Shortage of essential supplies, understaffing issues, and insufficient bed capacity in the primary healthcare centre (PHC) in Ghari Local Government Area (LGA), Kano, were among the concerns raised during a town hall meeting held in 29th August 2024, hosted by Akin Savvy Awareness Initiative for Africans, a community-based organisation, in collaboration with Nigeria Health Watch (NHW).
According to Haruna, a healthcare worker from Ghari PHC, "we have antenatal care units which is encouraging women to visit the hospital for antenatal services, and routine drugs to help boost their immunity but we face a shortage of beds and chairs for the increasing number of patients which makes them sit on the floor. We also need a scanning machine to improve our services."
Yusuf Shehu Umar, another healthcare worker, emphasised the significance of Basic Healthcare Provision Funds (BHCPF) -- which is offering essential medical care at no cost to vulnerable groups, including widows, orphans, and families of retirees, ensuring equitable access to healthcare. However, he noted that, "The facility is understaffed and lacks essential supplies such as [Artemisinin-Based Combination Therapy] ACT malaria treatment and mosquito nets."
A town hall meeting, attended by 28 community members, focused on addressing barriers to women's healthcare access, enhancing health-seeking behaviours, and reducing maternal and child mortality through community-health facility collaboration and policy advocacy.
Aaron Bawala, Community Engagement Coordinator at NHW, thanked the community for their cooperation and dedication. He explained that Ghari was selected as one of six LGAs for health system strengthening due to reports from the MS-Dat platform which highlights significant gaps in local healthcare especially relating to the maternal and child mortality.
Bawala explained the importance of community voices in healthcare, stressing that stakeholders cannot understand local health needs unless people speak up. He encouraged community members to share vital information to improve health facilities and services urging for community ownership of health facilities, ensuring they meet local needs.
Bawala noted the organisation's multi-stakeholder approach, working with Akin Savvy, Five Cowries, community reporters, and state stakeholders to address healthcare challenges.
Women denied access
One of the women community leaders present at the town hall meeting mentioned the cultural challenge women in the community face. She explained that many husbands forbid their wives from seeking prenatal care at health facilities, forcing them to deliver at home with the assistance of traditional birth attendants. She explained that this has further increased the rate of maternal and child mortality in the community.
Those in attendance, including representatives of the Kano State Primary Healthcare Management Board, Ward Development Committees (WDCs), community leaders, and civil society organisations, were implored to address the cultural challenges by engaging in community-wide awareness initiatives to advocate for greater understanding and support of women's access to health care facilities among men.
Improving healthcare through passing knowledge
Safiya Shuaibu Isa, Deputy Director of Advocacy and Partnership at NHW, encouraged WDCs to report their concerns to the relevant authorities, underscoring the importance of communicating community needs to those in positions of influence. She explained that NHW's primary aim is not to provide financial support but to empower the community by equipping them with the knowledge and tools to build a more sustainable health system that meets their needs.
Safiya highlighted the dire situation of maternal and child mortality in Nigeria, which ranks second globally for such deaths. She went on to explain the three delays in accessing healthcare: the delay in deciding to seek care, the delay in reaching a health facility, and the delay in receiving adequate treatment upon arrival at the facility.
Safiya emphasised that the government's Four-Point Agenda for the health sector renewal plan aims to tackle the challenges associated with the three delays in accessing healthcare, particularly by ensuring that there is one functional PHC per ward easily accessible by every community.
Quadri Wasiu, the Director of Programmes for Five Cowries, also spoke about a novel approach that utilises arts to disseminate health messages to adolescent girls in the community. Through visual storytelling techniques, he said, the organisation aims to transform girls into advocates for Sexual Reproductive Health Rights (SRHR).
He further explained that pictures, such as depictions of pregnant women accessing antenatal care, can effectively convey health information to a wide range of individuals, regardless of literacy levels.
'Quality health is a right'
"[Quality] health is a right," Safiya noted, urging the community to continue advocating for the renovation and rehabilitation of health facilities as the current administration has promised to revilise the health sector. She further encouraged participants to remain vigilant and keep their leaders accountable, ensuring that planned developments reach grassroots level.
Waziri Gidado, a representative of the Kano State Health Care Management Board, stressed the vital role played by WDCs in advocating for improved health facilities that can meet the needs of their communities. He highlighted the importance of leveraging resources from the Basic Health Care Provision Fund (BHCPF), the Kano State Contributory Health Insurance Management Agency (KSCHIMA), and other affluent citizens in the area.
He cited an example of how a maternity centre was built in another community through the community's efforts and support from wealthy individuals, advising the participants to present their needs in a way that focuses on achieving results rather than seeking money.
Hamidan Madawaki, a representative of the Health Secretary Ghari Local Government, reassured community leaders that his team was dedicated to raising awareness and partnering with local influencers to enhance the quality of healthcare in the area. He spoke about a recent meeting with ten WDCs, where a prominent member of the community pledged support for local health facilities, underscoring the potential for community collaboration to drive meaningful change.
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A satisfying outcome
Participants responded with enthusiasm when Akin Savvy inquired about their satisfaction with the town hall meeting, advising that future gatherings should include a broader spectrum of community members. As the conversation progressed, Akin Savvy probed about the most efficient means of transportation for pregnant women to healthcare facilities. The responses varied from motorcycles to cars, depending on road accessibility.
In addition, participants disclosed that their communities have registered skilled birth attendants, who provide invaluable support to pregnant women during the delivery process.
The discussions at town hall meeting aligns with the second pillar, which focuses on building an efficient, equitable, and high-quality health system. A key component of this approach is promoting health education among local communities, emphasising the importance of government and citizen voices and collaboration.
In closing, the participants were urged to act as community ambassadors by sharing the key insights and learnings from the meeting with others who were unable to attend. This would help to amplify the collective voice of the community, supporting government initiatives aimed at improving the overall health outcomes of their region.
