How to solve Nigeria’s complex health challenges

So far Nigeria has built about 30,000 PHCs across the country and yet the government is lagging seriously behind in the delivery of quality health services. In 2018, the World Health Organisation ranked Nigeria’s health care system at 187th out of 190 countries, with countries like Afghanistan, Somalia and the Congo outperforming Nigeria on the […]

So far Nigeria has built about 30,000 PHCs across the country and yet the government is lagging seriously behind in the delivery of quality health services. In 2018, the World Health Organisation ranked Nigeria’s health care system at 187th out of 190 countries, with countries like Afghanistan, Somalia and the Congo outperforming Nigeria on the index.

The deplorable state of the PHC system has taken a toll on the public health situation in Nigeria. A recent report showed that 1 in 13 women in Nigeria is likely to die during childbirth. The same report found out that about 58,000 women had died from childbirth complications in 2015 alone accounting for about 19% of global maternal deaths in the same year.

One can point to different reasons for the dire situations of PHCs in Nigeria; ranging from fragmented services to lack of qualified medical personnel to poor infrastructures. However, amidst all these, one of the fundamental issues facing PHCs is the lack of access reliable electricity.

Electricity is very important to PHCs for providing water supply, temperature control for medicine/vaccine storage, basic lighting, ventilation, and clinical processes, however, Nigeria’s erratic power supply has been one of the banes of Primary Health Centers in Nigeria. In 2018, the Heinrich Boell Foundation sponsored a situation analysis study that was carried out among 60 PHCs in Abuja, Nigeria. The study found out that almost half of the surveyed PHCs could not operate beyond 5 pm due to unreliable access to constant electricity, meaning that they could not accept overnight admission and they certainly could not handle emergency cases at night.  Meanwhile, the other half of the surveyed PHCs that could operate into the night often had to rely on alternative power source from petrol powered generators and other makeshift energy from kerosene lamps, candles and torchlight. One of the field monitors, during the study, reported meeting a midwife who had delivered a baby in the dark because the battery to the torchlight went dead in the middle of the delivery.

The lack of electricity is coming at a high cost to PHCs operations and it’s also a major barrier to quality health services. Certain PHCs in Abuja were found to spend as much as N500,000($1,300) annually on petrol powered generators, which are often paid out of the pocket of the medical personnel. Meanwhile, the PHCs that could not afford to run petrol powered generators, could not appropriately store vaccines and they lacked clean potable water.

Stand-alone solar power solutions have great potentials to provide access to cost-effective and reliable electricity for PHCs, especially the ones that are situated in low-income areas and away from the national grid.  A study done in India has shown that a solar-powered health centre treated 50% more patients, conducted 50% more safe deliveries and operated round the clock.

In Dakwa, Abuja Nigeria solar powered PHCs is also operational, which has been responsible for providing round the clock electricity access to the rural-based health care centres. The solar PV system has been running for two years, thereby, increasing the patronage from zero to about 100 patients a month.

Government agencies need to start considering how to provide the required funding to provide stand-alone solutions for PHCs. Here are some suggestions on how that can be done;

Increasing budgetary allocation for Health Care; the budgetary allocation to PHCs needs to be reviewed with more funds directed towards providing solar powered electricity to the already established PHCs. Diverting funds away from frivolous and redundant project: Building new PHCs are usually driven by political motivation rather than actual needs of the communities, and this is the primary reason why 80% of the health centres are not functional because a lot of these so-called PHC buildings do not have equipment and staff. Directing international donor funds to Solar solutions: There is a lot of international donor organisation that are spending millions of dollars on vaccines and health enlightenment programmes; some of these grants could be directed towards powering PHCs with solar powered energy.

Improved electricity for PHCs is equal to improved health services.

Chibueze Ebii, a communication expert, wrote from Abuja.