Year 2015 for Nigeria’s Health Sector will see new ways of implementing programmes, with the Health Bill now an Act, and possible exit from the list of polio endemic countries, with dwindling oil prices, there are fears for health care funding but some experts are very optimistic. Dr. Ado Muhammad Executive Director of National Primary Health Care Development Agency (NPHCDA) tells Ndidi Chukwu of Health Reporters that 2015 holds better things for the nation.
HR; We are just a mile away to polio interruption how is it that the NPHCDA made much progress in 2014 for polio interruption and other programmes?
Dr Ado ; I want to say the very best of the compliment to you and to all Nigerians, the year under review which is 2014 the agency made a lot of progress but before I state that I would use this medium to appreciate the media, both electronic and print media for all they did in 2014 which has contributed immensely to the progress that we made, there has been objective reporting of health programmes. 2014 in the Primary Health Care Sub-sector, we have seen a lot of progress, and achievements recorded in the area of maternal and child health. For maternal and child health programmes, on the maternal aspect, we have continued to provide skilled attendance at the point of delivery in our primary health care centers and nationwide. With the combination of MSS midwifery service scheme, and the SURE-P MNCH intervention we have been able to deploy over 12,000 frontline workers to over 2,500 primary health care centers nationwide and that is in about 459 Local Government Areas nationwide. The year under review has contributed significantly to skilled attendance at the point of delivery so that more women benefit from antenatal care and access to skilled attendance at the point of delivery. What this means that since 2014 we have seen less women dying from pregnancy and pregnancy related causes. This has also contributed to the reduction of maternal mortality rate in the nation. For child survival we also have seen and witnessed a lot of progress, new vaccines were introduced, we stabilized the availability of our routine vaccines in such a way that in 2014, there is no primary health care center in this country or local government area that recorded stockout of vaccine. Vaccines are made available in all facilities in this country. Not only are vaccines made available they are also bundled in such a way that when we deliver the vaccines we deliver the delivery materials in facilities and that has really moved up our routine immunization coverage from what it used to be, a coverage of about 48 to 50 per cent in 2012 and 2013, to coverage of 87 per cent nationwide. When you look at the disaggregate figure by states, some states have even attained 90 per cent and above. What this means is that less children are dying from vaccine preventable diseases. In 2014 we introduced new vaccine, we roll-out in activated polio vaccine as part of our end-game strategy for polio eradication and we also have in December 2014 also rollout the pneumococcal conjugate vaccine (PCV) which is also a part of routine immunization. What this means is that we are concentrating on more lives being saved because the immunization plus days (IPDs) consolidates our gains in terms of beefing our targets as we tackle polio. For the PCV, by the time we roll it out to all the states we will annually be saving about 240,000 lives so that will mean that we have averted about 240,000 deaths annually and that will add on to the number of lives we are saving. In 2014 we see the health bill becoming an act Mr. President graciously approved, signed and accented to the health bill, that is also a major achievement for us in the primary health care sub sector because that will further assist us and support us in terms of engaging the states and state primary health care development agencies in terms of making the Primary Health Centers functional with commodities with human resource and the facility itself been made user friendly it is a major achievement for us in NPHCDA. In 2014, we improved in capacity building as well in which primary health care workers have been trained all over the country, we also engaged civil society organizations and media to create demand for services.
HR; North-East is considered one of the high risk areas, in your health intervention programme, how did you cope with the current security challenge in the area?
Dr Ado; Before I go into that, let me in numerical figures also share with you the achievement we recorded in polio in 2014, we made progress on polio eradication, when you compare polio eradication and the previous years there is no time in the history of this country that this progress has been recorded, in 2014, we only had six cases of wild polio virus, and so far it is the best of all achievements when it comes to polio eradication. What this means is that we are tilting toward polio interruption in Nigeria, by 24th of this month, it will be six months without polio virus in Nigeria. This is indeed a major achievement, globally this is been acknowledged and commended, that was why Bill Gates said his most favorite story of 2014, his story was the turnaround in the Polio eradication story in Nigeria. What it means is that Nigeria’s Polio eradication programme and the NPHCDA is judged as the best performing programme in the world. Despite this achievements recorded, in maternal and child health in Nigeria we still have some challenges. Insecurity is a major challenge particularly in the North-East part of the country but this does not mean that insecurity will stop the provision of health services. We as professionals, we as responsible health care providers will continue to make sacrifice in ensuring that Nigerians irrespective of where they are have access to services. For North-East what we are trying to do is work with the Local Governments in closed collaboration at any point in time if there is IPDs we move in, we have not withdrawn completely we still provide services. We will continue to work with State and Local Government authorities with traditional institutions and religious leaders to partner with us in terms of giving a result oriented and quality services to these areas.
HR; 2015 is a very important year globally, the end of the MDGs and in Nigeria, we have the election around the corner, and we are all aware that the sector is almost ignored during election years, what is on ground for the remaining months to the end of MDGs and will the elections affect this process?
Dr Ado; For us 2015 is a consolation year, because we have made so much progress and we need to sustain the progress we have made in the sector and for that to happen we have to do those things we have done that are working very well and those things reviewed and are not working very well, we find how we can review them and turn them to positive working arrangement, for 2015, a lot of things need to be done. During election we observed that during campaigns attention is normally taken off the sector particularly at the State and Local Governments. We are conscious of that fact and we are working on mechanism on back-up arrangement to make sure that does not happen but if it does, we will see that health programmes and the sub national level will continue to be executed. For 2015 we are focusing on final interruption of wild polio virus, 24th July 2015 will be one year in Nigeria if we did not witness a new polio virus on any child, in five months’ time, if no case is recorded, we will be globally be said to have interrupted wild polio virus. It will be the first time in the history of Nigeria that it will happen so we are working towards ensuring that we continue to improve on the quality of the polio campaigns and make routine immunization available in all PHCs and we will continue to tackle the issue of refusal of vaccines in some few areas. We will work with state and local governments to see that each and every child eligible is reached with potent OPV so that we sustain the gains and consolidate it, so that no more case will be reported in Nigeria. Secondly, we are also working on consolidating routine immunization campaign already we have introduced new vaccines. 2015 focus is to continue to make available routine vaccines in all facilities nationwide so that no stock out will be reported. We also consolidate on our gains on improving routine immunization coverage so that we can create more demand for services and more children will be made available and we will be able to ensure that in all LGAs in the country, will not have routine immunization coverage less than 87 per cent. Thirdly, on routine immunization services, we intend to rollout PCVs to all states of the federation, we introduced the first phase in December 2014, in Kogi Lokoja, we intend to roll it out to all the states of the federation, so that all eligible children will be reached. By the time we do this, we will be able to save close to 300,000 lives annually that would have been wasted if PCV was not introduced. We are also going to roll out polio inactivated vaccine to all facilities in Nigeria already there is a campaign on it but we will incorporate it within the routine immunization programme and that will be part of the end-game strategy for polio eradication, so that the population immunity of all the population would be beefed in such a way that no polio virus can strive in any community. We will also consolidate gains made in maternal health services so far, and that includes further recruiting and employing midwives to PHCs across the country and beyond deploying midwives we also want to introduce some live saving commodities like Magnesium Sulphate and Misoprostol that are evidenced based commodities known to save the lives of women. Health bill is now a health act, it is a major achievement for us in the health sector, and it is a major legacy of Mr. President. It is one key area that posterity will remember him for. We intend to work with all stakeholders to ensure that we religiously implement the health act already we are discussing with a number of stakeholders both in the public and private sector so that we develop the framework for disbursement for utilization and for monitoring of these funds, this we intend to do with all stakeholders. It takes some time to plan if you want to get good result so we are working on how we will bring out the frame work, the guidelines for utilization of these funds; we are working very closely with the states to develop a robust framework for the utilization of these funds.
To be continued