Verifying the Performance of Primary Health Care Centres built across Nigeria II
As reported in previous bulletins
, data from the National Primary Health Care Development Agency (NPHCDA) indicates that the Nigerian Government has spent over N30.4 billion between 2001 and 2014 on construction of 687 Primary Healthcare Centres (PHCs). The NPHCDA also clarifies that the list is inexhaustible as many other PHCs have been built.
In an attempt to link data on the awarded contract sums to specific PHCs, it was difficult to uniquely identify the location of each PHC contracted out from the data provided by NPHCDA. Procurement monitors, therefore, harvested data on specific locations of PHCs across Nigeria from the MDG website portal to complement the data provided by the NPHCDA.
Through our locally developed program "Budeshi"
, we are in the process of using the Open Contracting Data Standards (OCDS) to standardize the data from various sources and link the contract sums to specific PHCs built.
Whilst the PHC data is being made standardized and linked, a general observation of PHCs is ongoing using the Minimum Standards for Primary Health Care in Nigeria published by the NPHCDA.
According to the minimum standards, PHCs are divided into 3 types based on the Ward Health System which are:
- The Health Care Clinic (Type 2)
- The Health Care Centre (Type 3)
From the visits of procurement monitors to PHCs in Kaduna, Abuja and Nassarawa states, the following observations have been made:
- Most of the PHCs built close to the city have decent structures and basic amenities as required according to the minimum standards. For example Kajuru PHC had an ambulance which is used to transfer critical cases to full hospitals. Other basic amenities as seen in some of the other PHCs include boreholes, solar systems and generators.
- The administrative officials of these PHCs are sometimes hindered in carrying out their roles effectively due to infrastructural issues ranging from lack of access road to inadequate staffing.
- Some of the facilities were seen to be in a state of disrepair which indicates a lack of maintenance culture by the Government on these PHCs.
- The monitors observed that most of the PHCs had insufficient drugs. In some cases, the drugs were expired and dispensed to patients (including a monitor who disguised as a patient) while some of them restocked the drugs from their personal pockets. It was also observed that the PHCs were under equipped as some of the minimum requirements stated in the minimum standards were unavailable forcing the personnel to improvise or simply refer the patient.
Other key findings of the monitors include:
- Lack of visible signpost
- Unstable Hours of Operation
- Non-accommodation of staff
- Non-payment of staff
- Poor Hygiene
In the coming weeks, we plan to organize a media briefing that will bring together stakeholders in the health sector to discuss findings and recommendations of possible remedies.
For more information on the findings of the monitors, please watch the video below:
We sincerely thank all our partners especially the Open Society Initiative of West Africa for their unrelenting support to Disclosure within the Nigerian Public Procurement Process in Nigeria.