Residents of Adedeji community of Ifelodun Local Government Area (LGA) in Osun State were full of hope of accessing quality healthcare which has long eluded them when the contract for the construction of a primary health care was approved in December 2023. Several months after, respite has yet to come their way after the contractor failed to deliver the project despite receiving the sum of over N88,000,000 million.
Suliyah Iyabo, a mother of four children and a resident of the Adedeji community in Ikirun, Osun State, narrated her journey through pregnancy and the need for a government hospital in her community to PEN PRESS.
“There are two popular and frequently used government hospitals in this town. One is at Moboreje area, which is about 15 minutes ride on motorcycle from here. The second is a state general Hospital which is between 30 to 45minutes drive. I prefer government hospitals, especially during pregnancy and delivery stages, because of specialists who are on standby unlike the private hospitals which are filled with auxiliary nurse trainees.”
However, for it is not every health challenge, especially emergencies, that residents of Adedeji will have the luxury of time and go to either of the mentioned hospitals.
Iyabo narrated further the difficulties she faced when she once went into labor and stressed the need for a Primary Health Centre within her community. Narrating her ordeal, she recalled the delivery of her third child, the only time she had to use a private hospital because of the long distance to a government-owned hospital.
“It would be better if there is a government hospital nearby. I had my third child in the car when my husband was driving me to the maternity at Moboreje. I couldn’t hold the pressure again, so I pushed. While my husband was driving with one hand, he was trying to catch the baby with the other. That was dangerous due to his divided attention under pressure, and it would have been avoided if a government hospital was close by.”
In commemoration of 2023 Universal Health Coverage Day, the Coordinating Minister of Health and Social Welfare, Muhammed Ali Pate stated that the government will make resource allocation (including the procurement process) transparent to all stakeholders. At the event, he also noted that the increased allocation in the proposed 2024 budget for the health sectors has demonstrated the readiness of the government to improve the health of Nigerians.
Pate added that the government intends to double the number of Primary Healthcare Centres (PHCs) from 8,809 to 17,618 across the country by 2027.
Eight months ago, a contractor was paid to build and equip a Primary Healthcare Center in Adedeji Community. Unfortunately, no work has started on this project as at the time this reporter visited the community in July, 2024.
According to data obtained from govspend, a total sum of N88,354,814 was paid to A3 Interbiz Link Services Ltd by the Pharmacists Council of Nigeria (PCN), the awarding entity, in December 2023. The payment was made in two tranches. A sum of N26,495,852 on the 29th of December, 2023 and a balance of N61,858,962 was paid the next day, 30th of December, 2023.
According to the World Health Organisation (WHO), over 1 billion individuals are at the risk of poverty due to the out-of-pocket spending on health. The organisation estimated that 75 per cent of projected health gains from the Sustainable Development Goals (SDGs) can be achieved through provision of well-equipped PHCs in communities and would save 60 million lives which will increase average life expectancy.
Quackery Reigns Supreme in the Absence of a viable alternative
Another resident of the community, Juliana Onaolapo, told PEN PRESS that having a PHC would afford the people of the community free or subsidized drugs and treatment. She added that the cost of treatment received from private hospitals is higher.
“May we not fall sick, the treatment given to each patient is different, and so is the bill. The care offered by these private hospitals range from treating stomach ache to obstetric care. Two of my daughters-in-law were delivered of their babies in private hospitals around here,” said Onaolapo.
The private hospitals she referred to are either the ones handled by quack nurses that operate from their homes or a standard private hospital outside the community. PEN PRESS confirmed the existence of a standard private hospital in the area and this was corroborated by another resident of the community identified as Sodiq Olanrewaju.
Falilat Bamidele, a woman in her mid 50s, compared the cost of treatment between private hospitals to a PHC, showing a glaring difference.
She said: ” Inflation in price of goods and services has affected the cost of treatment as well but it is cheaper at the PHC than in a private hospital. Recently, my son who was down with Malaria visited one of these private hospitals and he paid N3,000 for a 2 day- treatment which used to be 1,000. Malaria treatment in the community is within the range of N3,000 – N10,000 depending on the intensity and the private hospital patronised. However, a PHC gives the same treatment free, with drugs prescription and an option of getting it in the a pharmacy.”
She further explained that delivery in private hospitals, without operation, costs between N20,000 – N50,000 while a PHC only demands the pregnant woman’s ante-natal registration, and frequent check-ups, with a list of items required for the foetus/ baby and the mother during delivery.
“A small amount of money like N5,000 – N10,000 would be demanded to get things for the PHC after delivery,” she concluded.
Medical care at PHCs is subsidied by the Federal Government (FG) through the Basic Health Care Provision Fund (BHCPF), which was established to improve access to health care to the most vulnerable in society, particularly the poor, the elderly, women and children. Funds for the BHCPF is derived from a yearly grant of not less than 1 percent of the FG consolidated revenue fund, grants by international donors and any other source.
Olarenwaju told PEN PRESS that no government hospital has been established in the community since its existence and people reach out to their family doctors or visit private hospitals when sick.
“We are surrounded by quacks and no government hospital is serving this community. People either visit their family doctors or a nearby private clinic when they fall ill. There’s only one private facility close to the community. The bills of these alternatives may be affordable to some people, but all fingers are not equal, and a developing community like ours needs a PHC,” Olanrewaju concluded.
Another resident, Mrs Adetoro narrated how the long distance to Moboreje PHC made her deliver one of her babies along a bush path on her way to the facility.
“Another reason for a PHC is that this community is far from a government hospital and that is one of the reasons I had delivered one of my kids along the road. The maternal and neonatal mortality has increased because the quacks and Traditional Birth Attendants (TBAs) do not have the required knowledge to manage complications that may arise during childbirth,” Adetoro recalled.
“I will be very glad if there is a health center in this community. I prefer going there because they have specialists employed by the government,” she added.
Mrs Adetoro stressed that the community is big enough to have a PHC and considering the distance to the nearest government facility, especially when one has no vehicle or motorcycle.
According to the National Primary Health Care Development Agency, a PHC should be situated in a political ward providing health services to a population of 10,000 – 20,000 people. It should be a furnished detached building of at least 13 rooms with a motorized borehole, generator, gate house, medical equipment, 2unit of 1-bedroom flats for staff accommodation, and electricity connected with the national grid. The personnel expected in a PHC include: 4 mid-wives, 1 laboratory technicians, 1 medical record officer, 1 environmental officer, 1 Pharmacy technician, 1 community health officer, 3 community health extension workers , 6 junior community health extension workers and support staff.
However, Adedeji Community is estimated to have about 6,000 people and is under political ward 7 in Ifelodun LGA. Ward 7 has a maternity center in Eweta community, which is in a very bad state and lacks personnel.
Baale Reacts
Speaking, the Baale of the community, who simply gave his name as Baale Adedeji, narrated his futile attempts to attract a healthcare center in the community.
“As the Baale of this community, I have tried to get the government to build a PHC here a long time ago, though my wife runs a private hospital. The problem I encountered is mainly with the local government authority who demanded that I buy land for the hospital,” the Baale stated.
He continued: “However, the community had already contributed money for the development of the community school, so I could not impose another levy on residents of the community. Government is not ready to donate land to the community, they want us to buy it.”
He also stated that there was an abandoned clinic in the neighboring community but due to absence of health workers the facility has been converted to an office of Nigeria Security and Civil Defence Corps, NSCDC.
“A healthcare center is one of the amenities we lack in the community and the distance to access subsidized health care is too much,” he lamented.
Replying to PEN PRESS on the options the community members have in case of emergency, he said private hospitals (including those run by quacks) around come to the rescue and though the services offered were good, it could not be compared to a government hospital in terms of bills.
Contractor Untraceable, Procuring Entity Mute
Checks on the Corporate Affairs Commission (CAC) portal showed that A3 Interbiz Link Service Ltd, the company that got the contract for the project was registered on the 14th of April, 2014. The company operates from Block 1, National Maritime Authority Quarters, Phase 2, SIE Null, Abuja and has Abdulraheem Abdulsalam Ayotunde, Adeyemo Ismaheel Olasunkanmi, Abdulraheem Abdulquadri Ayomide, and Abdulraheem Minato Olokuta as directors.
The email address, a3inte@gmail.com, provided on the CAC website by the directors does not exist as an email sent to the address bounced back.
Checks at the official address of the company showed that the location is a residential address in a mini estate at the Maritime Quarters in Kubwa, Abuja but there was no record of an office there. PEN PRESS knocked on the doors of the residents of the address to make inquiries and the response was that there was no company domiciled in the building.
The procuring entity for the project, Pharmacist Council of Nigeria (PCN) defied Section 35 (2) of the Public Procurement Act (2007) which states that once a mobilization fee has been paid to any supplier or contractor, no further payment shall be made without an interim performance certificate issued in accordance with the contract agreement.
However, in flagrant disobedience to this provision, PCN made balance payment to the contractor a day after the first payment was made without assessing the status of the project or if anything had been done.
To obtain the contract details of this project, PEN PRESS sent a Freedom of Information Act (FOIA) request to the office of the PCN at plot 7/9, Industrial Layout Idu, Garki, Abuja, on the June 28, 2024 and as at the time of filing this report the it had not been responded to.
According to section 4 of the Freedom of Information Act (FOIA), where information is applied for under the Act, the public institution to which the application is made shall within 7 days after the application is received make the information available to the applicant.
A call was also put through to the PCN branch office in Osogbo on the July 8, 2024, the representative of the Council, Atere Kayode, responded to our reporter that he knew nothing about the project.
“I am at the state office and I don’t have any knowledge about it. Maybe you have to speak to the head office in Abuja,” Atere stated during a conversation with this reporter. On the same day, a call was put across to what is meant to be the Registrar’s phone number but the line was switched off. Just like Mr Atere’s number, the Registrar number was sourced through the PCN website.
A reporter was sent to the PCN headquarter at Garki in Abuja on Tuesday, August 13, 2024 and he was told to follow up the next day due to the absence of the Registrar. The next day, the reporter got there at 10.00 am and left around 5pm with the same story that the Registrar and Head of Department Planning, Research and Statistics of the Agency, to which the FOIA request was minuted, to were not in town and will not be back till next week.
During the stay reporter’s stay, the agency’s officials put up an act intended to frustrate him by directing the reporter from one office to another without providing answers to the FOIA request nor grant interview.
PHC an essential part of healthcare – Nurse
Semiat Bello, a certified nurse, while commenting on the importance of PHC described it as an essential part of healthcare made universally accessible to individuals in the community at a subsidized cost. “Primary Health Center in a community makes medical services available for dwellers of the community at their doorsteps, hence very important for good wellbeing. Another benefit of PHC is that it is cheap compared to private hospitals hence reducing the cost spent on health care,” Semiat stated.
Misappropriation of funds posing threat to health rights – CSO
Lanre Suraj, Chairman of HEDA Resource Centre, a Civil Society Organization leading anti-corruption campaign in Nigeria, said the allocation of funds to the PCN is a misappropriation of funds and contractors are just enablers used to achieve corruption and diversion of funds. It is obvious, he reasoned, that there is no sign of any serious implementation.
He added that the case should be reported to the International Corrupt Practices and other Related Offences Commission (ICPC), and the commission should ensure that the contractor is forced to go back to site and get the project completed, with effective monitoring by both the community and the commission.
He urged the media and the civil societies to continue monitoring corrupt activities and reporting them for public actions and proper investigation.
Reacting to the impact of corruption in meeting the SDG 4, he said that wellbeing for all is not only a goal to be achieved but also a fundamental right and the lack of commitment to people’s lives, standards and wellbeing has posed a threat to this right.
He concluded by charging the CAC to investigate information provided by the business owners applying for registration before endorsing them.
“The corporate affairs commission is bound to up its stake and investigate information provided by companies and individuals applying for registration and recognition. Cases of fraudulent misrepresentation and falsification by companies registered by the CAC are increasingly embarrassing and an agency like CAC is expected to rise up to the situation and stem cases of corruption associated with the companies and public office holders.”
This investigation is supported by John D. and Catherine T. MacArthur Foundation and the International Centre for Investigative Reporting.