MATERNAL, NEWBORN AND CHILD HEALTH: The six pillars to save one million lives – Adeyanju, Ondo Health Commissioner

By Chioma Obinna
Ondo State took the centrestage  during the ‘Operationalisation Meeting of Saving One Million Lives Program –for- Results (SOML-PforR) South-West Zone’, in Lagos.  The state health sector won the first and best performed health sector in the South-West with an improvement rate of 29.5 percent recorded since the disbursement of $1.5 million to all the 36 states of the country and FCT  to deliver high impact, evidence based and cost effective health interventions based on six pillars. The pillars are maternal, newborn and child health; childhood essential medicines and increasing treatment of important childhood diseases; improving child nutrition; immunisation, malaria control; and elimination of mother to child transmission, EMTCT, of HIV.   Sunday Vanguard spoke to  the state Commissioner for Health, Dr Dayo Adeyanju, on the secret behind the success.  

Adeyanju

What led to this feat?

It is a statement of fact that we have made remarkable improvement in the South-West, thus leading the whole region.  And that was between 2014 and 2015. It is no magic but with the facts that we have structure and we were training our system even before we received the fund and the fund now complemented what we had on ground and improved our system.

And we had paid attention to minute details. For example, we no longer focus on just the output but also the outcome and then the impact. The maternal and child health that you mentioned, that is not just our focus, that comes on twice a year but we have also made routine immunisation to  cover all the indicators.

And we  strengthened the routine  immunisation that we call Ondo State Routine Immunisation Services.  This was basically to create a peer pressure for care-givers to present their children for immunisation, ensure that they are able to benefit from dividends of democracy like our Free Bus Shuttle and Mega School meal. That way, people will actually present their children for immunisation. But one thing that we have always focused on is to have facilities and consumables in the hospitals. But then, what is critical is the ability to track the people and create demand for all of these things, that is why it is essential to utilise the system we have on ground like the Ward Development Committee to mobilise the people to come back for immunisation and pregnant women to deliver.  And then ensure that these women deliver in the facilities because one thing is for them to attend ante-natal and another thing  to come and deliver at the facilities.

We connect the people back to the facilities.  Those are the details we have paid attention in Ondo  and it is making a lot of differences in terms of tracking and, of course, we paid a lot of attention to our health management  information system  designed to help us know how we are performing because what you cannot measure, you cannot treasure.   So it is important that you strengthen your health management information system, focus on getting a feedback from the communities that are your beneficiaries so that you will be able to adjust in terms of improvement.

How did the $1.5 million worked?

What was important for us is to see how this fund will assist us under the six indicators listed. We looked at how we were going to disburse the fund right, through strengthening our primary healthcare because, if you don’t strengthen your primary healthcare, you will be waiting for complications. Strengthening primary healthcare will mean that you will be able to nip all those complications that should have arisen in the bud.  So this fund will go to the communities first, then the primary healthcare. We sensitised the communities, the Ward Development Committees to be more active in the primary healthcare under one roof. Then, we strengthened the facilities as well as the Primary Healthcare Development Agency to supervise effectively.  When you do well at the primary healthcare, that is the basis for you to impact on more people rather than focus on teaching  or secondary health facilities. Like I said earlier, our focus has been  on health information management system, primary healthcare system and maternal and neonatal as well as child health.

To give you a simple analogy, the babies that die between labour room and special care baby unit are quite many and not too many people pay attention to equipping every midwife to be able to resuscitate new born babies.  These are things we pay attention to in Ondo and ensure that no baby is lost having invested so much in the last nine months.

Influx of patients into  Ondo hospitals

When there is quality in healthcare delivery, it is obvious that everybody will besiege that arena.  If anyone is sick, he  will want to get the best.  We have put together what we call the state residency card to ensure that at each time we are able to checkmate the quantum of people that come around. And because we make provisions for everybody resident in Ondo and if you are not, then you will pay a token to access our services.  I tell you we want to ensure and that  is why we are collaborating with other states to see how they can gain from our experiences to improve  their health systems such that you don’t need to travel far to have access to  qualitative healthcare in  our state. But because it is putting pressure on  our systems so much, we tried as much as possible to see how we can checkmate influx so that people that are residents and are paying their tax don’t have to lose out from the services.

Do you support PHC autonomy?

Yes. They must have some level of autonomy because they have different settings with different peculiar situations. For example, you cannot compare what happened in the urban with  rural setting. For instance, the hard- to -reach areas like riverine communities understand their own terrain and know that there are some places where you should have boat ambulances. There are places you should have four-wheel drive ambulances. They know when people come to the market and when they don’t come and when to provide information. You cannot impose on them what to do. But the state government must provide supervision to track and ensure that they are able to deliver on set objectives.

Legacy for incoming administration

We have been able to put together the Social Protection Bill. We are going to the House for legislation. We are going to ensure that nobody will trample upon it because it is evidence of good governance. The people are already aware of it.  We must ensure that we make Universal Health Coverage our priority and, to be able to do that, we will use the available funds to drive all of it. What is important to us is that there is continuity in the system because we have built capacity of the civil servants, and the communities, are aware of the Bill because they are already buying into the new dispensation. Continuity and sustainability is very easy for us to do and we have no doubt about that.