pilot study on supporting and enhancing primary healthcare in Adamawa state at Bekeji PHC.
A report on the pilot project pioneered by Concerned Medics Foundation[CMF] between 1st October 2021 to 31st January 2022 at primary healthcare Bekaji, Yola, Adamawa state, Nigeria.
The project was a passion project birthed from the need to bring
accessible healthcare to the primary level i.e. the PHC. It was carried out by the Concerned Medics Foundation, which is an NGO
comprising of doctors and allied health professionals in Nigeria and in the diaspora.
This PHC project was a thought-out plan on how to bridge the gap of healthcare delivery from the grassroots to reduce the overburden on other levels of healthcare. The model was developed as a collaboration between the PHC, the NYSC (National Youth Service Corp), and CMF. Bekaji PHC was chosen as the dynamic centre to pilot the project due to the availability of a CMF member to oversee the project.
The main objectives and anticipated outcome of the project were:
• To increase the skilled manpower for the PHC, through a pool of volunteer doctors and healthcare workers, in order to help the underserved community access better health care services.
• A partnership between NYSC, which would post doctors to the PHC, and CMF, which would offer partial remuneration for the doctors as incentives.
• To implement the use of telemedicine in the diagnosis and treatment of patients having the advantage of specialists at home and abroad and to support and educate the local doctors.
• To collect data on the common ailments presenting and to provide written guidelines for wider dissemination.
The project was to run for a period of a year from 1st October 2021 to 1st October 2022.
The necessary approval was sought from Adamawa State Primary
Health Care Development Agency (ASPHCDA) and the Bekaji PHC.
Both were very receptive and enthusiastic about the project and
facilitated the smooth implementation and success of the model.
The facility was accessed and the project started initially with 3
volunteer doctors and a medical laboratory scientist, and later 2
further NYSC doctors were contracted to see patients on
weekdays 8am to 6pm.
CMF donated some medical supplies and consumables during the
course of the project, which helped with the management of about
250 patients during the 4 months the project ran. In addition, we
provided health talks during antenatal clinics and health education of the community health workers on common medical emergencies and their management.
The community benefited immensely from access to medical doctors and lab scientists, which was the first of its kind that we are aware of in the community at that level.
Some of these objectives were achieved very successfully. However, despite the success noted so far, a number of ‘roadblocks’ were encountered during implementation which included;
• inability to get NYSC doctors posted to the PHC, although some were recruited through CMF
• Supplementary payment by CMF was insufficient to make the project sustainable in the long term
• Some of the PHC staff were resistant to structural changes; lessons were learned which will help mitigate such problems in the future
• Lack of modern laboratory equipment and reagents for routine investigations to aid in patient management.
• Inability to digitalize patient records due to lack of computers in the facility. However a streamlined manual record keeping system was implemented and embedded
The project was suspended after 4 months in January 2022, with plans being made for further support in these areas, such as from other telemedicine providers/NGOs.
In summary; for the 4 months the project ran, due to the hard work and enthusiasm of participants, a number of significant goals were achieved and the project was a positive experience for all parties. In addition, there was very good feedback from patients, although some were surprised to learn that antibiotics are not always the appropriate treatment.
We demonstrated that, with more stakeholders involvement and funding, having doctors stationed at PHC is paramount in order to reduce the overburdening secondary and tertiary centers.
