DR. PAUL DOGO, is the Kaduna State Commissioner for Health and Human Services. He has been in the services of the Kaduna State Health Systems since graduation in 1984. In this interview with EMMANUEL ADO, he spoke extensively on the activities of the ministry and many other issues. Excepts:
Kaduna State Governor, Mallam Nasir El-Rufai, was recently quoted as saying: “Our programmes are structured to ensure that a pregnant woman does not die due to inability to access quality services during pregnancy and childbirth; that a child is not lost from preventable diseases, that communities are not overburdened with endemic diseases, and that community linkages are harnessed and promoted” . Interpret this statement in terms of your role as the health commissioner?
It’s very obvious to me that the governor’s statement was made from a well-informed and intentioned position. This statement defined the main problem and offered solution in a very pointed manner, as it were, taking the bull by the horn in tackling high diseases burden, maternal mortality of 547 per 100,000 live births and under 5 the mortality of 180 per 1000 live births and of course reducing the disease burden.
The structured programmes the governor talked about which we are currently executing are in two layers. The first are those programmes that are implemented by the health sector and these include the revitalization of the Primary Healthcare system, Free Maternal and Child healthcare programme, strengthening of routine immunization, observance of the maternal newborn and child healthcare which is commonly referred to as the child health week, child spacing programme, control of HIV/AIDS, control of Tuberculosis, and then tackling of neglected tropical diseases.
The second layer of programmes have to do with tackling the social determinants of health. You know there are social determinants that are outside the purview of the health sector but have very important significant impact on the health of the people.
How far have you gone on the implementation of the Kaduna State Sector Implementation Plan(SIP)?
The Sector Implementation Plan(SIP) is drawn from the State Development Plan which spans 2016 – 2020. Our 2017 budget is drawn from the Sector Implementation Plan and our 2017 budget in the Ministry has further been broken down into implementable and costed activities. There will be quarterly reviews of our performance. What we have done to enhance and ensure performance was to tie every activity to a programme officer by name, so the responsible officer will be held accountable. Because of the seasonal variation we have in the occurrence of malaria we have included in our annual operational plan chemo prophylaxis (chemoprevention) for children.
What are you doing to improve the quality of health care services in the state , considering the challenge of insufficient resource for health?
Still on our SIP it is meant to address the challenges facing the health sector. You rightly mentioned poor infrastructure, poor quality services and inadequate human resources for health. Although you singled out quality of service and human resources, I must also say that even infrastructure is very critical as far as the provision of quality healthcare is concerned.
The expansion and renovation of 255 Primary Health Centres, slightly more than that number because more facilities have been added.
So, one of the first things we did was to ensure that these facilities are brought to standard, and that’s why we’ve adopted the one PHC per political ward strategy. All health clinics in that ward will feed into it and the Ward Primary Health Centre is also going to feed into a Secondary Health Care facility and we’ve identified one in each of the 23 local government areas.
How soon are we going to start seeing the dividends and when do you expect the first graduates from the Kaduna State University?
As you would recall, we had severe problems with the accreditation, so the first batch of medical students had to be sent to Uganda to complete their clinical training. Towards the end of last year, they were here on holidays and their officials came to see His Excellency to show their appreciation. And by the grace of God they’ll graduate when he’s still in office. You can see the number that will be injected into the system. And do recall that 30 girls were also sent to Uganda to read medicine so as to raise female human resources for the health sector particularly targeted at our women.
So the Ministry has about 70 doctors on training?
Yes, outside the shores of the country. Remember that the objective is ensuring that our women deliver in hospitals. So if we can get female Gynecologists, Obstetricians managing them, I’m sure the women will feel more comfortable. This is a deliberate policy.
What is your ministry doing to ensure that ‘hard to reach’ areas are accessible for healthcare services?
Well, we’ve received tremendous support from UNICEF and we have reached quite a number of communities through a deliberate programme on Hard to Reach, where certain interventions have been taken on how to reach them.
One thing we have done under the strengthening of routine immunization is that all the Primary Healthcare Centres providing routine immunization are adequately funded, and carry out outreach services. This outreach service is what we use in accessing the performances of the PHCs and they must reach the hard to reach areas.
We also have the Community Orientated Resource Person(CORPS), who are residents within the community.
What is your ministry doing to check childhood killer diseases like pneumonia?
Well, I think it is very important for me to mention that our strategy in strengthening routine immunization is key. It is very important because it raises the immunity of the community so even when a child comes in contact with infectious diseases, he doesn’t get it or even when he gets any infection, it is very mild and will not lead to death.
So, it’s very important that Kaduna State is getting it right in respect to routine immunization. I did mention to you about the community oriented resource persons and their work in tackling Pneumonia in children. We use dispersible Amoxicillin it is now part of our essential drugs list and we ensure it is available. It is very effective in tackling Pneumonia.
We want to plead with mothers that anytime a child is having fever they should not hesitate to take the child to the nearest clinic. In respect to malaria the treatment is free in Kaduna state. We have been distributing anti-malaria drugs to our facilities in order to combat the problem of malaria.
How are you coping with the challenge of dearth of funds to execute your programmes?
Well, funding I must say is important but healthcare is not all about funding. Your attitudes and the ability to use the little you have efficiently and effectively matters a lot. Since this government came in what we have learnt is to be prudent, managing resources in such a way that we’re able to achieve much and then coordination instead of running vertical programmes. What we’re doing more and more is integration; once you integrate you reduce cost.