The Commissioner for Health and Human Services, Ekiti state in southwest Nigeria, Dr Oyebanji Filani, says the state had aligned its resources to strengthen infrastructure at the primary healthcare level.
Speaking to newsmen, on Thursday, in Abuja the nation’s capital city, Dr Filani said the state had used part of the resources mobilised for COVID-19 response in the state to set up a molecular laboratory and procure oxygen plants.
The resources, he said, were also used to procure ventilators, facilitate COVID-19 vaccine deployment, as well as set-up an ICU centre, which was still ongoing at the State’s Teaching Hospital.
“Beyond COVID-19 response, these infrastructural inputs served the Primary level of care as referral centres, which are critical in the health value chain.
“Risk communication is a critical pillar of the COVID-19 EOC. Beyond the response, the state has created more awareness of existing health facilities and services, thereby increasing service utilisation at the primary care level.
“COVID-19 response has also enabled us to engage better with private facilities to strengthen case detection.
“We had to train private clinics and equip them with RDTs to enable quick identification of COVID cases in private hospitals,” he explained.
The health commissioner noted that the pandemic had brought to the fore the importance of infection prevention and control in health facilities.
“Leveraging the pandemic response, we have trained PHC staff on Infection, Prevention and Control (IPC).
“This is to enable them quickly recognise, efficiently treat and if needed refer patients with infectious diseases while preventing the transmission of infection within the health facility and their immediate community,” he said.
Dr Filani described COVID-19 as being both a curse and a blessing.
“A curse in terms of all the losses we have experienced; loved ones, colleagues, friends and also the socio-economic setbacks that have occurred since the beginning of the pandemic.
He said that it has been a blessing because COVID-19 had caused the country to critically appraise its system’s readiness for inevitable public health events.
“It has exposed weaknesses in our system and at the same time, afforded us a chance to build back better by strengthening health security and service delivery,” he said.
The commissioner also spoke on how the state had been able to handle the challenges in its PHC delivery, ranging from human resources for health, to funding, and the key interventions to improve its delivery.
“In September 2020, we conducted a diagnostic assessment to determine the drivers of underperformance.
“Subsequently, a stakeholder retreat was held to co-create solutions aimed at improving health system performance and prioritise a set of high impact interventions for immediate and long-term implementation”, Dr Filani said.
He identified three key strategic areas to build a resilient and sustainable healthcare system, beginning with “a forward-looking Primary Healthcare agenda as the foundation for Universal Health Coverage.
“Improved stewardship and performance management, financing and quality of service delivery and strengthening health security.
“Our approach to immediate and long-term goals was, therefore, driven by interventions to be prioritised under the 3 strategic areas,” he added.
The commissioner further stated that in the past year, the state had made appreciable progress in the delivery of PHC services.
“Thirty-seven health facilities have been renovated in the past year and the process for the renovation of another 48 PHCs is in the works.
“Early in the year, 12 tricycle ambulances were procured, in addition to an existing 33 ambulances. These tricycles facilitate timely referrals from the PHCs to higher facilities.
“In February 2021, medical equipment, such as delivery beds, weighing scales, thermometers, sphygmomanometers, among others, were procured and distributed to 48 PHC centres in the State.
“244 health workers were re-trained on the management of the Basic Health Care Provision Fund (BHCPF),” he said.
According to him, the state increased the fiscal space for health and implemented high impact interventions that enabled us to leapfrog to our ambitions.
“With clarity on direction, we engaged our colleagues in finance and budget on how to increase the capital budget by 200 per cent for the health sector.
“We also leveraged additional partner resources, mobilising close to a billion naira in cash and kind as support to optimise service delivery in the State,” Dr Filani also said.
He added that “despite constrained fiscal space, however, more than 20 doctors were recruited in the past year to support quality service delivery in primary and secondary healthcare facilities.
“A National Youth Services Corps (NYSC), the medical fellowship was established, by which Corps doctors were actively encouraged to work in rural settings in the State.
“So far, 99 per cent of Corps doctors posted to the State, since the beginning of the fellowship has been retained, compared to an average of 50 per cent retention over the last three years.
“We posted nurse and midwives within senatorial zones, to ensure more equitable access to skilled health care services in rural PHCs, especially during childbirth.
“We recently trained 520 PHC workers, and more will be trained before the end of 2021” he further said.
Meanwhile, there had been the deployment of key interventions, in addition to the use of data for performance management, decision making and course correction and institution of continuous quality improvement mechanisms, he said.
“Deployment of EMR to enhance data reporting and minimising wastages and leakages,” had also been put in place, he added.