In Bogobiri the heart of Calabar, the Cross River State capital, three health workers sit around a table covered with Cross River State’s blue and white cotton material and a heap of books spread across the length of the table.

This is supposed to be one of the primary health care facilities in the state, and it is one of the facilities selected to benefit from the Basic Health Care Provision Fund (BHCPF).

This health facility that caters for areas including Etim Edem Park, Watt Market, Bogobiri, Barracks road and more, is basically a table with a mountain of books on it, and a few white plastic chairs all placed at the entrance of the hall within the premises of the Apostolic Church.

There is no building, no store room, no labour room and the health workers operate at the benevolence of the church, which stands opposite a mosque in this community of mostly Muslims.

“We have operated like this for about five years now,” says Ms. Mary Henshaw, who is in charge of the facility, adding that all efforts to get a befitting building has proved abortive due to lack of finances.

Ms. Henshaw revealed that most of the health emergencies rushed to the facility have been referred to their mother facility at Ekpo Abasi, a distance of approximately 4 Kilometers and that women who needed to deliver at night had to find their way to the University of Calabar Teaching Hospital, as the ‘centre’ does not run a night shift.

And that was the fate of Malam Aminu Bin-Usman when his wife was due for their last baby.

“My wife wanted to give birth in the night, we couldn’t come here. We had to run around and go to the teaching hospital,” he said, adding that it was easier for him because he owns a car and that the trouble for others without personal vehicles can only be imagined.

Malam Aminu, who is a member of the Ward Development Committee (WDC), a group of influential men and women tasked with overseeing and mobilising collective action at the grassroots, held that the greatest challenge faced by the facility is accommodation. According to him, accommodation problems have made it difficult for the facility to serve the community.

In June this year when Elizabeth Ugbong went to deliver her baby at the Primary Healthcare Center (PHC) in Bebuabie, in Obudu Local Government Area of Cross River State, she was asked to bring delivery items that included rolls of tissue paper and disinfectant. She was also asked to pay a bill of N18,000 – more than twice what the mother of three makes a month from the small hair-braiding business she runs from her house in the community of mostly farmers.

Speaking through an interpreter with her second child tucked in between her legs alongside a blue bucket she was using to wash clothes, Elizabeth added, “After giving birth, the hospital staff refused to let me go and take care of my children insisting that I must pay the N18,000 before I am freed.”

It took the intervention of her uncle who coughed out N10,000 after she had spent a week in the PHC before she and her newborn were discharged.

It was the same situation for Josephine Abang who had to cough out the sum of N11,000 to be allowed to give birth at the government-owned health clinic in Ohong, in Obudu, the local government of the State Governor, Ben Ayade.

But no receipt was issued for the N11,000 collected from her.

“I paid N4,000 for registration and I was later asked to pay N7000 when I gave birth.” The mother of one was on her way to the health facility for post-natal care and said she also bought “toilet tissues, Izal, and Dettol,” as the clinic staff insisted it was mandatory for her to provide them if she is to have her child at the clinic that serves the rural community.

The demand for money and other consumables by the health facilities before attending to patients runs foul of the intentions and objectives of the Basic Health Care Provision Fund (BHCPF).

CrossRiverWatch investigation further uncovered that despite authorities saying the scheme has fully commenced in the state, drugs required to treat patients for free are not available, and there is no sign that they have started receiving payments from the State Health Insurance Scheme (AyadeCare) for the smooth operation of the program.

Misappropriation Of Basic Health Care Provision Fund

Established under Section 11 of the National Health Act (2014), President Muhammadu Buhari officially rolled out the Basic Health Care Provision Fund (BHCPF) in 2018. The Fund, sourced from one per cent of the Federal Government Consolidated Revenue and contributions from donor agencies, is aimed at providing basic healthcare for Nigerians who cannot afford it, especially at the local health centres.

The fund is disbursed and implemented through three gateways: the National Primary Health Care Development Agency, (NPHCDA), which gets 45% of the funds, and in liaison with the State Primary Health Care Development Agency, which funds eligible PHCs in participating states.

The second gateway is the National Health Insurance Scheme gateway which gets 50 per cent of the funds and works with the state’s health insurance scheme (in Cross River, AyadeCare ) to insure the most vulnerable and help them access a basic minimum package of health services, and five per cent through the Emergency Management Treatment (EMT) gateway.

Facilities receiving BHCPF are to provide antenatal care, delivery, and postnatal care for pregnant women, immunisations and treatment for malaria, pneumonia, measles, and dysentery for children under five, malaria treatment, hypertension and diabetes screenings, and family planning for all adults.

On Tuesday, May 21st, 2019, Prof. Isaac Adewole, the former Nigerian Minister for Health while addressing the Senate said 14 states including Cross River had refused to participate in the program by not paying the required counterpart funding in the year the Cross River State Government had budgeted to spend over N1 trillion.

Adewole, who described the BHCPF as a “game-changer,” added that the fund has been structured “in a way that money will flow from the Central Bank to the primary healthcare facilities, bypassing all obstacles.”

Two years later, Governor Ben Ayade’s launch of the Basic Health Care Provision Fund and the State Health Insurance Scheme marked the commencement of the program that aims to provide free and affordable health care for the poor in Cross River State.

READ MORE HERE: https://www.icirnigeria.org/how-cross-river-phc-boss-and-husband-fleece-basic-health-care-provision-fund/

https://www.youtube.com/watch?v=2aeA_LM8S-Q