Health

PRIMARY HEALTH CARE

Newly Refurbished Primary Health CentreIn 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.

MATERNAL, NEWBORN AND CHILD HEALTH

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.

INTRODUCTION OF PERSONAL HEALTH RECORD BOOKS

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.

SAFE MOTHERHOOD BILL

The Safe Motherhood Bill became law in 2010, in order to regulate best hospital practices for child-bearing women and also to protect them against any harmful traditional practices. It provided for safe maternity care and services in the State, with the aim of initially reducing and finally eradicating maternal and newborn mortality in Kwara. The law made it an offence for any hospital, clinic, maternity home, primary healthcare centre or traditional birth centre in the State to provide maternity services without having all the requisite facilities, equipment and qualified, experienced personnel – indeed, it included an extensive list of the minimum equipment requirements. Additionally, every healthcare centre in the state providing maternity services needed to be duly registered with the state authorities and keep in stock a list of essential drugs and injections. Defaulters are now at risk of being fined anything from N50,000 to N500,000, imprisonment in some instances and the shutting-down of their premises until requisite requirements are met.

IMMUNISATION AND POLIO ERADICATION

Executive Governor Bukola Saraki Administering the Polio Vaccine

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.

 

 

 

 

MALARIA-FREE KWARA PROGRAMME

This programme was launched in 2008 and has had a tremendous impact in reducing malaria related fatalities in Kwara. The government oversaw the distribution of over 300,000 Long-Lasting Insecticide-Treated (LLIT) nets, 187,000 Artemisin Combination Therapy drugs (ACT), 370,000 Sulphadosine Pyrimethamine (SP) and 105,000 units each of Paracetamol, Vitamin C, B complex / multivitamins across the state. As a result, malaria in pregnant women was reduced by 20% and reported malaria cases in hospitals in general was reduced by 10% between 2008 and 2009 alone. As part of the guaranteed access of care for pregnant women, LLIT nets as well as intermittent preventive treatment of malaria are provided at appropriate times in the course of pregnancy. The State Government intends to provide at least 1 million nets under the scheme in the future.

COMMUNITY HEALTH INSURANCE SCHEME

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.

RECRUITMENT AND STAFF WELFARE

From 1991 to 2003, there had been little or no recruitment into the health force. The Saraki administration turned this around on coming to power, by recruiting and training 1,500 health workers of different categories including: physicians (94), pharmacists (3), nurses/midwives (852), laboratory technicians/medical scientists (32), medical record officers (18) and community health workers (350). In addition to an aggressive recruitment programme, the state undertook the training of radiographers in cutting-edge ultrasound techniques and the training of doctors and midwives in emergency obstetric care and extended life-saving skills.

RESIDENTIAL AND FINANCIAL PROVISIONS FOR MEDICAL STAFF

The state also recognised that one of the barriers to effective primary care was having adequate residential accommodation for medical staff in the rural areas, especially after the recruitment drive. So the administration therefore launched a policy that ensured that each primary care centre was manned by competent staff and had state- built staff quarters, to encourage job stability and sustain rural postings. Salaries and allowances were also enhanced and training programmes introduced.

It was understood by the state that most fatalities could be avoided if accident victims received timely first-aid treatment and made it to hospital quickly. In order to ensure that accident victims got the golden ‘first hour’ treatment after a traumatic event, the administration introduced an articulated A&E program and established ambulance points at major roads leading into, and out of, the state capital. Located at Budo Awero (Ogbmosho Road), Olokonla (Jebba Road), Odo Owu (Kabba Road) and Ijagbo (Oshogbo Road), these fully equipped, state-of-the-art ambulances were purchased to provide emergency first-aid services and evacuate accident victims to the nearest hospital. Similarly, hospitals have been provided with fully equipped ambulances to aid in the transfer of patients on a ‘need to’ basis.

MEDICAL DIAGNOSTIC CENTRE

Dr Bukola Saraki at the Inception of the Diagnostics Centre in Ilorin

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.

HIV/AIDS

The State has succeeded in reducing HIV prevalence by 36% since 2003, through the establishment of HIV counselling and testing centres in all local governments, collaborating with development partners, private hospitals and the Ministry of Education. The home and community management of HIV/AIDS, as well as the reduction in stigmatisation, have been strengthened by upgrading the Kwara State HIV/AIDS Control Agency [KWASACA] into a fully-fledged operation with legislative backing of the administration.

KWARA EYE CARE PROGRAMME

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.

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