Experts want action on health workers not showing up in PHCs

The Health Policy Research Group from the University of Nigeria, Nsukka has called on the Enugu State Government to take stronger steps against health workers missing from Primary Healthcare Centres (PHCs) in Enugu State.

The group’s Coordinator, Obinna Onwujekwe, made the call on Thursday during a program titled Stakeholders’ Policy Dialogue on addressing health workers’ absenteeism and strengthening accountability in PHC facilities in Enugu.

Mr Onwujekwe, who is a professor, also urged the government to improve accountability in PHCs across the state. He said the dialogue allowed representatives from the Enugu State Ministry of Health, Primary Healthcare Agency, National Health Insurance Authority, community leaders, and media professionals to discuss how to tackle absenteeism among health workers at PHCs.

The coordinator explained that the dialogue was set up to share research findings and engage policymakers on practical steps to cut down absenteeism among health workers. He highlighted that the research found transportation issues, lack of workplace support, and low community involvement as factors leading to absenteeism in PHC facilities.

Mr Onwujekwe said the group focused on three key actions that could help improve attendance and service delivery by health workers. He noted that they chose these actions after talking with relevant individuals and organizations.

"One of the findings is that providing transportation support to health workers, especially those serving in remote communities, will encourage them to report to work regularly.

"We also discovered that providing support systems within health facilities, where colleagues support one another, can improve attendance.

"Community involvement is equally important because when communities participate in monitoring healthcare services, it helps to strengthen accountability," he said.

The coordinator stated that the research showed that combining these three actions could greatly reduce absenteeism and enhance healthcare delivery. He mentioned that the policy dialogue aimed to turn research findings into real government policies and programs.

"We have conducted a study and generated evidence. What we are doing today is bringing stakeholders together to discuss how this evidence can be translated into policies and practice.

"We are talking about evidence-based policymaking, where decisions are guided by research findings rather than assumptions.

"Our expectation is that the government and other policymakers will take renewed action to ensure that these interventions are implemented across the state," he said.

The coordinator expressed hope that the recommendations would ensure that people seeking medical help at PHC facilities would find health workers available. He acknowledged that although Governor Peter Mbah of Enugu State has invested a lot in building PHCs, the research and policy dialogue would help keep health workers present at these facilities.

"Our research complements the efforts of the state government because we want to ensure that the health centres being constructed are not left without health workers.

"We expect the government to use this evidence to strengthen its actions against absenteeism," he said.

New System for Monitoring Attendance

Mr Onwujekwe praised the state government’s new clock-in system for tracking health workers’ attendance at PHCs. He argued that this move showed that the government was aware of the challenges posed by absenteeism.

He said solving this problem needs different strategies beyond just monitoring attendance. "The evidence we have produced will further help the governor and the state primary health care development agency to reduce absenteeism in PHCs," he said.

Pamela Ogbozor, a research associate, presented the research findings. She explained that the intervention ran from August 2025 to January 2026 in four PHC facilities in Nsukka, Igbo-Etiti, Enugu North, and Nkanu West Local Government Areas.

Ms Ogbozor noted that eight other facilities were used as control locations, where they did not introduce the interventions. She said that 100 percent of health workers in facilities with interventions regularly completed attendance registers, compared to 90 percent in control facilities.

The research associate also shared that 15.4 percent of workers in intervention facilities left before their shifts ended, compared to 48 percent in control facilities. She explained that types of absenteeism include workers not showing up, arriving late, or leaving early.

The researcher warned that absenteeism could lead to complications for patients, increased risk of death, and extra workload for those on duty. A representative from the Independent Corrupt Practices and Other Related Offences Commission, Stephen Obi, said absenteeism and ghost workers were serious problems for healthcare delivery.

"Absenteeism and ghost workers go together and to the commission, it is a serious challenge," he said. Mr Obi mentioned that the dialogue offered valuable information that he would share with the commission.

One participant, Alex Ugwu, praised the program. Mr Ugwu, who is the chairman of the Ward Development Committee at Hilltop PHC Ngwo, told reporters after the program that the initiative expanded their knowledge on how to tackle absenteeism in PHCs.

"This program has helped us to know the areas to improve to address absenteeism in the health sector across Enugu State and beyond," he said. He commended the research group, stating that past research had led to government policies that improved healthcare services in his community’s PHC.