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World Bank: Bringing Healthcare Closer Sokoto, Zamfara States
- By Simeon Ogoegbulem
- Published Monday 27th 2009
- PoliticalWorld
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THE World Bank has never hidden its desire for a better health for the people, especially people from low income countries of the world. This desire for better health perhaps informed the designing of the Health Systems Development Project (HSDP). The Health Systems Development Project (HSDP-II) is a primary health care project focusing on systems strengthening and provision of care at the community level.
Initially, the total cost of the project was put at $153.22 million. The amount is made up of $127.01 million contributed by the World Bank while the balance of $26.21 million was contributed by the federal government and the 36 state governments and Abuja. Like most facilities, the World Bank contribution came from the International Development Association (Ida), the concessional window of the bank.
The HSDP-II has three components, namely, strengthening capacity for system management in all states in Nigeria. The HSDP II through this seeks to strengthen the Ministries of Health in the 36 states of the federation in the areas of planning, financial management, monitoring and evaluation. The World Bank also envisages that the project would also provide limited support to improve the technical skills of trainers and key health provider’s component.
The second component is on strengthening the delivery of priority health services. This involves the support of activities aimed at improving the delivery of primary health care services, including immunization services, safe motherhood interventions and communicable diseases control. The third component targets the Federal Ministry of Health, through capacity building and strengthening key public sector health functions and processes, as well as coordinating, monitoring and evaluating the implementation of the project.
Success Stories
During the field visit to some of the facilities financed and executed by the HSDP II in Sokoto and Zamfara States, it was a brilliant story of success as the project has brought health facilities closer to the people. According to Anne Okigbo-Fisher, Task Team Leader of the HSDP II of the World Bank, the key achievements of the project across the states, include improved access to health services to communities which hitherto had no access through the renovations/constructions of health facilities from zero in 2003 to a total of 790 by 2007. These projects were supported with essential medical equipment, motorcycles and ambulances for referral and the procurement of essential drugs.
The visit to some of the HSDP II-funded projects gave an insight into what the ordinary villagers were going through in the country to access quality Medicare as exemplified in the two states of Sokoto and Zamfara. The siting of the health facilities has in most cases bridged the distance the villagers have to go through to access a Primary Health Centre (PHC) from between 50 to 60 kilometers to between 30 to 40 kilometer radius.
The HSDP II has also been able to facilitate increased national coverage for immunization for all four essential antigens, namely BCG from 26.6 per cent in 2003 to 47 per cent in 2005, DPT from 38 per cent in 2003 to 65 per cent in 2005 and Measles from 25.5 per cent in 2003 to 50 per cent in 2006. The World Bank says the project contributed significantly to this state through the increased skills of trained health personnel, expansion of health facilities and repair of the cold chain equipment in all the participating state local councils.
Moreover, the successes recorded by the project include increased utilization of facilities for outpatient departments (OPD) and Ante Natal Care (ANC). It has also enhanced utilization between 2003 and 2006 from 4,073,335 to 10,898,998. Another area that the project has recorded very significant success is training of human resources for health through interventions in the health training institutions (HTI), such as, school of nursing/midwifery and school of health technology. Interestingly, the majority of the schools involved had been refused accreditation in the past but now fully accredited due to project interventions.
HSDP-II Projects in Sokoto State
Dr. Muhammad Jabbi Kilgori, Sokoto State Commissioner for Health was a good example of the demonstration of genuine political will to effect change in the live of the rural dwellers. Jabbi Kilgori, with the full support of the HSDP II Team in the state were very much around to tell their success stories of the HSDP II in Sokoto State. Showing good grasp of the project garnered through practical involvement in the day-to day implementation of the project, outlined the extent the HSDP II has been able to transform the health landscape of the state. To say that there is the political buy-in by the authorities in Sokoto state is to state the obvious.
The Sokoto state health commissioner also disclosed that the State have drawn down $7million while the counterpart funding of N50million has been provided by the State government. According to him, the project has constructed four new primary health centres in Achida, Jabo, Binji-Muza and Hamma’all. It also upgraded/renovated five clinics to the status of Primary Health Centres at Tambuwal, Bafarawa, Gwadabawa, Sabon Birni and Goronyo. The nine primary health centres have been completed and handed over to the beneficiary LGAs.
Another port of call was the Sultan Abdurahman School of Health Technology, Gwadabawa. The school was conceived to produce middle manpower to man strategic health facilities in the state. The principal informed the team that the projects undertaken by the HSDP-II include supply of library books, standby generator and laboratory equipment as well as female hostel accommodation. Significantly, the project helped the school to meet the accreditation requirements for some courses. At the time of the visit, about 18 students of the school have been sent to Jos, Plateau State to sit for their professional examinations in Medical Laboratory Technology. By fulfilling the accreditation requirements, the school is considering to introduce three additional courses in the Higher National Diploma (HND) cadre, namely, health services, x-ray technology and reproductive health. By these improvements, the school has admitted 681 new students, bringing the total number of students to about 1,800. For the first time, the school was able to send about 18 students to Jos to sit for their professional examinations in medical laboratory technology.
Field Experience In Zamfara State
While the Stokoto state ministry of health showed strong commitment to the project as the commissioner for health with his team dedicated the whole day in taking the visiting team round the projects. The opposite was the case in Zamfara State. While the state health ministry except for the HSDP II Team was lukewarm, the communities who are the beneficiaries have shown that there are ready to own the projects
The first place that was visited by the team was Kurya Madora PHC, Kaura Na Moda local council of Zamfara State. This project involves the renovation and expansion of the old structure. At the cost of N54million, the project consists of wards, water borehole, 2Nos 3-bedroom staff quarters, Standby Generator with large expanse of land fully fenced with a dwarf wall. At the time we visited, the Clinic officials said they had conducted average of 5 deliveries in March with a resident doctor.
Apparently overwhelmed by her tenacity and dedication to the improvement of maternal health needs of the people, the overjoyed people of Kuyar, conferred the title of “Hanatu Kuyar,” meaning dedicated mother on Anne Okigbo- Fisher. While the projects could be regarded as huge success, the fear however is on the sustainability and ownership of the projects.
Another health facility funded by the HSDP II in the state was Nahuche PHC, Bungudu L local council. The project also involved renovation and expansion of existing structure at a total cost of N46million. It was however disheartening to note that between January and March, 2009, there were already more than 42 reported cases of meningitis disease recorded in the Clinic. Apart from the Clinic building, the project provided boreholes, ambulance and solar-energy powered equipment. The Vice Chairman of the Committee on health, Sani Mohd Nahuche disclosed that the community contributed money to acquire the land on which the Clinic was constructed. He said that the community is fully interested in the project and as such, would see that the infrastructures are well maintained. He also assured that the committee would continue to undertake vigorous awareness campaign to ensure that the women and children especially patronize the Clinic.
Conclusion
The media tour was an eye opener for the journalists on the team.
The challenge is therefore for both the states and the local councils to work in such a manner to ensure that health facilities are brought even closer to the people through the maintenance of the facilities put in place by the HSDP II.
Initially, the total cost of the project was put at $153.22 million. The amount is made up of $127.01 million contributed by the World Bank while the balance of $26.21 million was contributed by the federal government and the 36 state governments and Abuja. Like most facilities, the World Bank contribution came from the International Development Association (Ida), the concessional window of the bank.
The HSDP-II has three components, namely, strengthening capacity for system management in all states in Nigeria. The HSDP II through this seeks to strengthen the Ministries of Health in the 36 states of the federation in the areas of planning, financial management, monitoring and evaluation. The World Bank also envisages that the project would also provide limited support to improve the technical skills of trainers and key health provider’s component.
The second component is on strengthening the delivery of priority health services. This involves the support of activities aimed at improving the delivery of primary health care services, including immunization services, safe motherhood interventions and communicable diseases control. The third component targets the Federal Ministry of Health, through capacity building and strengthening key public sector health functions and processes, as well as coordinating, monitoring and evaluating the implementation of the project.
Success Stories
During the field visit to some of the facilities financed and executed by the HSDP II in Sokoto and Zamfara States, it was a brilliant story of success as the project has brought health facilities closer to the people. According to Anne Okigbo-Fisher, Task Team Leader of the HSDP II of the World Bank, the key achievements of the project across the states, include improved access to health services to communities which hitherto had no access through the renovations/constructions of health facilities from zero in 2003 to a total of 790 by 2007. These projects were supported with essential medical equipment, motorcycles and ambulances for referral and the procurement of essential drugs.
The visit to some of the HSDP II-funded projects gave an insight into what the ordinary villagers were going through in the country to access quality Medicare as exemplified in the two states of Sokoto and Zamfara. The siting of the health facilities has in most cases bridged the distance the villagers have to go through to access a Primary Health Centre (PHC) from between 50 to 60 kilometers to between 30 to 40 kilometer radius.
The HSDP II has also been able to facilitate increased national coverage for immunization for all four essential antigens, namely BCG from 26.6 per cent in 2003 to 47 per cent in 2005, DPT from 38 per cent in 2003 to 65 per cent in 2005 and Measles from 25.5 per cent in 2003 to 50 per cent in 2006. The World Bank says the project contributed significantly to this state through the increased skills of trained health personnel, expansion of health facilities and repair of the cold chain equipment in all the participating state local councils.
Moreover, the successes recorded by the project include increased utilization of facilities for outpatient departments (OPD) and Ante Natal Care (ANC). It has also enhanced utilization between 2003 and 2006 from 4,073,335 to 10,898,998. Another area that the project has recorded very significant success is training of human resources for health through interventions in the health training institutions (HTI), such as, school of nursing/midwifery and school of health technology. Interestingly, the majority of the schools involved had been refused accreditation in the past but now fully accredited due to project interventions.
HSDP-II Projects in Sokoto State
Dr. Muhammad Jabbi Kilgori, Sokoto State Commissioner for Health was a good example of the demonstration of genuine political will to effect change in the live of the rural dwellers. Jabbi Kilgori, with the full support of the HSDP II Team in the state were very much around to tell their success stories of the HSDP II in Sokoto State. Showing good grasp of the project garnered through practical involvement in the day-to day implementation of the project, outlined the extent the HSDP II has been able to transform the health landscape of the state. To say that there is the political buy-in by the authorities in Sokoto state is to state the obvious.
The Sokoto state health commissioner also disclosed that the State have drawn down $7million while the counterpart funding of N50million has been provided by the State government. According to him, the project has constructed four new primary health centres in Achida, Jabo, Binji-Muza and Hamma’all. It also upgraded/renovated five clinics to the status of Primary Health Centres at Tambuwal, Bafarawa, Gwadabawa, Sabon Birni and Goronyo. The nine primary health centres have been completed and handed over to the beneficiary LGAs.
Another port of call was the Sultan Abdurahman School of Health Technology, Gwadabawa. The school was conceived to produce middle manpower to man strategic health facilities in the state. The principal informed the team that the projects undertaken by the HSDP-II include supply of library books, standby generator and laboratory equipment as well as female hostel accommodation. Significantly, the project helped the school to meet the accreditation requirements for some courses. At the time of the visit, about 18 students of the school have been sent to Jos, Plateau State to sit for their professional examinations in Medical Laboratory Technology. By fulfilling the accreditation requirements, the school is considering to introduce three additional courses in the Higher National Diploma (HND) cadre, namely, health services, x-ray technology and reproductive health. By these improvements, the school has admitted 681 new students, bringing the total number of students to about 1,800. For the first time, the school was able to send about 18 students to Jos to sit for their professional examinations in medical laboratory technology.
Field Experience In Zamfara State
While the Stokoto state ministry of health showed strong commitment to the project as the commissioner for health with his team dedicated the whole day in taking the visiting team round the projects. The opposite was the case in Zamfara State. While the state health ministry except for the HSDP II Team was lukewarm, the communities who are the beneficiaries have shown that there are ready to own the projects
The first place that was visited by the team was Kurya Madora PHC, Kaura Na Moda local council of Zamfara State. This project involves the renovation and expansion of the old structure. At the cost of N54million, the project consists of wards, water borehole, 2Nos 3-bedroom staff quarters, Standby Generator with large expanse of land fully fenced with a dwarf wall. At the time we visited, the Clinic officials said they had conducted average of 5 deliveries in March with a resident doctor.
Apparently overwhelmed by her tenacity and dedication to the improvement of maternal health needs of the people, the overjoyed people of Kuyar, conferred the title of “Hanatu Kuyar,” meaning dedicated mother on Anne Okigbo- Fisher. While the projects could be regarded as huge success, the fear however is on the sustainability and ownership of the projects.
Another health facility funded by the HSDP II in the state was Nahuche PHC, Bungudu L local council. The project also involved renovation and expansion of existing structure at a total cost of N46million. It was however disheartening to note that between January and March, 2009, there were already more than 42 reported cases of meningitis disease recorded in the Clinic. Apart from the Clinic building, the project provided boreholes, ambulance and solar-energy powered equipment. The Vice Chairman of the Committee on health, Sani Mohd Nahuche disclosed that the community contributed money to acquire the land on which the Clinic was constructed. He said that the community is fully interested in the project and as such, would see that the infrastructures are well maintained. He also assured that the committee would continue to undertake vigorous awareness campaign to ensure that the women and children especially patronize the Clinic.
Conclusion
The media tour was an eye opener for the journalists on the team.
The challenge is therefore for both the states and the local councils to work in such a manner to ensure that health facilities are brought even closer to the people through the maintenance of the facilities put in place by the HSDP II.
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3 Responses to "World Bank: Bringing Healthcare Closer Sokoto, Zamfara States" 
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