Lagos PHCs: How local govts abandon facilities to residents

THERE are several houses in the fairly large community but one has a peculiarity that cannot be missed by a visitor. Sitting in the heart of the rural settlement, both young and old often visit the vicinity until some months ago.

Gradually but steadily, the accessories had taking turn to fall-off the building. Flaking walls, broken windows and benches, worn surface and widening cracks – all seems to bothered no one until a mild windstorm visited last April and blew off the roof of the community’s prized asset.

Except for the faded signpost that partly reads: “…Primary Health Centre, Ikorodu, Lagos” and a stale patina of a hospital, nothing else would suggest the relevance of the dilapidated structure to health services in the Lagos community.

Residents – fairly elderly among them – recalled with nostalgia how they had made complaints to health workers at the facility, received first aid treatments, medications for malaria, plus antenatal care and child deliveries at the centre. Today, those services are no more, leaving the entire community in the hands of traditional medicine and self-help.

Traditional care was the sole alternative Biola Sonayan was left with during her last pregnancy. Twice she had delivered at the PHC itch-free after thorough grounding in maternal care, pathway to safe delivery and awareness of warning signs during pregnancy. Now that the facility is no more to give guidance, Sonayan settled for Traditional Birth Attendant (TBA).

Delivery turned out to be a very complicated one. Travelling several kilometres to Ikorodu General Hospital on emergency saved her life, but not of her baby. “It was the toughest delivery I ever had,” Sonayan said, adding that her family would have been saved the trouble if the PHC was around for much longer.

Pa Ajilo, another resident in his 70s, said the community did their best to salvage the health facility from falling, which is, telling the Local Government officials – all residents in the community – to see to it free-fall.

“You know the adage of a goat owned by the entire village (often left to starve to death), that is the case of this place. Government gave us and the people expect them to take care of it. Government didn’t, so it collapsed,” Ajilo said.

The argument is not different from others in the neighbourhood and often the case in many parts of the state where primary health care has failed. Many residents are unaware that it is the duty of the local government to provide them both the facility and basic healthcare for free.

By the enabling Acts, the Local Government Authorities are saddled with provision of primary health in their jurisdiction and mandated to commit at a percentage of monthly allocation to healthcare.

Permanent Secretary of the Lagos State Primary Health Care Board (LSPHCB), Dr. Olukayode Oguntimehin, and our respondents reckoned that the local authorities have abandoned the onerous duty of providing health.

The lot, however, appeared to be different in some communities, where the residents are enjoying the full benefit of a functional PHC. Among them are: Iwerekun II PHC in Bogije, Ibeju-Lekki LGA; Ikeletu PHC in Ijede; Ayobo-Ipaja PHC, Ayobo; Meran PHC, Amikanle in Agbado Oke-Odo; Satelite PHC in Oriade LCDA; Rauf Aregbesola PHC in Mosan-Okunola LCDA and Egbe-Idimu PHC among others.

Member of the Bogije community, Taiwo Jacob, was glad to show that the three PHCs in Ibeju-Lekki LGA – Iwerekun II, Orimedu I and Orimedu II – are now functional, through the self-help initiative of the community and support of the Partnership for Transforming Health Systems, phase two (PATHS2) programme.

He said while PATHS2, a United Kingdom Agency for International Development (UKAID) sponsored agency, renovated the facility in Iwerekun and supply 20 KVA generator, contributions by the residents ensured that the facility has water supply, its beautification, supply of plastic chairs, benches and sanitation of the premises.

Taiwo, who is the chairman of the Ward Heath Committee for the LGA, said PATHS2 had trained them on community ownership of the facility and “it is our responsibility to keep the facility running, whether government comes or not.”

In Ikeletu PHC in Ijede, Ikorodu, the local government is not forthcoming. Nonetheless, the WHC, led by Disu Soyiga, have mobilized residents through donations to keep the health facility running.

While Soyiga thanked PATHS2 for drugs and equipment through the Sustainable Drug Revolving Fund (SDRF) mechanism, he said: “we (residents) have been donating funds to erect the fence, sink borehole and provide fuel for the ambulance to run.”

The commentaries are not any different in about 82 PHCs (one per Ward) out of 376 Wards in Lagos State. PATHS2 State Team Leader, Dr. Ibironke Dada said one of their strategies, for five years now, was to raise a team of Ward Health Committee in each PHC, to look after the facility on pro bono basis.