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COVID-19: Training, equipping PHC workers on prevention, control

Some nurses and midwives drawn from 20 Primary Health Care (PHC) centres in Abuja, recently got trained and equipped on maternal and neonatal resuscitation, infection, prevention and control in the COVID-19 era. REGINA OTOKPA reports

 

In the past five months, the Federal Capital Territory (FCT) and other states in the country, have been grappling with the faceless enemy, the COVID-19 pandemic. As at Sunday, July 26, the FCT has recorded a total of 3,451 cases of confirmed COVID-19 cases, ranking second to Lagos State, which accounted for 14,300 of COVID- 19 cases out of a total number of 39,977 confirmed cases in the country.

 

Given the recent trend of community infections in the FCT, the chances of recording more cases from various communities are increasing daily due to the high state of noncompliance to laid down guidelines aimed at containing the virus. Sadly, most residents of Abuja city and its communities no longer wear facemasks except they get to environments where there’s strict enforcement even as some wear it wrongly. The old culture of shaking is still a norm, the protocol of frequent hand washing is still a mirage and social and physical distancing is gradually fading away.

 

Also, social life in Abuja is back on full gear as though all was well. Hotels are back to business with some not strict on COVID-19 guidelines. Soccer betting shops, football viewing centres, drinking joints are over crowded on a daily basis just as residents have resumed parties, weddings and other celebrations.

 

Unfortunately, these careless lifestyles are not only exposing more persons and families to COVID-19 but the lives of health care providers at the Primary Healthcare Centres (PHCs) are more at risk compared to their counterparts at the secondary and tertiary levels of healthcare provision due to inadequate access to Personal Protective Equipment (PPE) or weak infection prevention and control measures. The issue is too complicated to joke around with as health workers can be exposed to COVID- 19 asymptomatic patients, who visit the health facilities for a range of other services.

 

A recent data released by the World Health Organisation (WHO), pegged the number of infected health workers in Africa at 10,000 at the last count. Many health centres were found to lack the infrastructure necessary to implement key infection prevention measures, or to prevent overcrowding. In a bid to address this huge challenge, the Rotary Club of Abuja Federal and JHPIEGO, an affiliate of John Hopkins University, recently had a one-day skills training and distribution of preventive equipment such as face shields, resuscitation kit, and respiratory timer.

 

The participants were drawn from 20 PHCs from across Abuja communities which included; Sauka, Kuchingoro, Lugbe, Tunga-Maje and Bwari. Excited about the training, Acting Executive Secretary, FCT Primary Health Care Board, Ndaeyo Iwot, commended Rotary Club of Abuja Federal for keying into the ongoing efforts of the government in reducing the alarming rate of maternal and neonatal mortality in the country.

 

Iwot said that training and provision of tools were most needed to better equip nurses and midwives from contracting infections, especially those at the PHCs. He however urged Federal and state governments to urgently declare a state of  emergency on maternal and under five mortality.

 

 

 

The FCT, he said, was already putting mechanisms in place to do such, in order to ensure mothers, new born and children under the age of five were protected from preventable deaths.

 

“In this COVID era, the face shield being given to them is mainly to prevent blood and all other fluids that splashes in the labour room from splashing on the face of the care providers. We also do not expect the care provider to infect the new born baby or the mother. “The respiratory counter is to count the respiratory count of the child to determine if its too slow or to high; to determine the vulnerability of the child that has just been born.

 

“There is a state of emergency in the country in maternal and child mortality. No mother, no child in Nigeria is expected to die from preventable deaths. “We partnered with the NPHCDA, Ministry of Health, WHO to come in and have the approval from the minister that a state of emergency should be declared in that sector in this country.

 

The 36 states and the FCT are expected to key into this and quickly declare state of emergencies in their various states and the FCT. “FCT has appointed a programme manager and we are also drawing a programme to launch that so the coordination of all activities and programmes that are going to lead to a reduction in maternal and child mortalities in the FCT could be integrated and coordinated,” he said.

 

Speaking to Inside Abuja, President, Rotary Club Abuja Federal, Rotarian Dr. Patrick Ezie, said the training was targeted at providing the much needed technical support to the 20 PHCs, with a view to  broadening their capacities to provide better services while protecting themselves, patients and the community members from being infected with COVID-19.

 

According to him, the training was predicated on a needs assessment survey carried out by the Rotary Club of Abuja Federal, which revealed the many challenges confronting PHCs especially in the COVID19 era. ”

 

This is to build their knowledge base on COVID-19 and in supporting them to be able to provide better services to the community and also to protect themselves from COVID-19 while doing that and also improve their skills on resuscitation. “Because of COVID, we have seen a lot of deaths in the communities. If the nurses and midwives are not fully knowledgeable about COVID and resuscitation techniques, it will further worsen the current mortality rate of women and children.

 

“We are also building capacity of these healthcare workers to understand how to isolate COVID19 patients to avoid the patient infecting people at the healthcare centre and that community before referral to COVID-19 management centres.”

 

Ezie, who stressed the need for establishment of more PHCs in Abuja communities, said that, “you cannot isolate a COVID patient where there is no health care structure.” However, the Director, PHC, FCT Primary Health Care Board, Dr. Rukayat Wamako, said the Primary Healthcare Centres have the capacity to deal with COVID-19 cases being the first point of contact at communities.

 

He explained that although the PHC centres do not offer treatment for COVID-19, they have been trained on how to handle patients for few  hours until transferred to a COVID-19 management centre.

 

She called for the establishment of isolation wards in all PHC centres and at least, one testing centre in each of the six area councils in the FCT. Wamako noted that village health community and ward health community in the 62 wards of the FCT involving 55 PHCs, have been adequately trained on COVID-19.

 

These set of individuals, she said, would help in penetrating the communities to search for persons suspected to have been infected with the virus, and refer them to appropriate centres where they could be isolated and receive treatment if tested positive to COVID-19. “All our primary healthcare centres are well equipped and open at this era of COVID-19.

 

“A massive training has been done on the emergencies of taking care of the COVID-19 pandemic patients segregation; triage of patients. Such training has taken place with the efforts of the NPHCDA to all our primary health care workers, the front liners. “Every healthcare centre ought to have in each ward, at least an isolation ward where they isolate for just two hours. Within two hours, if you get a patient through the patient triage, you raise an alarm and call for evacuation of such patient.

 

They don’t treat but can triage a patient. “In the six area councils, a meeting was conducted last two months on how to establish a testing centre in at least one area council to help reduce the work load. The tension that NCDC is facing because they are almost overwhelmed and COVID-19 is escalating and it’s real.”

 

Also speaking to Inside Abuja, representative of JHPIEGO, Oluwatobi Adebayo, who expressed worry over the high rate of maternal mortality and low acceptance of modern contraceptive method and usage by women in the country, stressed the importance of paying close attention to the welfare of women and children, especially the first one minute of a child’s life, which he described as the most crucial.

 

“The issue of new born and maternal mortality is more problematic in sub Saharan Africa and Nigeria is contributing a significant portion of that. Till date, we know there is still a high maternal mortality rate in Nigeria. We still have a very low percentage of the population embracing modern contraceptives with the overstretched health system that we have in Nigeria today.

 

“We felt that building a bottom-up approach is the way forward in this era that we are, to ensure they not only have the capacities to make sure they keep the mothers and babies alive, but also to ensure those health care providers that are offering these services are not unduly exposed to infection from the patients,” he said.

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