Despite launching a health insurance scheme to cater for the health needs of all categories of people, the Akwa Ibom State government has yet to make any budgetary provisions for family planning services, particularly in the supply of basic consumables and commodities. This is hampering access to family planning services.
Like the health insurance scheme being implemented by the state health insurance agency and carried out in Primary and secondary health facilities in many local government areas of the state, family planning services are also offered in some Primary Health Care Centres (PHCs and Secondary health facilities as well but the critical issues of funding, inadequate health workers and office space continue to retard efficient service delivery.
According to checks while family planning services are supported by Non-Governmental organisations in selected local government areas, health workers are afraid that families stand the risk of losing out after the partners might have completed their tenure and closed out of the state.
“I want to thank The Change Initiative (TCI) and other partners working in this Local Government Area,” a health worker stated during a recent visit to a Primary Healthcare Centre in the state.
“If not for their support, we would not have been able to offer many services, we need consumables, expendable materials for one-time use like needless, sterilizers, gloves, anaesthetic and iodine,’’ she said.
The health worker who did not want to disclose her name said when she was newly posted to the health facility, there was no facility for conveniences and no running water at the health centre.
“This office serves as a counselling room and it is used for procedure, there is no privacy, ” she said.
“ I had to engage a plumber to fix the toilet from the imprest that was provided by the local council. Now, I have to buy fuel to put on the generator to enable me to sterilize the tools I use,’’ she said.
“Now the office space that I have is not enough, I need a space that will ensure privacy between the client and others.
“When clients come for services, the space is so small that I can hardly have any privacy with my client, I am thinking of doing a partition,’’ she said.
Experts believe that Family Planning (FP) services if effectively deployed can help improve the health of the family, and ensure child spacing so that couples enjoy the benefit of ‘having children by choice and not by chance.’ It can also be an effective tool in reducing maternal mortality in the state.
According to Taiwo Johnson, a development expert and director at TCI, family planning is a low-hanging fruit for maternal health if properly implemented.
“A woman should have children because she can not because it happens,” she said
These issues have however made Akwa Ibom health officials in charge of family planning to express optimism that funding was likely to be improved for family planning given the renewed attention being paid to the health sector by Governor Umo Eno.
“We are optimistic that funding for FP services will improve soon.
The governor recently directed that all junior workers in the state civil service be enrolled under the health insurance scheme, ” they said.
In addition, Governor Eno directed that all junior civil servants from salary 01 to 06 be enrolled on the state health insurance scheme at a cost of N180m covering 9,150 junior workers. As commendable as this gesture is, which many believe shows the commitment of the state government to the health needs of the people, it is against this backdrop experts believe that making a budget line for FP should not be a difficult task.
“The state government can conveniently commit to spending N100m to boost the uptake of FP services in the state, and the government would not go broke,’’ according to an expert.
The poor uptake of FP services is compounded by the dearth of health workers. Some health facilities are manned by only one health worker, who is not even a nurse and is not equipped to provide FP services.
To compound the situation, health workers who were due for retirement as required by the civil service rule were given automatic extensions of additional years as the state government failed to recruit young and fresh health workers into the system. This means fewer hands in the health sector as the workload increases.
As for FP commodities, a variety of items that healthcare providers use to provide family planning services such as implants, injections, intrauterine devices and condoms among others, are also being provided by partners.
‘These commodities are available in our facilities and many clients are responding particularly after we carry out outreaches in the communities by the community mobilizers, ‘’ a health worker stated.
She said more was still needed to be done in getting the services available to the people.
“There is a pathetic case, a woman who had seven children before, recently gave birth to a set of twins bringing the number of people in the family to nine.’’
‘How does a family of nine feed properly,’’ she said.
In the next year’s budget of N955bn presented to the state assembly by the Governor, N300bn is for recurrent expenditure while N655bn is for capital expenditure.
A breakdown of the recurrent expenditure shows that personnel cost would gulp N115.6bn while overhead cost would cost N184.3bn. It is not known whether family planning services are covered in the social sector allocation and as often the case, budgetary allocation is the first step and the release of the funds is quite another.
The Coordinator of FP services in the state, Enobong Eshiet is hopeful that funding will improve in the coming years.
“If the releases are made as included in the budget, we are optimistic that things would improve, ” she said.
Supporting childbirth spacing could be one way of ensuring the well-being of the family and with the health insurance already implemented in Akwa Ibom State, family planning services if funded by the state government could go a long in making the much-needed difference in the health of the family.
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How Poor Funding Hampers Uptake of Family Planning Services in Akwa Ibom is first published on The Whistler Newspaper