Despite Huge Yearly Budgetary Allocations To Health Sector, Public Hospitals Remain Ill-Equipped, Under-Staffed In Kogi

By Adisa-Jaji Azeez

In this report, The Informant247’s Adisa-Jaji Azeez details the severe decline of healthcare system in Kogi State. Infrastructural decay, poor staffing and inadequate equipment in public hospitals across Mopamuro, Yagba East and Yagba West LGAs have left residents without access to quality medical service. This is despite the state government spending billions of naira on the health sector.

David Aiyeku is sitting under a tree, his back resting on his recliner wooden chair, as the reporter’s motorcycle taxi stops before a small mud house. The 80-year old man has lived in his small hometown of Okeagi since retiring from the Nigerian Army decades ago. It is the evening of 14 May and the reporter has just arrived in the town after a 35-minute ride from the neighbouring Mopa, the headquarters of Mopamuro Local Government Area of Kogi State in the North-central region of Nigeria.

Mr Aiyeku looks surprised when the young stranger greets him and asks for directions to the primary healthcare centre in the community? Warmly responding to the greetings, he asks about the journey from Mopa.

Indeed, the journey was rough because the motorcycle taxi operator’s experience was put to test as he danced around the several rough patches of the road.

Mr Aiyeku’s house is a stone’s throw from the community’s primary healthcare centre built in 2012 under the Millenium Development Goals scheme of the Nigerian federal government. But there is not much going on in the facility because of lack of equipment and manpower, the old man says, his anger obvious.

The first sight of the hospital from a distance is of the peeling paint on the building. It is almost 6 p.m. when the reporter arrives at its gate but it is locked. Mr Aiyeku had explained that the hospital has only one person on its staff, a female nurse, who also routinely goes to Mopa to get drugs.

Peeping inside from the gate, the corridors are dimly lit and the scent of disinfectant and plaster hangs in the air. In one of the rooms, probably a ward, patients’ beds lay dirty and uncovered. The room seems not to have been used for some time.

The Okeagi Primary Healthcare Centre was built under the MDGs programme in 2012

In an interview with the reporter, a youth leader in the community, Samad Tijani, decries the neglect of the health centre in Okeagi and pleaded with Governor Ahmed Ododo to repair, equip and employ more staff for public health facilities in the state.

Like Okeagi, like others

Between Okeagi and Ayegunle-Ilemo lies Bago Tiv Camp, a settlement of Tiv people from neighbouring Benue State. The settlement has no healthcare facility, electricity, potable water and other social amenities.

The settlers go to Okeagi or Aiyegunle-Ilemo when they need medical service.

“We don’t have access to health care, so we do self-medication or visit the neighbouring health centre,” Sunday Ebenezer, the community’s leader. says.

Bago Tiv Camp

He says their women employ self-help for child delivery at the camp, owing to the long distance to the neighbouring communities.

The condition of the Aiyegunle-Ilemo health centre underscores the burden of infrastructural decay, poor staffing, inadequate equipment and underfunding that public health facilities across Kogi State in North-central Nigeria bear.

Ayegunle-Ilemo Health Centre. PC: Adisa-Jaji Azeez

The centre is a shambles. There are cracks on the walls and floors of the decrepit building that houses the centre, and the roof is leaky. The tables and benches inside the building are just as decrepit. The centre also has no essential medical equipment and is not supplied with power, water or drugs.

The facility also lacks sanitation and hygiene infrastructure

Back View of the Aiyegunle-Ilemo Health Centre

Ibrahim Ayodeji is a resident of the community. He says the government rented an abandoned old building to start the centre. “We have reached out to the state government through the local government, asking for a new building with proper equipment. Our wives prefer to have home deliveries instead of visiting the health centre. For serious cases, they go to the General Hospital in Mopa.

“Last year, the roofing sheet was blown off by the wind, and the community had to struggle to renovate it.” Mr Ayodeji says.

Staff Office of Aiyegunle-Ilemo Health Centre

A resident, Rebecca Samuel, has a two-year old baby. “The only thing I have received for the baby from the health centre is immunisation injection,” she says to the reporter.

Mopa General Hospital

The road leading to the Mopa General Hospital is in a deplorable state.

The main gate to the General Hospital Mopa

While waiting for the hospital receptionist to arrive, this reporter chats with a patient who identifies herself as Mrs Bose. She says to be attended to at the hospital, patients must contribute money for fuel for the facility’s generator.

A bed at Mopa General Hospital

She recalls once escorting her sister-in-law to the hospital for childbirth and they were asked to get fuel for the generator while the woman was in labour.

“We have had poor power supply for almost two years, so the hospital relies on a generator donated by a politician. We also bought a solar (lamp) by ourselves, which is no longer working,” a nurse, Oladele Agbaje, says.

“The last renovation of this hospital was during the Idris Wada administration around 2012-2016. Even our generator and the x-ray machine were donated, the latter by the late Chief (Silas) Daniyan,” she added.

The ceiling appear ready to fall

The hospital also does not have an ambulance. “When there is a need for referral, we tell the relatives to provide a means of transporting the sick person,” said Mrs Agbaje.

After about 20 minutes of the reporter’s inspection of the facility, a young man arrives with a key to the former pharmacy. The room is old and dirty, with the ceiling appearing ready to fall. The pharmacy was relocated to another room, the officials said, but the new place is also not in a good condition.

Almost all the buildings are in bad shape. The main building is old and the beds in the wards are in poor shapes. The theatre room, where surgical operation is conducted, is not equipped to the standard of a General Hospital, which is usually a secondary health facility run by state governments.

The reporter observed that the entire workforce consists of a doctor, Community Health Extension Workers (CHEWs), a lab technician, an ad-hoc staff member, a pharmacist and nurses.

The reporter’s tour of public health facilities in Yagba East Local Government of Kogi State revealed the same story.

The BHC Omowa Mopo Isanlu was repainted by the Basic Health Care Provision Fund (BHCPF) IMPACT YEAR 2022/2023.

The borehole in the centre is functional, the refrigerator for keeping drugs is also working but with solar power, as the community has had no electricity supply for almost two years. Neighbouring health centres depend on these refrigerators to preserve their immunisation drugs.

Ireti Jacob, who is the Matron of the hospital, said the basic healthcare provision fund given to them was used to paint half of the facility’s building. Its borehole was drilled by community efforts.

Back-view of BHC Mowa Mopo

“Hopefully, when the basic health money comes again, we can finish the renovation work, because we still need to complete the painting. Also, some equipment like baby cot, stretcher and a new wheelchair were donated by a foundation, ” Mrs Jacob added

“The absence of electricity supply for almost two year adds to our struggle but a solar panel is serving as the lifeline for a single medical fridge, ” she added

Isanlu General Hospital

At the General Hospital Isanlu, the officer in charge denied the reporter access to the facilities.

The health centre at Odo-Eri in Yagba West LGA, about 45-minute drive from Isanlu, operates from two adjacent rented shops. This facility is supposed to serve the town and the surrounding communities, and serves as a maternity centre offering antenatal care, birth delivery, immunisation, and family planning services.

However, the centre hardly resembles a proper health facility, with no functional beds, and a labour room furnished with only a table. The equipment is scanty, barely sufficient to provide emergency obstetrics care services.

Odo-Eri Health Centre, Yagba West LG

A resident of Odo-Eri spoke to this reporter. “The health centre is not well-equipped; that is why most of us prefer private health centres. I visit only when I have a headache or need to check my BP.”

According to her; “when I was in labour, the midwife that was in charge of my delivery asked my family to get a cord clamp and a mucous extractor – essential birth supplies that any hospital should have) instead of requesting us to purchase them.”

The reporter next visited the General Hospital in Egbe.

At a canteen near the general hospital, the reporter asked an elderly woman about the hospital. “God will never let me see will take me to that hospital ever again,” she swore. “I will never agree to be admitted there.”

She said the roofs of some of the buildings had fallen and the morgue is sited too close to the patients ward. However, she had kind words for the workers, saying their efforts were being hampered by a lack of equipment.

Dilapidated Doctor’s Lodge, General Hospital Egbe

The doctor’s lodge is overrun by weeds and trees, and the building itself is dilapidated.

Moving around the hospital premises highlighted the extent of the decay. As a result, many residents depend on private health centres. This has led to a significant decline in attendance and internally generated revenue.

Emergency care Unit, General Hospital Egbe

During the tour, the doctor, Raphael Israel, lamented the condition of his lodge. He goes home to sleep every night or sometimes inside his office, he said.

The needs of the facilities are stark. Improvements in infrastructure, equipment and funding are crucial to ensure that the residents of Odo-Eri and Egbe have access to quality healthcare services.

Laboratory Unit, General Hospital Egbe

Reaction from NGO

“It’s devastating to think about the lives being lost and the suffering of our people due to these avoidable circumstances,” Abakpa Ujadu, the Programmes, Advocacy, and Training Officer of Activista Nigeria based in Kogi State, said.

“The deplorable state of Kogi State’s health institutions is a consequence of neglect and mismanagement. Despite budget allocations, these facilities remain in terrible shape, making access to medical services difficult for the people. This is unacceptable and heartbreaking, as it directly affects the well-being and lives of our citizens,” he said.

Mr Ujadu urged the government to prioritise the rehabilitation and upgrading of the facilities to meet the standards required for quality healthcare delivery. “There is a need to ensure transparency in the health centres and hold officials accountable for the utilisation of funds,” he stressed.

Kogi State’s Health Budget

Despite these significant investments, health centres across the state remain under equipped and poorly maintained.

In 2021, 2022 and 2023, the Kogi State government allocated ₦13,000,494,174 but the Full-Year Actual expenditure was ₦9,124,567,607 for the construction and operation of hospitals and health centres. In the revised budget, ₦4,507,537,919 was allocated for the rehabilitation and repair of these facilities, with the Full-Year Actual being ₦1,171,706,274

In 2021, the Revised Budget allocated ₦2,968,632,000 for the construction and Provision of hospitals and health centres with the Full-Year Actual expenditure amounting to ₦1,841,273,610. For the rehabilitation and Repair of these facilities, the revised budget was ₦2,225,296,000, while the Full-Year was ₦291,890,413

In 2022, the Revised Budget allocated ₦4,935,046,174 for the construction and provision of hospitals and health centres, with the Full-Year Actual expenditure amounting to ₦3,207,468,978. For the rehabilitation and repair of these facilities, the revised budget was ₦1,133,145,919, while the Full-Year Actual was ₦325,940,108.

In the 2023 Revised Budget, ₦5,096,816,000 was allocated, with the Full-Year Actual expenditure being ₦4,075,825,019 for the construction and provision of hospitals and health centres. The revised budget for rehabilitation and repair was ₦1,149,096,000, while the Full-Year Actual was ₦553,875,753

Government silent

This reporter visited the state’s Ministry of Health but could not meet the commissioner, AbdulAzeez Adeiza who also did not respond to a call and a WhatsApp message to his phone number.

The Commissioner for Finance was contacted on WhatsApp but he did not keep a promise to create time for a conversation on the observed issues despite a series of reminders.

The story was supported with funding from the Centre for Journalism Innovation and Development (CJID).