Ganduje Blazes The Trail In Primary Healthcare Delivery

From Maduabuchi Nmeribeh, Kano

A fortnight ago, Kano state Government organized the Kano 2020 Primary Healthcare Summit, an event that showcased in no small way the uncommon achievements recorded in the Primary Healthcare sector by the state Governor, Dr. Abdullahi Umar Ganduje. The tremendous achievements in primary healthcare delivery under the watch of Ganduje as Kano state Chief Executive also drew the commendation of the Federal Government when the Minsiter of Health, Dr. Osagie Emmanuel Enahire handed a plaque of honour to Ganduje, awarding him Nigeria’s champion of primary healthcare delivery. Dr. Enahire handed the award to Ganduje at Coronation Hall, Kano Government House, shortly after declaring open, the Kano 2020 Primary Healthcare Summit.

Ganduje is the second person receiving award of such nomanclature in the last 27 years. Dr. Enahire said the award was bestowed on Ganduje for his continued effort in the development of primary healthcare system in the state, in line with global best practice.
He expressed delight over Ganduje’s sterling performance in the health sector, pointing out that the rate at which Kano is moving in the development of the primary health care system is encouraging and superb.Dr. Enahire revealed that, “we at the Ministry, we are united in arriving at the decision that led to the Award of this merit to His Excellency Governor Abdullahi Ganduje. All the indices used before they arrived at this level, were scientifically proven, that they all appreciated the immense contributions of the Governor in the area mentioned, primary health care delivery system.”

He further stated that because of his unassuming belief and acceptance of the efforts being put by Ganduje in the health sector generally, “this is my third time of coming to Kano in less than a Month. This signifies that, Kano is doing well in the sector because I cannot just be coming without being satisfied that the Governor is doing very well.” Dr. Enahire noted that, Kano state under Ganduje, “understands the importance of the health sector and not at the detriment of other sectors of the state, because we have been following trends and see for ourselves. Dr Ganduje is that Governor who believes in healthy society. And who works towards improving same.”

Also speaking at the event, the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shu’aib disclosed that, “the last time such award was given, was for the last 27 years. Here we are awarding Governor Abdullahi Umar Ganduje with it, Champion of Primary Health Care.

“We looked at the quality leadership that gave birth to effective and efficient primary health care delivery system, with good budgetary provision to the sub-sector and good management, before we arrived at the winner of the award.”

He added that the incredible leadership demonstrated by Ganduje, in his untiring effort in developing primary health care in the state, which culminated into making other state to copy from Kano, was another reason why the Governor exhibited multi-faceted feats being achieved in the healthcare sector.
He particularly commended Ganduje for his resolve to stamp out polio in the state, adding that, “since when the Governor was a Deputy Governor, Kano state and the nation in general, would not forget your efforts towards polio eradication.

“While His Excellency the Governor came up with the idea of Health Care Influencers, as another strategy to strengthen primary health care delivery system, it is on record that, other states see wisdom in the style. It is known to all that, the Governor is doing extremely amazing things in this sector.” According to him, the women participation as Influencers is another way of helping the primary health care sector become more entrenched and with more grassroot support, where sense of ownership would be achieved.

In his remarks, Ganduje said, “this Summit heralds a milestone in the health sector, particularly primary health care delivery in the state. We all believe that the welfare of our people from the grassroot is another cornerstone.” He added that Ganduje is pumping enough resources towards achieving effective and efficient primary health care delivery system in the state.

Ganduje, however, conducted Dr. Enahire and his entourage to the State Cancer Centre, which is under construction, which the Vice President Prof, Yemi Osinbajo laid its foundation few weeks back. Also over 500 women were taken to Muhammadu Buhari Specialist Hospital for free Cancer screening, as part of activities to mark the year 2020 World Cancer Day.

The same scenario played out during the 2019 End of Year Health System Strengthening Program Review Meeting, when Ganduje, received commendation from two world renowned philanthropists and healthcare promoters for his efforts in ensuring adequate healthcare delivery in Kano state. The President of Dangote Foundation, Alhaji Aliko Dangote and President of Bill and Melinda Gates Foundation, Mr. Bill Gates, who are partners in polio eradication and healthcare delivery in Kano state, who gave the pass mark to Ganduje, also tasked him to do, even more, in ensuring that Kano residents have adequate healthcare services. The duo commended the Ganduje administration for working towards improving health system and strengthening community engagement towards the success of Routine Immunization.

Dangote specifically expressed happiness that Kano state government has recorded remarkable achievements in terms of data quality and encouraged its health team to work towards the development of a robust data quality improvement plan before the end of the year. He maintained that the Kano health team should target their goals towards reducing the discrepancy between administrative and survey data for all key health indices. Dangote made the remark during the 2019 End of Year Health System Strengthening Program Review Meeting, held via Skype, at Africa House, Government House, Kano. The Africa’s Richest man who is also an indigene of Kano, noted that, “Kano has made a lot of deliberate efforts to ensure community engagement gains from Polio, RI etc. are maintained, as we transition to integrated PHC service delivery across the whole state; It is therefore good to hear community linkage strengthening being highlighted as area to prioritize during the last PHC summit. On the financing and financial management, it is good that the state has sustained its record of timely retirement of funds in the health systems strengthening program but would like to encourage the team to review the current approach to monitor timely implementation of work plan and utilisation of program funds for impact. I will not relent but continue to talk about program data. I therefore, will like to encourage Kano to develop and implement data quality improvement plan at all health facilities that connects to LGA, Zone, and State mentoring plans; and also be sure that the plans don’t only address capacity gaps, but also work to improve behaviors around data inflation.”

Also in his message to the meeting, Mr. Bill Gates, represented by Dr. Chris Elias, President Global Development Fund, congratulated Ganduje for remaining on track for a robust health programme since the tripartite partnership between the state government, Bill and Melinda Gates Foundation and Dangote Foundation took effect in 2012. He added that, “this is a highlight of political commitment. It is remarkable to see the success made in the successful implementation of the Seattle resolutions agreed back in November, 2019 with particular reference to the commitment by His Excellency to complete transfer of salaries of Primary Health Care staff to the State Primary health Care Management Board by March, 2020. Other areas we noted success and worth commending include a more realistic costing of the minimum service package which will help fast track implementation of Primary Health Care Under One Roof (PHCUOR) components. I am quite happy to note the good work around the 2-way referral linkages; so great to hear about the increased number of successful 2-way referrals from primary health facilities to secondary health facilities from 26 complete referrals during the pilot stage in Q1 2019 to 1,225 in Q4 2019. Great to hear the continuous efforts to finish the Polio work especially with timely disbursements of counterpart funds for SIA campaigns but more needs to be done at this critical time particularly with the attendance of the LGA chairmen at the evening review meetings. These activities are very critical to success as we aim towards having Nigeria certified polio free.”

Speaking during the meeting, Ganduje promised that the state government would do its best to identify and fill the gaps that were brought to fore during the meeting. He promised that the state would, “scale up existing referrals network service between primary health centers to secondary health centers and would implement resolutions of the 2020 Primary Heath Care Summit with emphasis on rationalization of the minimum service package investment plan.”

At the meeting the state Commissioner for Health Dr. Aminu Ibrahim Tsanyawa showcased how the state excels in broader health system strengthening, with a graphic evidence of 20 percent in 2017, 20 percent again in 2018 and a visible increment to 40 percent in 2019. He noted that the state health system strengthening efforts, “have evolved over the years with the aim of improving overall healthcare service delivery, while the overall goal is to strengthen the health systems and ensure integrated health care service delivery.”

Dr Tsanyawa stated that, as a success story on Primary Health Care Under One Roof (PHCUOR), the scorecard of its components hints that, ownership and governance is represented by 75 percent, legislation 50 percent, minimum service package 63 percent, repositioning 36 percent, systems development 100 percent, human resources 75 percent, funding 86 percent operational guidelines 100 percent and office set-up, which makes the overall score of the PHCUOR to be at 69 percent. He said of the eight milestones for the end of year review exercise. Tsanyawa revealed that three areas are done with. These are, to finalize and operationalize quality of care strategy, while baseline assessment at selected 50 health facilities was conducted.

He added that secondly, an area looking at sustainability and strengthening in-sourced last mile direct vaccines delivery, which stands at the position that Monthly in-source delivery is sustained and lastly the achievement of 6 Months with no detection of cVDPV from last positive isolation. Which discloses that there was no detection since 2018, while on the part of the ongoing areas are, where final MSP investment plan is validated, validation of HRH assessment data, which is also ongoing, establishment of DMT in all secondary health facilities and the monitoring of data management is still ongoing, memo detailing harmonisation shared with State Executive Council for ratification is also ongoing and then the final dissemination to all stakeholders.

In the area of vaccination, Dr Tsanyawa hinted that, “the state aims to implement identification of Missed Opportunities for Vaccination (MOV) at primary health facilities while strengthening the current gains of MOV practices at secondary health facilities.” All in an effort to further consolidate the visibly identified commitment of the state government, under Governor Ganduje, Commissioner discloses that in trying to achieve some notable milestones, the state adapted the Seattle Declaration. He further stated that under this, “HCH provided PHC and Polio updates at the Q1 2020 State Executive Council meeting, state counterpart funds released for all the three remaining polio and non-polio campaigns in 2020, salary payments by the state primary health care management board is expected to commence from March 2020, state to commence implementation of MSP investment plan by end of Q2 2020 and that state Ministry of Health is currently leading the advocacy visits to the Emirates, among others.”

Dr. Tsanyawa noted that understanding the vitality of healthcare financing, the state government deposited, according to the Governor’s remarks, that 100% funds of its counterpart contributions of 2019 RI and HMoU and hinting that the state has agreed to nearly double the denominator for the basket fund to N800 Million in 2020, explaining that, “This will make more funds available for child spacing, nutrition and other PHC services. The state has validated all 484 health facility BHCPF1 bank accounts and currently orienting health workers on the BHCPF1 operations and funds will be disbursed to the health facilities after validation of business plans by the SPHCMB this quarter.” As top priorities for the year 2020, Dr Tsanyawa said the state would optimise Reach-Every-Ward (REW) microplan to incorporate other PHC services beyond RI by February 2020, develop plan to fill identified statewide human resource for health gap, by March, 2020, to achieve Kano State Polio Free Certification, by June, 2020, among others.

In their separate remarks, Minister of Health Dr Osagie Ehanire, Co-Chair, Bill and Melinda Gates Foundation, Mr Bill Gates, (who was represented) Chairman Dangote Foundation, Aliko Dangote and Executive Director of the National Primary Health Care Development Agency (NPHCDA) Dr Faisal Shuaib, all commended the effort and commitment of Ganduje in keeping faith with all sections of the MoU. After the commendation, that was extended to other areas of the health sector, some of them highlighted areas that need further improvement.

The Emir of Bichi, Aminu Ado Bayero, spoke extensively on the role of the traditional institutions in improving health care delivery system in the state, assuring that, “We will do everything humanly possible to always support this development.” He finally ordered all District Heads, Village Heads, Ward Heads, Imams and other community leaders to make sure that they always strive hard to achieve optimally in the state health care system.
Twenty four hours after the meeting, Ganduje, determined to ensure that the programme is working across the state, took Routine Immunization (RI) campaign into the hinterlands, assuring that his administration will continue to ensure adequate healthcare delivery to all residents, with special interest to the masses in the rural areas. Ganduje who personally chaired the RI Reconciliation Meeting in Kura Local Government Area, expressed happiness over the level of data reconciliation and compliance to immunization by residents in the community. He assured that his administration would work tirelessly to make sure that the development of primary health care delivery system in Kano continues to appreciate.
He promised that, “I will be sending my Commissioners to similar Reconciliation Meetings across the state. For them to also monitor and be conversant with the process to appreciate the work we are doing. This will also encourage the actors. I mean the community leaders and the health workers,” he added.

Speaking at Sani Marshall Primary Health Centre in Kura, Ganduje promised to continue to strengthen efforts to improve quality data on Routine Immunization exercise at the community level, urging for effective involvement of community leaders and health workers to fully utilize the available health facilities to improve and assuage the health needs of the citizens. He appreciated the authentication of the Data collected, describing it as a strategy for improving the quality of the data in the registers of community leaders and the Primary Healthcare workers, adding that, “I am also calling on our people to be supportive of this.”
Ganduje pointed out that the authentication process of the reconciliation meetings are absolutely necessary and important, noting that, “with this, we are telling our development partners that we are up and doing in this process. And we are also showing them that our efforts in this and other areas are yielding results.”

Speaking during the meeting, representative of World Health Organization (WHO), Dr. Bashir Abba, commended Ganduje for what his administration is doing to make sure that healthy population thrives in the state. “We all come to understand that universal health coverage is the fastest, easiest and more accessible in improving our health,” he said. Dr Abba promised that WHO would be in Kano to ascertain the total wiping out of the Polio, as the absence is recorded for over two years now, adding that, “Kano is doing very well and we are all appreciating that.”

In her remarks, representative of Bill and Melinda Gates Foundation, Harolyne J. Appia, said the Kura visit showed them how local communities are linked to the Primary Health Care delivery system, “this also shows your commitment in this area Your Excellency.” She expressed satisfaction that the financial management, data quality, community engagement among others, were given all the necessary attention by Ganduje’s administration, adding that, “we are calling for a continuous commitment as shown by the leadership of Dr. Abdullahi Umar Ganduje. We are all determined to continue supporting you.”

Dr Hashimu Abubakar who represented Clinton Health Access Initiative (CHAI) also commended the effort of the state government for taking along with her communities in the primary health care delivery system, adding that, “we also appreciate the Monthly meeting between government and the local communities. We will continue to work and in hand with your government in the primary health care system, so as to improve the health of the population.”
In his remarks, the Commissioner of Health, Dr. Aminu Ibrahim Tsanyawa disclosed that the Primary Healthcare facility is attended by over 300 people, adding that, “all the Ward Heads are doing their best in this area. That is why we are recording these feats. “It is through the engagement of our community leaders that we find it very easy to detect those children that are vaccinated and those that were not vaccinated. So the immunization of our new born are taken good care of.”
The AUTHORITY reports that over 10,000 books, that serve as Manuals were distributed to the community leaders for easy understanding of the exercise during the meeting. The meeting was attended by representatives from WHO, UNICEF, Bill and Melinda Gates Foundation and CHAI, who all appreciated the strategy and the commitment shown by Kano state government, traditional leaders and health workers.

Indeed, Ganduje is blazing the trail in primary healthcare delivery. Residents of Kano who are benefiting from this dividends of democracy, being yawned in many states across the country are encouraging Ganduje, urging him to not only sustaining the tempo, but to do even more the keep the people healthy for a better and more productive society.

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