In 2023, a woman, Nneamaka, lost her four-month-old pregnancy at Iboko, a small town in Izzi Local Government Area of Ebonyi State, due to a lack of basic drugs by a primary healthcare centre.
Though her town did not have a primary health centre, she managed to visit one at a neighbouring town named Okpoduma. Yet, essential medicines for a pregnant woman were lacking.
Drugs such as Paracetamol were not on the shelves and no doctor attended to her – only nurses.
“I lost my child because I did not get the adequate medical attention I needed, she said.
Many Nigerians like Nneamaka seeking painkillers such as Paracetamol and Aspirin in primary healthcare centres (PHCs) may not find them as they are insufficient to reach all patients.
There are also acute shortages of antibiotics such as Amoxicillin and Erythromycin, including basic antimalarial medicine like Artesunate. Even drugs such as Vitamin A, Vitamin K, Calcium Gluconate, Salbutamol, Gentamycin, and Streptomycin are hard to find.
According to the National Bureau of Statistics (NBS) data released on Wednesday, only 34.3 percent of these drugs are available in PHCs, leaving nearly 66 percent of the essential medicines out of the reach of patients.
“The availability of essential drugs is considered an important element in determining the quality of health care in health facilities,” the NBS noted in the 2023 National Health Facility Survey (NHFS) report, which highlighted systemic gaps in healthcare delivery nationwide.
The statistics agency said 49.4 percent of essential medicines are unavailable in secondary facilities
The report said only 29.9 percent of PHCs and 68 percent of secondary health facilities are equipped with functioning basic medical equipment such as thermometers, blood pressure monitors, and stethoscopes. The North-West zone reported the lowest availability of such equipment (20.9 percent), while the South-West recorded the highest (48.8 percent).
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The Issues
Official data show that Nigeria has about 30,000 PHCs but only 10 percent across the states of the federation are functional and operational.
“The centres are not functional, either the buildings have become dilapidated or they cannot be accessed. When we talk about functionality, it entails uninterrupted power supply, but it is not stable. It also entails constant water supply, but it is not available. It equally involves medical personnel, but they are not adequate,” Olorunnimbe Mamorah, former minister of science and technology, said.
“If primary healthcare centres do not have all these facilities, they cannot render any services. What are these services? It includes ante-natal care. One of the reasons we had infant and maternal mortality is due to poor access to ante-natal care. Immunisation, especially for vaccines preventing childhood diseases, is very fundamental.”
Several PHCs, especially those in rural areas, are dilapidated and abandoned, with leaky roofs. BusinessDay recently visited Amananta PHC in Ebonyi State and found it had no drugs and no doctor.
At Ndingele Primary Healthcare Centre, also in Ebonyi State, only one nurse was on duty. Important drugs like Oxytocin, used in inducing contraction in pregnant mothers during labour, were absent.
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Health experts want govt to do more
Healthcare experts and analysts say shortages of essential medicines in healthcare facilities across Nigeria are dangerous, warning that the situation would severely undermine delivery of quality healthcare delivery, increase the cost of accessing care, and worsen the burden of out-of-pocket expenses on citizens.
Olayinka Oladimeji, former director, primary healthcare systems development at the National Primary Health Care Development Agency, highlighted the devastating impact of the medicines shortages. He explained that healthcare facilities lacking essential medicines cannot deliver quality care.
“If you go to a healthcare facility without essential medicines, what kind of care would you get? They can only provide sub-optimal care. The lack of essential medicines reduces healthcare facilities to mere consulting centres,” he said.
To address the issue, he urged the Nigerian government to ensure the effective implementation and monitoring of the Basic Healthcare Provision Fund (BHCPF), which guarantees funding for the procurement of these essential medicines.
He also called for an expansion of the scheme to include more primary healthcare facilities. Presently, less than 1,000 of Nigeria’s over 30,000 healthcare facilities benefit from the fund, he revealed.
Adaobi Onyechi, a public health expert, emphasised the disproportionate impact of drug shortages on vulnerable populations who cannot afford alternative options. She warned that the lack of affordable medicines could lead to worsened health conditions, increased disability, or even death.
“Vulnerable Nigerians, who make up a significant portion of our population, bear the brunt of these critical shortages. Public healthcare facilities, where medicines are supposed to be more affordable, are the worst affected. When citizens turn to private sources, where costs are higher, they risk falling deeper into poverty, and citizens who can’t afford alternatives risk worsened diseases or death,” Onyechi explained.
According to her, the report is indicative of a collapsing healthcare delivery system in Nigeria and demands an urgent overhaul.
Barth Ufoegbunam, chief medical director at Gracevalley Medical Centre, echoed these concerns, lamenting the compounding effect of these shortages on Nigeria’s already troubled health sector. He cited the existing challenges, including a shortage of medical personnel, as further exacerbating the crisis.
“Today, the doctor to patient ratio is 1 : 9083. We are grappling with a shortage of medical personnel. This makes matters worse, and quality healthcare delivery difficult to obtain,” Ufoegbunam said.
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