On a mission to improve healthcare access and quality in Wudil Local Government Area (LGA), at the Kofar Kudu Primary Health Centre (PHC) in Wudil.
The session was attended by approximately twenty (20) participants from the community, representing diverse voices and perspectives including healthcare workers, community leaders, representatives of local organizations, and citizens with direct stakes in the quality of local health services.
Dinatu Dama Maji, Executive Director of the Kasham Girls Initiative, opened the meeting by underscoring the vital role of community engagement in enhancing local health services. She encouraged participants to share their experiences and concerns.
"We are here not to blame anyone, but to bring forth issues affecting healthcare delivery and seek solutions," she said. Dinatu stressed the importance of open dialogue, encouraging everyone to voice their experiences and participate actively
The Community Engagement Coordinator, Aaron Bawala from Nigeria Health Watch highlighted the severe challenges facing Nigeria's healthcare system, particularly in maternal and child health, where the country has one of the highest mortality rates globally. Aaron's words underscored the gravity of the situation, pointing out that the government aims to address these issues but needs local input to understand community-specific concerns.
"If we don't communicate our needs, the government won't know what to address. Health is a priority, and each of us has a role in ensuring our healthcare needs are met.". He Stressed.
Participants voiced several concerns regarding health services in Wudil. Rabiu Shu'aibu, a health education student, highlighted the lack of qualified staff and equipment, which often results in diagnostic errors. He shared personal experiences demonstrating how inconsistent blood test results across different facilities have led to confusion.
"It happened to me, there was someone who tested my blood and said my blood group is A+ and when I got tested again somewhere else it was A-, it's not good. Two tests, one from the government hospital and one from a private hospital did not tally." He stated
"When health facilities lack skilled personnel and appropriate equipment, trust is eroded," he explained.
Rabiu's comments led to a broader discussion about trust in local health facilities, with others expressing the view that many Wudil residents prefer private facilities, even at a higher cost, due to their perception of better quality and reliability.
This revelation led the conveners to probe further on why are women not utilising PHCs for skilled birth, is it as a result of the delay in making the decision to seek skilled care?
This significant part of the discussion focused on barriers women face in seeking healthcare services at PHCs, particularly for childbirth.
Zaliha Dahiru Isah, a representative from Utai PHC, spoke about operational challenges, noting that most PHCs operate limited hours, which prevents women from accessing timely maternal healthcare.
"Pregnant women often face emergencies outside of normal hours, and when PHCs aren't open, they are forced to seek help elsewhere or risk complications at home," she said.
Zaliha added that the lack of staff further discourages women from seeking care, as it results in delays and overcrowded wards.
Rabiu Shu'aibu also described instances of poor attitude of some healthcare workers, which deter women from returning to PHCs for future services.
"There are cases where women are hesitant to go to PHCs because of the disrespect by officials especially the midwives, so they prefer to stay back at home and give birth despite the risk. However, their husbands are now seeing the negative effects from all angles"
Others pointed out that poor road conditions hinder access to healthcare for pregnant women, often compelling them to deliver at home.
Cultural norms in Wudil were also identified as a major barrier to healthcare access.
The Chief Imam of Wudil, a respected community leader, highlighted the discomfort many women feel when interacting with male healthcare providers. He stressed the need for more female healthcare workers at PHCs to make women feel comfortable seeking care.
"We also need more female health workers so that our women will feel free to attend to their health needs," he explained, adding that this adjustment could significantly improve maternal health outcomes.
Logistical issues, such as the state of local roads, were also discussed. Many participants described the challenges pregnant women face in reaching PHCs, particularly in remote areas. Due to poor road conditions, women are often transported on motorcycles, which can exacerbate their condition during labor.
Security officer Aminu Aliyu shared a case where a pregnant woman had to endure a difficult journey on rough roads, only to arrive at the hospital and find there were no available beds.
"More Beds must be provided and also the midwives are not available, we have a shortage of their services," he said, underscoring the need for both road improvements and additional hospital beds.
Several participants highlighted the positive impact of incentives on health-seeking behavior.
Zainab Ahmad Adam, a health worker explained that the introduction of incentives has given rise to women and children enrollment in PHCs. Before we suffered to get people to come and get vaccinated for Routine Immunisation but now, they come willingly because of that.
"Even pregnant women are now frequenting PHC because of the free medicine and incentives." She stated.
The district head of Wudil, Alhaji Muhammad Wudil, supported this view, adding that transportation incentives could make a significant difference, especially for residents in remote areas.
"First of all, we must do more on the issue of incentive. Some organisations are doing that to encourage people to come to hospital. At least transportation is covered for most of them especially at this trying time." He spoke.
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He advocated for finding ways to make transportation to PHCs more affordable or even free, citing it as an important step toward increasing healthcare access and reducing maternal and child mortality.
During the meeting, community members were encouraged to continue utilizing health services at local facilities. By doing so, they can identify more challenges these facilities face and communicate these issues to policymakers through local government structures. This process will help hold them accountable for improving health outcomes in the community. The discussions at the town hall meeting closely aligned with the government's strategic health sector renewal plan through its Four-Point Agenda, specifically the second pillar which aims to create a healthcare system that is efficient, equitable, and responsive to community health needs. By amplifying citizens' voices and fostering collaboration, the community can play a pivotal role in identifying and addressing healthcare gaps. A key strategy to achieve this goal is to strengthen health education at the community level, fostering collaboration between the government and the people it serves.
As the meeting wrapped up, participants were encouraged to become community advocates by sharing valuable insights and lessons learned with those who could not attend. This collective engagement will help amplify the community's voice and enhance government efforts to improve health outcomes across Wudil LGA.
