In 2003, it was a widely known fact that 70-80% of illnesses in adults were related to inadequate, or a complete lack of, primary health care. Treating “primary” illnesses obviously prevents them from progressing to become more chronic and therefore results in fewer fatalities. In Kwara, therefore, this issue was immediately to ensure better overall health for the citizens and a reduction in the alarmingly high mortality rate. Dr Saraki and his administration went to work, firstly building, or rehabilitating, a total of 103 primary health centres across the state to a minimum specified standard, which included equipment for outpatient services, family planning consultations, nutritional items and supplements for patient management, ante- and post-natal services, modern laboratory equipment and cleaning facilities. Electricity and running water were also connected to all the centres.
The health of a nation’s most vulnerable children is used as an indicator of that nation’s commitment to the health and welfare of its population. In view of this, the administration ensured that all those involved in child healthcare in the state had training in Integrated Management for Childhood Illnesses (IMCI). The IMCI strategy promoted the accurate identification of childhood illnesses, ensured appropriate combined treatment of all major illnesses, strengthened the counseling of caretakers, and speeded up the referral of severely ill children. The IMCI training also served to improve the skills of the healthcare staff, family and community health practices and the overall health system, from the gateman of the health facility to the consultants in charge. In the home, it promoted improved nutrition, preventative care and the correct implementation of prescribed care, thus reducing death, illness and disability.
Across the world, countries such as Japan, Malaysia, Kenya and India have used variations of home-based health records to reduce dramatically the deaths of pregnant mothers, newborns, infants and children. In Kwara, the Saraki administration was the first to introduce this innovative tool, which guaranteed the access of pregnant women to a comprehensive package of healthcare, starting from antenatal care and ensuring continuous care throughout pregnancy, delivery, early infancy and childhood up until the child’s fifth birthday. Being a simple yet effective method of managing the much-needed information and statistics of mothers and children, it is also used for planning and forecasting for the future welfare of the population. The Personal Health record has now been copied by the Federal Government as part of the midwife service scheme.
The administration also implemented a state-wide polio programme which culminated in a zero-level prevalence of the Wild Polio Virus (WPV). The state has achieved over 90% coverage in routine immunisations, significantly higher than the national average of 80%, and the extensive coverage in the National Immunisation Program (NIP) for routine immunisations has made it the leading State in the North Central Zone. The strict surveillance programme implemented across the LGAs has also meant that Kwara has remained polio-free despite it being surrounded by states that still have cases of WPV.
The main health policy thrust of the Baraki administration was to provide efficient/ effective healthcare delivery to the people of the State. The rationale for the establishment of Community Health Insurance Scheme (CHIS) was to make quality healthcare services readily available, accessible, acceptable and affordable to the majority of Kwarans, most of whom live in rural areas. To achieve this, Kwara State started the CHIS in January 2007 at Shonga in Edu LGA. Only a year before, the Shonga Centre maintained a monthly patient enrolment of about 16; but in roughly 3 years, the scheme has been scaled up to Lafiagi in the same LGA with 25,427 individuals currently enrolled, while the expansion to Afon in the Asa LGA of the Central Senatorial district has 14,249 enrolees, making a total of 39,676 enrolees. At the inception of the scheme, each enrolee was required to pay a sum of N200 for one year’s accessibility to healthcare services for all categories of ailment; this fee has since been increased to N300.
The scheme is a tripartite arrangement with the Dutch Government, represented by PharmAccess, while the Kwara State Government is in partnership with a private sector healthcare company. Activities carried out by the Kwara State Government for the launch of the scheme included the upgrading of the physical infrastructure, training of staff with the support of PharmAccess and the conduct of routine Outreach Programmes based on the data of patient encounters. Presently, efforts are being made to scale the scheme to the southern senatorial districts in the state.
The Kwara State government, under the direction of Dr Saraki, also embarked on a project to establish an advanced medical diagnostic centre in Ilorin (referred to as “K-ADC”) as part of a holistic vision for improving the healthcare delivery system of the State. The K-ADC will be strongly linked to the existing state-owned primary and secondary service providers, as well as serving as a referral diagnostic centre for all the States in North Central Nigeria. It has been designed to be a state-of- the-art centre with Imaging and Laboratory Divisions, complete with a 64-slice CT scanner, 16-slice CT scanner, 1.5 Tesla MRI scanner, ultrasound, echocardiograms, mammograms and routine x-rays. The Centre will also have a full-fledged Laboratory services division, complete with automated haematology, biochemistry, immunology and microbiology units. The centre will be managed by in-house specialists, including radiologists, radiographers, cardiologists and cardiac nurses.
A new college of Nursing was also commissioned in December 2010.
In partnership with Sight Savers International (SSI), the Saraki administration set about attempting to reverse the trend in visual loss among the less privileged. Numbers of patients seen and screened increased from 11,340 in 2003 to 48,526 in 2009, whilst the number of cataract surgeries increased from 120 in 2003 to 2,630 in 2009. The Kwara Eye Program is so reputable in the sub-region that there has been an influx of patients from neighbouring states.