By Ndidi Chukwu
The Sabin Vaccine Initiative and National Immunization Financing Task Team (NIFT),has organized an Anglophone Peer Review Workshop for Sustainable Immunization in Africa to ensure funds are made available for Immunization activities in Nigeria and Africa. Five African countries participated in this event to chat ways on how the countries can sustain their immunization programs. Dr. Kabiru Ibrahim Getso, Kano state Commissioner of Health has participated in the workshop. He shared the Kano experience in this interview with Health Reporters.Excerpt:
Sir, what will you take home as knowledge gained from this Anglophone Africa Peer Review Workshop for Sustainable Immunization?
Talking about financing immunization programs, it is an important issue, this workshop is very relevant in the sense that we are coming up with action plans that will help us to chat roadmap to financing immunization in Nigeria and also in our states. Talking about Kano state, we have a road map we have drafted which is helping us finance immunization services. There is tripartite MoU agreement reached between the Kano state government, Bill and Melinda Gates Foundation with Dangote Foundation. This is also helping us a lot to finance immunization programs in the state especially now that the resources are dwindling. The government doesn’t have enough resources to adequately fund health care in the country. A basket is created in which funds are contributed by these partners, these funds are used to manage immunization services in the state.
What plans is your state putting in place to sustain immunization financing by the time this tripartite agreement elapses?
The agreement is ending by December 2016, so we are already looking at ways that we can sustain this immunization financing, if it is not reversed. Part of what we are doing is to increase budget for RI services in the state, we are also looking at how we can partner with other organizations and philanthropists so that we can have more funds to manage these programs.
Are there specific approaches that you have adopted?
We have Primary Health Care under-One-Roof, this tripartite MoU is about polio eradication and we are hoping that by next year we are going to eradicate polio from the country from there we will start thinking of how to finance RI. Because we are going to use RI as a platform to strengthen the entire Primary Health Care using the concept of Primary Health Care under-one-roof. So what we are trying to do now is to look at how we can have a sort of MoU signed between the state and other partners on primary health care so that we can use it to sustain and boost PHC services in the state. We are looking at increased funding for PHC services in Kano state
What is the status of your state’s 2016 budget?
Just this week the funds have been released, like I said we have this tripartite MoU so the state have released its own part of the funds
Adequate participation of CSOs in your planning meetings like the Routine Immunization working group can improve and strengthen accountability and transparency. Since you said the funds are released are the CSOs being carried along and do they have the kind of information they require to carry out their advocacies for immunization financing?
Yes, CSOs are carried along during planning for RI activities in the state, they are part and parcel of the RIWG in the state so they play important role in making advocacy in the state, to other partners and philanthropists, so that they can join the states to provide funds for RI services in the state and also to participate in conducting activities that aim at having RI services improved in the state. As such CSOs have made critical impacts in the state and we will continue to work with them in polio eradication and RI.
Implementation of RI services lies with the health ministry which you are in charge of, people are worried about transparency in budget expenditure, and are there accountability mechanisms in place which will ensure adequate utilization of funds released for RI?
Accountability framework is something we are passionate about, any fund that is disbursed we have mechanism to track to make sure that these monies that have been released are used judiciously. There are sanctions for the officers that have not used those funds the way they are supposed to be used and we have a system that will check whether these funds have been used or not. If they are not used they are returned to the state, each health facility has account through which funds are disbursed for RI. There is documentation for all these and we have supervisors at each level that are supposed to monitor the conduct of these activities. So there is a lot of accountability in the process.
From your experience in this peer review workshop what would you be doing differently in your state to ensure improved Immunization Coverage?
Routine immunization is one of those areas that have not been doing well in area of coverage, even though the administrative data shows the good coverage if you look at the survey data there is dismal coverage. A lot needs to be done, in Kano state we have an annual work plan which is broken down into quarters so every quarter we prioritize our activities. For instance, this first and second quarter we are looking at strengthening the cold chain system, this is one of the situation we want to address in the second quarter we will ensure adequate coverage. Our vaccine delivery system is another strong point in RI system and a model that other states even countries are adopting because we have vaccine delivery system where vaccines are delivered from the satellite cold stores directly to the health facilities at the localities.
This is one of our strong point and it has helped to ensuring that we don’t have stock outs for vaccines. we are also collaborating traditional leadership, we have a committee called the Kano State Emirate Council on health, this collaborate and plan RI activities together in the state, we are using this committee as a platform to make advocacy in communities, the stakeholders in the committee sensitize mothers to bring their wards for immunization. These are the strategies we are adopting to ensure we have improved coverage of RI services in Kano State .