By Vincent Ujumadu
AWKA — FOLLOWING the release of the fact sheet of Service Delivery Indicators, SDI, survey for 2013 in Anambra State, which exposed the problems in the health sector, stakeholders from the health departments in al the 21 local government areas of the state brainstormed in Awka to suggest ways of improving the situation.
The stakeholders were armed with the report of the survey sponsored by the World Bank, the Bill & Melinda Gates Foundation and Hanova Medical Limited. During the two-day exercise, the stakeholders considered issues raised in the report point by point after which recommendations were made to the policy formulators of the state government on what should be done to put the health sector on the right track again.
According to the report, there was only 17.1 per cent adherence to clinical guidelines, while adherence by doctors, nurses/midwives and para-professionals were 32.8 per cent, 21.7 per cent, 14.2 per cent and 10.8 per cent respectively.
Similarly, the absence of health workers from facilities ranged from 32.6 per cent in health posts to 48.5 per cent in secondary health facilities, while 42.8 per cent of doctors, 39.1 per cent of nurses, 44.4 per cent of para-professionals were absent from all facilities during unannounced visits.
It was, however, observed that 43.9 per cent of excused absence was in the form of training, official mission and approved absence, while 15 per cent and 8.6 per cent were unapproved absence and sick/maternity. The report said that only 15 per cent of all health facilities had work plans, while 7.4 per cent had quarterly implementation plans, adding that availability of work plans among the primary tier health facilities was even lower, recording 14.4 per cent, compared to the secondary facilities which stood at 51 per cent.
The stakeholders who worked in groups, in their recommendations, agreed on the need to employ more staff, provide the necessary infrastructure, including vehicles for monitoring activities, refrigerators for storing drugs at the right temperature, training and retraining of staff, improved budgetary allocation to the sector. Essentially, the survey centred on what health workers know, what they do, what they work with, as well as management of resources, supervision and financing.
Dr. Dale Ogunbayo, who provided technical support for the survey described the outcome as an eye opener, adding that it would assist authorities to improve on areas the country was lagging behind. According to him, rather than apportion blames, the best thing to do is to find the way forward, which was why the stakeholders who operate at the primary healthcare level to make the necessary input that will guide the state government in making policies that concern the health sector.
Some of the participants admitted that the report was not a surprise to them, noting that it revealed the anomalies which they had been complaining about anytime they had opportunity to interact with officials of the ministry of health. They observed that in some of the Primary Health Centres, there is only one staff and wondered the kind of result to expect from such a situation. They also complained that local government chairmen were not helping matters as they are only interested in ventures that could yield money for them.
For instance, most of the stakeholders said that although all local governments have giant generating sets to power the entire local government, the chairmen abandoned them and procured only the small ones that light their offices, keeping the entire local government in darkness. They also allege that drugs supplied to the health centers are not properly accounted for, leading to some health staff purchasing drugs they administer to patients and charging them money, when such services were expected to be provided free of charge.