MONTHS OF ADMIRAL NYAKO’S LEADERSHIP OF ADAMAWA STATE: THE HEALTH SECTOR SCORE CARD

Regardless of which side of the raging debate on the politics of Adamawa state one stands, one thing that is unarguable is the fact that the recent annulment of the gubernatorial election and the removal of Admiral Nyako as the Governor will result in substantial wastage and lost opportunities for the state in all sectors but that of the social sector especially the health sector will be most especially hard hit. This is because of the significant and far reaching initiatives put in place by the young administration to move the health sector forward will have to wait the outcome of the elections and some of the opportunities may be lost entirely. Essentially the state and its people and not the political gladiators are the overall losers at the end of it all.

Eight years of the Boni Haruna administration resulted in the near complete collapse of the health sector in the State with poor infrastructure in terms of both building and utilities, shortage of medical and diagnostic equipment necessary for effective healthcare delivery, severe shortage of skilled health manpower and poor motivation of the few health workers available. The state also had serious difficulty addressing preventable diseases and accessing opportunities for leveraging national and international assistance program.

The health sector challenges in the last 8 years faced the following significant challenges:

      Inadequate staff:

There was severe shortage of skilled health manpower in the state work force with Doctors and Nurses most affected. The state had less than 40 doctors in its 14 hospitals including the Specialist hospital in Yola to run its about 2000 hospital beds in contrast to the 150-bed Federal Medical Center Yola that has over 60 doctors in its employment. It is safe to assert that beside the Specialist Hospital Yola, all other hospitals have only 1 medical doctor manning the 60-100 bed hospital.

To further worsen the situation, the state school of Nursing and Midwifery got their accreditation withdrawn due to poor infrastructure, lack of skilled manpower and paucity of teaching aids. A similar situation existed at the School of Health Technology, Mubi where its accreditation was also withdrawn due to poor infrastructure and staffing. The school’s permanent site was moved to Michika (for political reasons) but there was no commitment to ensure its completion and just like the few projects motivation embarked upon by the Boni Government and in-spite of the political undertones, it was abandoned at less than 20%. The old site meanwhile was starved of funds and allowed to degenerate to a sorry state. 

      Physical infrastructural Challenges

The status of physical infrastructures at most of the government owned secondary health facilities was poor and incapable of supporting the delivery of quality effective health care services. The state of the buildings are poor, basic utilities especially water and power are also in short supply, while the internal road network is also in bad state of disrepair.

The attempt by the government to rehabilitate several general hospitals but unfortunately except for one (General Hospital Michika), all the others are at various stages of abandonment.

Poor maintenance of physical infrastructure, equipment and other facilities:

The culture of maintenance of facilities including medical and diagnostic equipment was absent at all health facilities. It is sad to note that large quantity of good quality, highly needed and serviceable medical and diagnostic requiring very little resources to fix are laying waste at several facilities but most significantly at the state medical store in Kofare.

      Absence of a strategic plan

The state in the last 8 years never had a strategic plan to clearly formulate its vision, mission as well as strategic directions. This by implication means programs and projects were conceived and implemented without a holistic/big picture view that looks at how the pieces fit together. Another drawback of lacking a strategic plan is the fact that as a pre-requisite for any constructive engagement and support by most donor agencies, the state could not avail itself of several opportunities for assistance and support by National and International donors.

      The Nyako Score card:

Since the coming of the Nyako administration, several far reaching initiatives and programs were undertaken in line with the desire to ensure an immediate improvement in the performance of the health system which will in-turn lead to the improvement of the health status of Adamawa State citizens. These initiatives were borne out of the need to respond rapidly to the poor condition of the sector. Some of the initiatives among others include:

      Review of staff salaries:

The government took the important and critical decision to approve the implementation of the 22%/HATIS IV scale for all health workers with a view to reverse the serious attrition of skilled health care providers in the employment of the State due to non-competitive remunerations. This measure was also complemented with an order to the State Health Management Board to embark on a recruitment drive to attract additional health workers for the teeming population of the state.

   Free Medical Services for Women and Children under-5:

The government in line with its desire to lessen the burden of health care on its teeming population pauperized by 8 years of wasteful, unfocused and poverty-inducing government took steps to commence a free health care scheme providing all pregnant women and children under 5 with free and comprehensive health care services at all hospital owned by government. This laudable program is a quest to provide succor and relief to the most vulnerable groups in our society. The state has supported the program with drugs, medical equipment, supplies and training to ensure its successful implementation at all cottage and general hospitals across the state. Local management committees made up of community groups, civil society members, women and community leaders were constituted to ensure proper monitoring and successful implementation. The project was also supported with vehicles to monitor the implementation, efforts that are undoubtedly important for the successful implementation of the program.

Rehabilitation of Health Facilities and Constructions of new ones:

Admiral Nyako’s administration appointed Consultants to conduct condition survey for the rehabilitation and constructions of several health facilities across the state. The projects include;

• upgrading of the cottage hospitals at Hong, Mayo Belwa and Borong to general hospitals,
• upgrading of Primary Health Centers at Toungo and Shelleng to Cottage hospitals
• completion of Maiha cottage hospital and Dumne Cottage Hospital (phase I),
• renovation of Fufore and Guyuk cottage hospitals
• construction of cottage hospital Gella
• rehabilitation and construction of new blocks at the School of Nursing and Midwifery
• rehabilitation and construction of new blocks at Garkida General Hospital

   Emergency Ambulance Service:

The State has created Emergency Medical Services through the purchase of 6 State of The Art (SOTA) Ambulances from the USA, in addition to an 8 week intensive hands-on training of Emergency care nurses who will be deployed to designated sites at each of the 3 senatorial districts to provide first aid and transport victims of accidents and emergencies to the nearest health care facilities.

      Donation Medical & Diagnostic Equipment:

In order to ensure the availability of good quality medical and diagnostic equipment at the state health facilities, the state will very soon take delivery of 15, forty feet containers with medical and diagnostic equipments from the USA under a memorandum of agreement signed with a non-profit organization called World Medical Relief. With these supplies, it is hoped that the medical and diagnostic equipment needs of the state will be substantially addressed.

The re-activation of abandoned Hospital projects

The government has taken seriously the issue of abandoned rehabilitation work at several hospitals commenced by the last administration. A team of consultants under the direction of the Due Process Office are conducting a thorough assessment of the contracts with a view to advising government on the way forward. Already payments were made to the contractors handling work at the Jada Cottage Hospital (its ironic that a project as politically sensitive to the Atiku Camp being his home town and handled by his boys could not be completed in the 8 years of the administration). Also payments were also made to the contractors handling Michika General hospital and the Specialist Hospital with marching orders to ensure the immediate resumption of work at the 2 sites.

The Restoration of the accreditation of School of Nursing and Midwifery

The government of Admiral Nyako also took impressive steps and make significant investment to the improvement of infrastructure, staffing as well as teaching aids at the School of Nursing and Midwifery. This has resulted in the provisional restoration of accreditation to the school by the Nursing and Midwifery Council and for the first time in 3 years the school was able to admit new students.

Mobilizing additional resources from the MDG, other local donors and the International donors:

The National and International statesman status of Admiral Nyako coupled with the state’s new image as a serious-minded, development focused state has succeeded greatly in the state leveraging opportunities for supporting its health and social sector services. Already a conditional grant for the construction of one hand-pump bore hole and Ventilated Improved Pit-latrine (VIP) in each of the 226 from the Millennium Development Goals program and work will start in earnest. Similarly, The Department of Foreign and International Development (DFID) of the British Government through the Health Reform Foundation (HEFORN) offered their support towards the development of a 5 year health sector strategic plan. This is already a work in progress.

Additionally, an American based faith based charity has offered a $ 50m interest free grant to be applied to the improvement of infrastructure as well as social sector intervention.

Other Plans by the Nyako Administration to improve the performance of the Health sector include:

Making Adamawa State Health Sector attractive to health workers with competitive remunerations and adequate incentives:

In addition to the implementation of the recent approved package (for both civil servants in addition to the HATIS for health workers, a package of incentives to retain and attract health workers to the state is planned. The package includes the improvement of the poor state of staff living quarters, creating a set of employment incentives among others. It is also been planned that attractive measure be put in place to ensure the optimum attraction and utilization of the large number of Adamawa indigenes who are specialist doctors working within and outside Nigeria on temporary or better still permanent staff of the state government.

      Revitalize and Strengthen Primary Health Care

The poor status of the primary health care level and the obvious need to strengthen that level cannot be over-emphasized because of the linked nature of our health system and the fact that any weakness of a part is a weakness of the whole. The state intends to undertake rigorous reforms of the health system including the possibility of setting up of a Primary Health Care Board.

      Capacity Mobilization:

To address health worker mal-distribution, especially affecting quality of service delivery in the rural areas, the State Government intends to develop innovative mechanisms to mobilize latent human resources capacity in the wider population and channel that capacity to the health sector service delivery needs. This will form part of efforts to revitalize the Primary Health care level and the health sector reform program.

CONCLUSION:

Adamawa State is indeed lucky to have a focused committed and honest candidate for Governorship in person of Admiral Nyako. The Admiral is also lucky to have been given an 8-month opportunity to prove to all including skeptics that he has what it takes to bring Adamawa out of its dismal existence. Indeed the people of Adamawa have a unique opportunity to compare his 8-months leadership with the 8 years of the Boni Haruna administration and take their destiny into the hands by voting Nyako back to the Government House. It is evident for all to appreciate that if the state could be revitalized and re-engineered for greater performance within this short span as a result of committed and focused leadership, a fresh mandate of 4 years will assure Adamawa state citizens of a state that is the envy of all where basic amenities are available, accessible affordable and adaptable to the future.

      Dr M. Mohammed is a Medical Practitioner based at Wuro Hausa, Yola.