Anas Sani Anka
Health sector is one of the pillars often which people used to measure sustainable development of every society. Zamfara since it’s creation in 1996, stakeholders are of the opinion that successive and current governments have not done well to enhance it to the basic minimum standard. They believed without the support of the development partners the state health sector would have been in state of comatoes.
The revelation on the Zamfara health sector twenty six years after is short of developmental inspiration as experts believed Zamfara is lagging behind in all the basic indicators.
Twenty six years after the state has on the average of seven hundred health facilities taking care of over five million people and with scarce human resources that are depreciative in number.
According to the data by the former Chairman of the Nigerian Medical Association in Zamfara Dr. Mannir Bature, Zamfara state has a total number of just (350) medical doctors with over 75% of them based at Gusau the capital city of Zamfara state and distributed across the Federal Medical Centre Gusau, Yariman Bakura Specialist Hospital, King Fahad and Farida Specialist Hospitals respectively.
On the average look one medical doctor per (1000/1) patients – doctor ratio the state presently is in need of at least additional medical doctors to meet up with the growing human resource needs. Additionally however, the state is facing serious internal and external brain- drain mantra. Some medical doctors are exiting state health facilities to other states that have better working conditions as well as those leaving the country to other catchment opportunities in another countries.
Dr. Mannir Bature in an exclusive interview with Thunder Blowers said, even last week he had written referee Report to many medical doctors as well as Consultants who are leaving Zamfara and the shores of Nigeria to the Kingdom of Saudi and rest,
Another point of lamentation is that, the state’s 26 years after does not have any medical doctors training institutions and that affect our chances to grow more medical doctors that can satisfied our human resources for health needs. The very few or limited number of those who filled in our vacancies at the famous Usmanu Danfodiyo University Sokoto, Ahmadu Bello University Zaria and Bayero University Kano.
As for the availability of infrastructure the condition is that even the existing seven hundred health facilities that we have do not have the matching standards in terms conducive working environment especially the requisite facilities. It will surprise the reader of this piece to note that in the whole of Zamfara state it was just very recently one single (C.T. Scan ) Machine) was procured at the Federal medical Centre Gusau. This C.T. Scan Machine is commonly found at the General Hospitals at Katsina and the parts of the neighboring states.
The state as at now does not have a single Magnetic Resonance Imaging (MRI) Machine. There are other basic facilities required for the medical practitioners and that alone constitutes the basic rationale behind the migration of medical personnel.
In the opinion of Dr. Bature none of the existing Primary Health Care Centres in Zamfara has reached the Minimum Basic Standard of operation or in alternative “Basic Minimum Package”. Despite the fact the state has all the laws needed to facilitate health care management, the government is not apt in following the laws guiding the operations of health care management in the state. “we have the primary health care development agency in Zamfara and we have Zamfara Contributory Health care Management Agency (ZAMCHEMA) and because the federal government of Nigeria in collaboration with the World Bank had established the Basic Health Care Provision Funds money are provided to these organs of the government for onward distribution to primary Health Care Centres in the state. The question begging for an answer is, are these organs releasing the funds as instructed and for the sole purpose?.
Another problem that is affecting the health sector in Zamfara is the lack of political will on the side of the government to provide adequate funds that are needed to develop the sector. The issue is not even the appropriation of the funds but releasing what was appropriated to provide the basic services. If one makes an analysis of the health sector budget in Zamfara for the past ten years it was not more than one time the budget of Zamfara health sector crosses the borderline of 15% and even with that the budget performance in terms of releases hardly goes beyond 20%. If not for the donor agencies Zamfara state health sectors would have been in shambles.
Currently the condition of some of our secondary health facilities especially the General Hospitals is basically worrisome. General Hospitals Tsafe, Anka, Gummi and rest are all in such a condition that is non-attractive to human habitation.
On the availability of Health training institutes, it was alarming to state that, apart from the state government owned school of Nursing and Midwifery and College of Health Sciences Tsafe there are no other health training institutions established by the government in 26 years to cater for the training of human resource for health. Katsina for instance has an average of five School of Nursing and over ten Colleges of health sciences. Sokoto has four Schools of Nursing and many colleges of health Sciences.
There is also the case of corruption involving the Health Service Management Board of Zamfara where a lot of ghost workers are fused into the state Payroll. Evidence has established that the Board over the years has become a conduit – pipe where names of ghost officers are smuggled into the Payroll of the state. A 2021 Audit conducted by the Chairman of the Board was able to establish names of medical doctors/officers on transfer, those whose contracts have expired, those whose licenses have expired as well as those without health related qualifications but smuggled into the Payroll of the Health Management Service Board because of their special salary scale. This ugly development has affected the capacity of the state to be able to recruit more professional health personnel.
Finally the operation of the private hospitals in Zamfara is also another source of concern as government has neglected its role of supervision and monitoring of private health facilities. Record has shown that, many private health institutions in Zamfara are operating with an Interim Accreditation and the Inspectorate Division of the Ministry of Health is not able to conduct regular visitatio of the private health facilities in Zamfara to see their modus operandi.