Abuja — It is 4:30 am. Maria Agba, 25, comes off a taxi which had brought her to the General Hospital Nyanya, Abuja .

She had made an arrangement with the driver to bring her to the hospital by that time. She rushes off to the antenatal clinic, tears a number from a piece of paper written with numbers, pulls a sit from the stack of chairs and sits down according to her number. She is number 12 which means twelve others had come before her.

Her typical experience represents those of hundreds of expectant mothers who attend ante natal clinics in Government Hospitals in Abuja. The story is the same at the District hospitals in Asokoro, Wuse and Maitama.

"If you come here anything after 6 am you may not be able to get a number and that means you would not be attended to," Maria, a pregnant woman said. Most of the other women she said, try to come early to be among the first 120 people if they are to be attended to.

Some of them quickly find a place to sleep while waiting for the nurses that would come to attend to them, probably by 9am. Others, whose houses are nearby, come as early as 4am, pick their numbers and return to their homes to wait for the day to break properly.

There have been allegations that some of the nurses reserve numbers for their friends making it difficult for other women who come later to be seen.

"If you come at a time that you can no longer pick any of the numbers, you are usually asked to go and come the next week. Each of us comes on a particular day", another woman who would not want her name on print said.

She explained that the nurses have asked them to visit for their routine ante natal checks on particular dates according criteria ranging from first pregnancy to age, number of children among others.

For women in the second trimester of pregnancy, the visits for them could be once in a month while those in the last trimester or who need special attention may be asked to visit fortnightly.

"Those in the last one month of their pregnancy visit every week because they need to be closely monitored' a nurse said in one of the hospital.

Reacting to the issue of the expectant mothers coming so early to be attended to, an official of the Federal Capital Territory Administration said the last 'rightsizing' exercise in the health sector in the FCT was done in bad faith as the government of the former Minister of FCT, Mr Nasir el'Rufai sacked many health workers as a result of disagreement over demands for increased salaries and allowances.

"Many health workers were sacked. So the hospitals in FCT are understaffed. The few left cannot do much. The Garki district hospital is under concession and the workers either sacked or reposted to other hospital" the official said.

Apart from this, there is increasing concern over the high cost of attending ante natal clinic. The FCT Department of Health and Human services has come out with a long list of what an expectant mother must buy before she can be delivered of a baby in the hospitals under it. In some cases, women who do not have money to buy them are not attended to during labour as the nurses always insist that there is nothing they can do for them.

The list has 17 items each for the baby and the mother. The list includes natural hospital disposables, which the hospital would have provided for a fee to the patients. These include items like three packets of pads; a pair of slippers; a towel; shaving stick and a packet of detergent.

Others are four wrappers; a packet of razor blade; a toilet roll; three pairs of gloves; a bottle of Dettol; and a mucus extractor.

The remaining items listed for the expectant mothers are; a bottle of jik; four nylon bags, an old newspaper, two injector ergot; 2 ml syringe and needle chronic 2/0+.

The items that a mother must buy for her baby are two baby gowns; two or four baby napkins; baby sponge; baby soap; four napkin pants and a baby showel. Others are; a baby blanket, a baby comb; olive oil; a cord clamp; methylated spirit and cotton wool.

The remaining items for the baby are; baby oil; baby powder, catherter size 16 and 2 yards of markintosh.

"The nurses usually inspect the items six weeks to your expected delivery date and if they are not complete you are on your own," Maria said.

The women seem to be helpless as most of them cannot afford antennal services in private hospitals.

However there seem to be a silver lining in the sky for improvement of services in hospital across the country as the SERVICOM Office General Outpatient department (GOPD) service improvement pilot would soon be rolled out.

Already, the pilot has been working at the Asokoro District hospital and the Federal Medical Centre Keffi, near Abuja . The pilot which aims to reduce patients waiting time at GOPDs could successfully be applied in other service windows like antenatal clinic.

Already, the introduction of what is now known as the triage system at the Medical centre in Keffi has reduced waiting time from between 3 and 7 hours to less than thirty minutes.

In Asokoro the implementation does not seem to be going well for various reasons.

"A further three months of support to Asokoro has now achieved the implementation of the appointment and triage system at Asokoro. However, while this implementation has the full cooperation and support of nursing staff, it does seem still to be suffering from low cooperation of GOPD doctors in both completing their appointments records and in attending their clinics at the agreed times or at all" says Saghar Faroughi, SERVICOM GOPD pilot Manager.

She said the success recorded at the Federal Medical Centre, Keffi would be discussed in series of seminars on GOPD improvement planning to hold for health workers in Abuja.

"The seminars are targeted at management, Nodal Officers and GOPD practitioners of hospitals throughout Nigeria. Each seminar will cover as many as around 100 participants and is intended to inform hospitals of the service improvements that can be achieved." Faroughi said.

She said that hospitals who indicate interest in the improvement either before or after the seminars would be evaluated and "cherry picked" for roll out.

Our reporter learnt that SERVICOM in the last one year has evaluated over 40 hospitals to determine their service compliance with the principles of SERVICOM. Presently the SERVICOM Institute is working on service improvement planning workshop for the evaluated hospitals to help them develop improvements plans that would revamp their services.