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[January 20, 2014]
Vaccination Against Pneumonia and Meningitis Will Spread in 2014 [interview]
(AllAfrica Via Acquire Media NewsEdge) Dr Ado Muhammed is the Executive Director of the National Primary Health Care Development Agency (NPHCDA). In this interview he spoke on how polio has been confined to three states and the plans to immunise Nigerians against pneumonia and meningitis. Excerpts: What are your achievements in two years on this seat? What we have achieved in the last two years is that we have repositioned primary health care in Nigeria. Irrespective of where Nigerians live, they have access to affordable and quality primary health care. Primary health care is community-driven. We have ensured that vaccines are available at the right time, so that the issues of them being out of stock are no longer there. We make them available in a good form and in high quality. We have worked on interrupting wild polio transmission in Nigeria. So far we have been able to reduce polio transmission by almost 59 per cent. We have been able to reduce the geographical spread of wild polio virus from 11 to three - Borno, Yobe and Kano - States. We have also ensured equity in the distribution of vaccines. Before now, some vaccines were available in private hospitals, but not available in public hospitals. For instance rotavines vaccines against diarrhoea were not available in public hospitals in the last four years, but they are now, so that irrespective of household income, a child should be able to access it. We are also rolling out pneumucoccal conjugate (pcv) vaccines to tackle the issues of pneumonia in the country. We are also tackling the issue of meningitis so that the seasonal outbreak we always experience is reduced or eliminated. We are making HIV services available. Even at local government and primary health care levels Nigerians should be able to access HIV services and commence treatment.
Why is Bauchi not mentioned as one of the endemic states? Last December, the governor mentioned that intending pilgrims from two local governments in the state had been blacklisted due to the outbreak of wild polio in the state.
There is a difference between endemic cases and states that have imported cases. Bauchi falls under the category of imported cases, because the cases reported in Bauchi were as a result of the spread from other states. You know, Bauchi is not too far from Borno. The transmission may have come from towns that share borders with Borno, which is one of the states with endemic cases. It was imported outbreak, and we have contained it already.
Is the insecurity in Yobe and Borno responsible for the endemic cases of wild polio virus in the two states? Yes. Before the state of emergency was declared, 17 local government areas could not be reached. With the state of emergency, we can now access 15 local governments and carry out immunisation. As at now, even two local governments are still completely inaccessible. There is the security challenge issue in these states, but we are working round the clock to ensure that children in these two local governments can be accessed so that they can benefit from the immunisation against wild polio and other childhood diseases.
You mentioned the Five-Year Rolling Plan of immunisation against polio. How are you going to accomplish that? When you look at immunisation in Nigeria, it's been a mixed bag. In the 1980s, there was high coverage and in the 1990s, there was a decline in coverage. We need to find out what the issues are. As an agency, we reviewed why, at times we make progress against some of these childhood diseases, and later we have reversals. In order to tackle it, it became imperative to build the systems. We had to develop the Nigerian Routine Immunisation Strategic Plan - for the first time. It's a plan to tackle the challenges we face, including perception at the lower levels, infrastructure, building human capacity and even meeting the demands of the people for these services. Health is a right, not a privilege. Therefore, immunisation is a right. People should be immunised. We are building a system so that the gains that we've made in the last two years would not be reversed. We have as our hallmark, the issue of accountability - it's key to the plan.
How are you engaging governors and local government chairmen in this regard, because they are those who should be very concerned about primary health care delivery? They are closer to the people.
It's true. Primary health care is the responsibility of local and state governments. We, as an agency, alone cannot make it happen. What we do is to go on advocacy to states and local governments. We meet state governors through the National Economic Council, headed by the Vice President. We also engage them through the Nigerian Governors' Forum.
How have they demonstrated their support? We are making some good progress, because governors are now speaking about polio. They've been supporting the campaign and even primary health care generally. In fact, in the last two years of our interactions with governors, we have been able to help them establish 27 Primary Health Care Agency in the states. That shows that the governors are really supporting us. I told them that, for us to get quick results in primary care services we should be under one roof, not just under the Ministry of Health. We are helping to make the 27 states PHCDAs functional to tackle and coordinate the challenges in their states.
How are you working with SURE-P? We have the MSS project with SURE-P, which is making the desired impact. It's helping to reduce maternal mortality, in terms of women benefiting from skilled delivery of children. We are, at present, available in 1,000 facilities nationwide and we have deployed almost 8,000 work force under the SURE-P. A lot of women are attending these facilities and benefiting from the services provided there.
Do you engage traditional birth attendants? They are not part of the recognised work force in Nigeria. But we have worked out a partnership with them so that when women are pregnant, the TBAs would encourage them to go to health facilities to access our services. We also encourage them to bring women who are at the point of delivery to our facilities. These are the only ways we can work with them. The essence of SURE-P MAMA scheme is to reduce mortality. For that to happen we must engage all state agencies, to encourage women to come to our facilities to be attended to by skilled health care personnel.
What is the response of the international community to these efforts? They have demonstrated their pleasure. For instance, the World Health Organisation (WHO) and the United Nations Children's Fund (UNICEF) have commended the Federal Government for the gains made in polio reduction in the country. Also, Bill Gates came to the country recently, during which he appreciated this agency and government for the progress being made in immunisation. He also appreciated the governors' support and partnership with this agency, which led to the successes being recorded.
Before now, one of the major problems was lack of funds. Now, we hear that Bill Gates and Alhaji Aliko Dangote have come in. Are you now attracting other rich Nigerians to come in and contribute funds? In the last two years, we have engaged the private sector for funding. There is actually no sector that would claim that it has enough resources. It's all about creatively looking for other sources of fund, and efficiently allocating the resources that you have. What we have done is an attempt to identify other sources of funding for primary health care. What came to mind was the private sector. In the last two years we have been able to establish the Nigerian Private Sector Health Alliance. It is meant to galvanise other sectors to provide support for health in terms of funding, corporate social responsibility, mobilisation, so that we get additional resources. The coming on board of Dangote is as a result of that initiative. We are in talks with the Minister of Communication to see how we could use the mobile telephone masts across the country as centres where we could store our drugs. This is to reduce the distance which primary health care centres would need to travel before they can get their drugs. That's how we are engaging the private sector, to leverage on their strength to support primary health care.
In many communities, primary health care centres are not functional. Many are overtaken by weed. Some villages don't have centres at all. What are you doing about these? In this country, we have 16,500 primary health care centres in all. Some are functioning, some are not. What we have done along that line is to ensure that they are all functional. I mentioned earlier that 27 states have established local primary health care development agencies. What we plan is that those ones will now take charge of these health centres in their states. Before now, it has been difficult. Secondly, what we have as a programme is to ensure that there is one primary health care centre per political ward. We have found out that in some political wards there are multiple primary health care centres, while in some there is none. We are working with the National Assembly to ensure that every political ward, which has no primary health care centre, gets one. Primary health care is the cornerstone of our health policy, because when there is health care, there will be socio-economic development. If we get the primary health care right, the health system would work in this country.
Copyright Daily Trust. Distributed by AllAfrica Global Media (allAfrica.com).
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