone who has had cause to use the primary health care facilities in Nigeria in the past, I will say that to the common man the primary health care had been a great help in the area of pre-natal and post natal care, immunization, and prevention and treatment of some very common ailments.
However I do believe there are problems with primary health care in Nigeria if one look at what the four essential components are for a Primary health care according to WHO . Below is what I think these are from my own observation.


Lack of enough publicity
Most people don’t know these healthcare centers are there. This limits their patronage. 

Poor or no community buy-in the running of the health care centers
Our politicians think health care is only the buildings and facilities. In a country where a lot people are still illiterates the importance of community buy in cannot be over emphasized. This effectively has not made it easy for primary health care in Nigeria to be “People-Centered”

Lack of adequate number of personnel to man these centers
This could be blamed on brain drain from Africa of medical personnel to the Western Nations.

Though at least three years old, the summary of details leading to service failures in the Health sector
as posted here have not really changed. What has changed are the structures put in place by various
Government measures. HMO's have become a visible part of the sector. However, like all other structures
and systems put in place in Nigeria, the Nigerian factor plays a great destructive feature.

There are allegations that NHIS funds are mismanaged. There are stories that HMO's undercut each other just
to make sales not caring if the services that providers are supposed to carry out can be done adequately
at rates they charge. Providers complain that agreed rates have not been reviewed since the first post on
this topic was published. Yet we know that the exchange rates have at least doubled in the space of time
that has elapsed leading to increases in operating costs.

If the Health sector reforms were to run according to stipulated mechanisms, it would work seamlessly.

State after state has seen the benefits of forms of Health Insurance or Managed care as practiced in states like Oyo etc.
For the scheme to work well it is necessary that it be run as social service and managed judiciously mainly at
the PHC level. What will work in a system like that being offered by Lagos State which is to be launched tomorrow is to
allow the form in which it is being launched to be managed as a frugal system by PHC's while those desiring secondary care
be made to pay something close to what is being charged by HMO's but managed by the LSHS.

My suggestion arises from a discussion i had today with a Medical Director of an LSHS participating provider, who said that
their review of rates and structures for the LSHS showed that it was well thought through, but required the fix mentioned above.