Patients, doctors blame PHCs' ineffectiveness for crowded tertiary hospitals across Nigeria

Some patients and healthcare practitioners have blamed the ineffectiveness of Primary Healthcare Centres (PHCs) for patients crowding secondary and tertiary health institutions in their quest for healthcare services.

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They said this in an interview with the News Agency of Nigeria (NAN) on Sunday in Lagos.

According to them, the situation is the primary cause of the persistent lack of bed spaces in secondary/tertiary health facilities across the country.

Speaking, Livinus Abonyi, dean, Faculty of HealthCare Services of the Federal University of Allied Health Sciences, Enugu, underscored the need to strengthen the PHCs in the country for optimal performance.

Mr Abonyi, also an associate professor of Medical Radiography/Medical Imaging, lamented that the PHCs were poorly funded, particularly in terms of manpower and facilities/equipment.

He said that PHCs need not only to be equipped with adequate manpower and resources, but also to be empowered to function 24 hours to accommodate health emergencies that usually occur at night.

Mr Abonyi, who decried the large number of patients seeking healthcare at secondary and tertiary health facilities, said that the situation has resulted in a persistent lack of bed spaces in the health institutions.

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According to him, if the PHCs are functioning optimally, a greater percentage of health cases would be handled at that level, such that only about 30 per cent of the health cases would be referred to the tertiary health facilities.

“Presently, a patient can visit about two to three tertiary hospitals without getting a bed space – that is real.

“If anyone wants to test it, the person should just pretend to be very sick; you will go to the first one – they will say no bed space; you go to the second one – the same no bed space.

“There are many citizens who are carried back home dead because they are unable to get a bed space.

“If we have functional primary healthcare facilities and associated levels of care, we wouldn’t be facing such, because earlier intervention prevents disease progression to a certain level where it will require further treatments.

“But, if at the early stage it was addressed and tackled conveniently, the person would have gotten well, and it wouldn’t add to the population that would bring pressure to the tertiary health facilities,” Mr Abonyi said.

A teacher, Donatus George, lamented how his wife passed out in the process of being transferred from one public hospital to another due to a lack of bed space and a limited number of health personnel.

According to him, the circumstances that surrounded the death of his wife are an unforgettable experience, calling for intensified efforts to strengthen the emergency response system of the nation’s healthcare system to avert avoidable deaths.

A General Physician, Gerald Chinasa, frowned at the general Nigerian mentality and belief that the best healthcare services could only be obtained at the tertiary health institutions.

Mr Chinasa, who said that quality healthcare services were possible even at the PHCs, explained that equipping the PHCs with adequate manpower, resources, and equipment were key to achieving it.

He said, “An old established norm takes time to change. The fact that many Nigerians already believe that the best healthcare is only obtainable at tertiary health institutions can be changed with time.

“If the PHCs should be up and running efficiently, with little awareness campaign, people’s orientation toward PHCs will change and they will start patronising it. This will invariably reduce the population and workload on secondary and tertiary healthcare facilities.”

The Chief Medical Director, Lagos University Teaching Hospital (LUTH), Wasiu Adeyemo, decried the population of patients and workloads at the hospital, explaining that not all health conditions were meant to be handled at the tertiary health institutions.

Mr Adeyemo, who called for the establishment of more public hospitals across states, said that the few existing ones were not enough to cater for the teeming population of the country.

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He decried that most secondary healthcare facilities and PHCs were not living up to the expectations, as they often push health conditions that were ordinarily supposed to be handled at their levels to the tertiary healthcare institutions.

“It is not every health case that is supposed to be handled at the tertiary healthcare level. Virtually all health conditions should be first treated at either the secondary healthcare level or PHCs, as the case may be, then, if need be, they will be referred to the tertiary level.

“Unfortunately, most of these health cases are being dumped on us at the tertiary level to handle. And the worst aspect of it is that the majority of the cases usually come in without prior notification or contact with the hospital to ascertain its preparedness to handle the situation.

“Inasmuch as we are a tertiary health institution, there is a limit to what we can do considering the number of facilities and personnel on the ground.

“In a situation where patients on admission are occupying the existing beds and facilities, do you have to tell a patient who is still very sick to vacate the bed in order to admit a referred patient, who comes in without due notification, or what will you do? Mr Adeyemo asked.

(NAN)