Saturday, April 1, 2023

Niger State health sector and Gov. Abubakar Bello’s giant strides, by Awaal Gata

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The health sector in Niger state was nothing to write home about at the time Governor Abubakar Sani Bello assumed office in 2015. But at the moment, the sector is faring ahead of many other states in the country, thanks to the ingenuity and foresight of the governor who appointed a competent and visionary man, Dr Mustapha Jibril, to man the health ministry.

Every affair requires an astute plan in order to gain a fair or good result. In view of this common sense, after assuming office in November 2015, Jibril charted a plan which would assist him in effectively carrying out what he was brought to do. He sprang to work by developing a Comprehensive Health Plan (which is also known as Niger Health 1.0) for the state. This plan wasn’t simply developed with the developer going to bed thereafter; it was routinely reviewed to make sure that it is in consonance with the needs of the time. This led to the emergence of an Annual Operational Planning which has been robustly in effect since 2017.

Nigeria, according to WHO, has ten thousand Primary Health Care (PHC) centres in its 9,423 wards across 774 LGAs. However, most of them have been moribund and many wards do not have functional health centers. It has been the policy thrust of the federal government to revitalise, to the standard of WHO, any centre that is moribund and also ensure that every ward has at least one functional health center. This includes having the required number of qualified medical personnel, facilities and medical equipment. Accordingly, the first state to heed to this policy since the emergence of President Muhammadu Buhari was Niger.

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Before 2015, Niger state’s health budget was barely six percent (6%) with poor release and inadequate implemented. But the Sani Bello-led Niger State raised the health budget to eleven percent (11%) and releases and implementation have been consistently improving. Even though there were PHCs in Niger at the time the administration came on board, these PHCs were not working effectively and the populace were not getting quality health care services. Jibril assessed all of them, diagnosed what ailed them and developed a plan which has been making them effective, via the PHC agency he resurrected.

Within these four years, outbreak of diseases has been minimised in Niger State thanks to the precautionary acumen of the man at the helm of affairs at the health ministry. To stem outbreak of diseases, an Emergency Operations Centre (EOC) has been set up. It isn’t that it was set up and those behind it went back to bed; the EOC works round the clock discharging the duties for which it was created, and this led to the prompt combating of the outbreak of Lassa Fever and Meningitis at a time in the state.

Infrastructural deficit is one of the issues in which Nigeria’s health sector has been mired. Niger is not an exception. But giant strides have been made in ameliorating this issue in the state in the last four years. Within this time, the Maternal and Newborn Hospital in Minna was completed and put to use. The construction was started by the previous administration and left midway. The Sani Bello-led administration completed it and affixed a state-of-the-art neonatal unit, which has been a case study in the whole of the country.

To key into the policy of having a PHC centre in every ward, five brand new centres have been built in five wards that previously had none, while dozens of the existing PHCs that were suboptimal were renovated, equipped and put to use. Still under this scheme, all of the 274 wards in the state received the healthcare attention of the state government, especially in the area of providing basic equipment for PHC centers.

Not only the PHC centres enjoyed the exemplary overhauling of the health sector spearheaded by Jibril, the secondary centres also did. Apart from the modernisation of the laboratory of the Minna General Hospital, IBB Specialist Hospital, Minna was also renovated and equipped with the equipment it was previously lacking which impeded its efficacy. The same thing happened at the General Hospitals in Kutigi, New Bussa, Mokwa, Lapai and Suleja. Locals say this is also ongoing at Lemu General Hospital.

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As with every job, personnel welfare is of utmost importance. It brings the best out of them and boosts their commitment. Apparently, this is why the administration did not toy with the welfare of the health workers. In Kuta, it was understood that accommodation was an issue for the staff, hence the administration built from the scratch, a quarters for them at the General Hospital. This, obviously, spurred the procurement of eight additional operational vehicles for the health ministry and her agencies. This also, should be the reason behind increasing the wages of health workers in Niger State to bring it to parity with their counterparts at the federal level.

As at today, Niger state is one of the only 4 states (Lagos, Yobe, Kano are the others) in the country to implement this salary increase for health workers during the last four years of this dispensation, despite the recession. This is why the four states were exempted from the last nationwide strike by the Joint Health Workers Union in 2018.

Effective manpower was also an issue in the sector before 2015. The problem is today no more. Within four years, 400 nurses, doctors and midwives have been injected into the Secondary Health Care subsector, while 250 midwives have been injected into the PHC level. Plan is also underway to massively recruit community health workers across the state.

The administration is futuristic. If it wasn’t, it would not have beamed its searchlight on the institutions in which healthcare givers are trained. There was a dearth of them, and the existing ones were dysfunctional because of infrastructure deficit. They were also battling with teaching quality and accreditations. The administration saw to the full accreditation of the School of Midwifery, Minna and Bida after 20 years of partial or no accreditation of their programmes. Other interventions of the Sani Bello administration included the rehabilitation and full accreditation of the School of Nursing, Bida, and the establishment of a brand new School of Nursing and Midwifery in Kontagora for geopolitical equity.

During the last four years, the state’s Drug and Hospital Consumables Management Agency was resuscitated to ensure that quality medicines are available and affordable throughout the state at all times. This achievement has attracted the attention of the UK based Pamela Steel Associates as well as the Bill and Melinda Gates Foundation, both of who are supporting the state to take the supply chain reforms to the Next Level.

Although healthcare has been subsidised to the most affordable level in the state, free surgeries were still routinely conducted during Jibril’s leadership of the sector. In his time, over 5,000 indigent Nigerlites benefited from general surgeries, while 1,000 people benefited from different forms of eye surgeries to restore vision. These, added to the free VVF surgeries and cancer diagnoses and treatments  carried  out by the Wife of the Governor, Her Excellency, Dr. Amina Abubakar Sani Bello, could embolden one to say that many aspects of healthcare are basically free in Niger.

Not done yet, the Governor signed into law the state healthcare financing law called Niger State Contributory Health Scheme with functional offices and a full complement of staff who are already working round the clock for its implementation. The law captures both the formal and informal sector as well as the vulnerable, which makes it two steps higher than the national health insurance scheme which targets only the formal sector.

Before coming to office, Jibril had worked with many international health organisations such as the UNICEF and the Global Fund as well as the Federal Ministry of Health and the National Primary Health Care Development Agency, and Niger comparatively benefited immensely from it. Before him, never had the state enjoyed more partnerships with international partners, never had it enjoyed more health donations, and never had the state stayed more on the radars of international organizations.

From partnerships he masterminded, Niger got N1.5 billion for Basic Health Care Provision Fund  – only two other states got same; signed a 2.5 billion MoU with Bill and Melinda Gates Foundation on the strengthening of PHC systems; attracted close to 3billion from the Saving One Million Lives Program. More funds were also attracted for safe motherhood/family planning interventions from the Nigerian Urban Reproductive Health Initiative, Association for Reproductive and Family Health and the Clinton Health Access Initiative.

The state also partnered with Catholic Relief Services to tackle malaria. It also implemented the Hard-to-Reach Project in which 850 remote communities in 17 Councils were captured courtesy of support from the Canadian Government. Because of the responsive government and leadership of the state Health sector, UNICEF is planning another maternal and newborn health intervention worth 5million US dollars in state.

As a result of these achievements, Niger’s health indices are now moving in a positive direction. HIV/AIDS has come down from more than 1% prevalence to 0.7% which is lower than the national average. Immunization coverage is also improving and newborn deaths is decreasing.

All these achievements were made possible by Mr. Governor’s foresight in choosing an accomplished health practitioner and compassionate politician in the person of Dr. Jibril to head the health sector. Call it putting a strong square peg in a square hole.

Even though he achieved far far beyond precedence and vacated his position on May 28, 2019,  many of his new “brainchildren” in the health sector are still in the queue for legislative assent and implementation.

Recently, on one of Niger’s Facebook groups, a debate about who was Governor Sani Bello’s best commissioner came up. Although most of the debaters’ submissions were amateurish, majority of them mentioned Jibril. Health is phenomenal to man, so the debaters might not be far from the truth.

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