When Dr Olusegun Mimiko became Governor, Ondo State was said to have one of the worst maternal and child health indices in southern Nigeria. The public health care sector was poorly funded and the citizens of the state were mainly at the mercy of private practitioners: the good, the bad, and the unscrupulous. One of the goals of the Mimiko administration was to ensure affordable and good quality health care for all citizens of Ondo State. Recent reports suggest that Ondo State has made giant strides in health care, up to the point that it is being put forward for emulation across the country as a model for Maternal and Child Health at the primary and secondary levels.
There existed and still exist, four State Specialist Hospitals: in Akure, Ondo, Ikare-Akoko and Okitipupa. The specialist hospitals (otherwise known as ‘tier A’ general hospitals) were designed to provide tertiary health care services in Ondo State. The state also has what is called ‘tier B’ and ‘tier C’ general hospitals spread across the state. There are also 18 Comprehensive Health Centres in each of the 18 local government areas that make up Ondo State. And there are Basic Health Centres (primary health care facilities) across the villages.
In addition to these health facilities, the Mimiko administration founded “Mother and Child Hospitals” in Akure and Ondo town to provide specialist care to mothers and children alongside the existing Paediatrics and Obstetrics departments in State Specialist Hospital in Akure. The “Mother and Child Hospitals” provide free health services to pregnant women and children under the age of five. Ondo State has increased its funding of health care and its good profile in the country has attracted a lot of donor funding from various international bodies to further support the state in the health sector. Ondo state now has a world-class diagnostic centre in Ondo town, a product of Public-Private partnership. The state also has a Trauma Centre and Renal Centre in Ondo town. Plans are afoot to create in Ondo town a world class health care village
Impressive as all these may seem, the facts on ground do not totally support the image of Ondo State as the Nigerian healthcare El Dorado. In fact, it is now more difficult for people in Ondo State to access good quality health care, due to the high cost of healthcare in the state. The price of health care services in the state has steadily gone up in the past two years. Hospital admission which used to cost about N1500 previously has now gone up by 100%. It is commonplace to see patients being unable to carry out ordered investigations due to cost. By the time patients have paid for investigations and documentations, they often have nothing left to procure required drugs.
It is baffling that the Mimiko administration chose to construct new health facilities when there already existed health facilities whose infrastructure and equipment just needed upgrading and adequate funding to provide the same services. The new health facilities in the state such as the Trauma Centre and the Renal Centre are exorbitantly priced, putting them out of the reach of common citizens of the state whose taxes were used to build and equip these health facilities. The old hospitals remain in a state of neglect, with a lot of uncompleted projects within the hospitals. They are understaffed, ill equipped and poorly funded. It takes just a visit to the ‘tier A, B and C’ hospitals to really open one’s eyes to how deplorable they are. The wards look terrible, the toilets and baths are eyesores, their Accident and Emergency units lack the necessary emergency drugs, and their laboratories do not possess the necessary equipment. Yet the government focuses on building new parallel hospitals.
Health care is anything but affordable in Ondo State. The price of health services in public health care facilities owned by the Ondo State government rival and are sometimes are more expensive than in private facilities. For this reason, patients often prefer obtaining referral to the federal government-owned tertiary care facility in Owo rather than to the state ‘tier A’ specialist hospitals. This is particularly important, because most Nigerians are without health insurance, given that about 100 million Nigerians live on less than a dollar per day. In addition to ignorance, this high level of poverty is responsible for the inability of people to access health care around the world. The free health scheme which might provide some respite for mothers and children only functions well at the “Mother and Child Hospitals” and there are only two of them in the whole state. The scheme is ineffective in the general hospitals because drugs and materials for patient management are often not available in these hospitals anyway. The “Mother and Child Hospitals” are directly administered by the office of the governor and not the statutory State Ministry of Health, which also raises the issue of accountability and transparency.
It is important that the government addresses these issues. Governor Mimiko can and should do better to stand by his promises and make health care affordable to citizens of Ondo State. Due attention should be given to the existing health facilities which are usually a patient’s first point of call. The government should stop paying lip service to free health. The people need to know in good detail which services and commodities are free, for whom, and which services and commodities, although declared free are not be available. The Ondo State government needs to rethink how to effectively implement its free health scheme. Governor Mimiko should stay true to his manifesto. The citizens of Ondo State deserve better.
Dr Ayomide Owoyemi is a pre-registration house officer at the State Specialist Hospital in Akure, Ondo State. He tweets @ayomidejoe
