No society can make progress without adequate provision of healthcare facilities for the citizenry. Both at the primary, secondary and tertiary levels, our plans involve a holistic review of the healthcare system. We are implementing programmes that will ensure affordable healthcare systems is available in all the nooks and crannies of Oyo State.
Review of Health Campaign Promises
(One Year in Office)
1. Evaluation of existing healthcare system; structures, personnel, current funding modality, utilization of resources and expenditure on health.
A committee on Oyo State Health Care System was established. Amongst the outcomes of the committee are:
- Rehabilitation/equipping of Adeoyo State Hospital.
- Ring Road Movement of Jericho Specialist Hospital to a new site.
- Introduction of Public-Private Partnership and international donor agencies.
2. Cost benefit analysis (CBA) of current expenditure on healthcare for individuals and the state, to compare with CBA using health insurance.
The last administration kick-started the State Insurance scheme. A CBA shows that out-of-pocket payment for healthcare averages N50,000/annum/resident of Oyo State. This amount is reduced by 84% to N8,000/annum/resident. This frees up money that is plunged back to improve the economy of the state and her citizens. Governor Seyi Makinde, therefore, decided to further drive to push up the enrolment of civil servants and other artisans to the scheme. Within the last one year, 58,000 persons (formal and informal sectors) have been enrolled under the Oyo State Health Insurance Scheme. In addition, there has been an introduction of Community based health insurance using Eyin Grammar and Ogungbade Community in Egbeda Local Government Area (LGA) as pilots.
So far, persons under the Oyo State Health Insurance Scheme have benefited from the following interventions:
- Over 80 caesarean sections done.
- 3 orthopaedic cases done.
- over 30 myomectomy surgeries done.
3. Meeting with all stakeholders for a stakeholders’ analysis (representatives of associations, NHIS, selected representatives of communities, representatives of workers, etc.), planning, implementation and evaluation of the various strategies.
• Quarterly meeting with healthcare providers in the public and private sector to ensure continuous improvement of the Health Insurance Scheme and quality of health delivery in the state. (Fortnightly review meeting with Health Maintenance Organisations).
• Statutory monthly meetings with all medical officers under the scheme.
• Meeting with the Federation of Informal Workers Association of Nigeria (FIWAN), Nigerian Barbers Association, and Butchers Association of Nigeria.
4. Eventual involvement of all the levels of healthcare in Oyo State.
Establishment of Stakeholders Forum. i.e. World Health Organisation (WHO), United Nations Children’s Fund (UNICEF), Nigerian Medical Association (NMA) and Association of General and Private Medical Practitioners of Nigeria (AGPMPN).
5. Finally, to give it the highest form of political will and support from the government, an Oyo State Strategic Health Development Plan with constitutional backing and approval using the National Strategic Health Plan as a template, will be developed, circulated, implemented and also, evaluated with full participation of all stakeholders.
Oyo State Strategic Health Development Plan II has been developed. The document is in the pipeline for dissemination and constitution back up.
6. Establishment of appropriate health boards for the primary and secondary facilities. (first 3 months of the administration).
Not yet commenced.
7. Eliminating multiplicity and duplication of roles by establishing a committee to merge duplicate units and recommend terms of reference. (first 6 months to final executive approval).
The work to eliminate, multiplicity and duplication of roles by the Oyo Health Reform Committee inaugurated by the Honorable Commissioner for Health is in progress.
8. Developing linkage framework for partners involved in providing resources for health delivery in Oyo State. (first 3 months).
Oyo State, in conjunction with Management Science for Health (GF), developed a linkage framework for all partners working in the area of health sector.
9. Institutionalization of non-partisan Ward Development Committees for the PHC and Facility Development Committee (FDC) for Secondary Health Care which will be fully involved in the planning, implementation and evaluation of health programmes and services. (first 3 months of the administration).
There has been reactivation of the Ward Development Committees in all the 351 Wards of Oyo State. Oyo State now has a data bank of the Chairmen of these committees as well as their contact numbers. Some of them have commenced meetings, and in the next few weeks they will be trained in the working of the Primary Healthcare system (PHCs) for the new paradigm shift in the PHC structure.
10. Integration of health programmes and services especially for PHC programmes. (first 6 months of the administration).
. The state has been able to achieve another obligation of having PHC Under One Roof (PHCUOR) by the full redeployment of the PHC staff into the Primary Health Care Board. This will help reduce bureaucracy and ensure efficiency as envisioned by the National Health Law.
• Complete renovation of 3 Primary Healthcare Centres (PHCs) with the installation of state-of-the-art medical equipment and solar powered inverters for 24-hour service delivery. The three renovated PHCs through capitations to the PHCs are:
Primary Health Care, Oranyan.
Primary Health Care, Afin Oyo, Alaafin’s palace
ALGON Comprehensive Health Centre, Eyin Grammar, Molete.
11. Appropriate counterpart funding and timely resource allocation.
The state has been able to continuously support the PHC service and collaborate with willing partners by showing good commitment with provision of counterpart funds to cement such collaborative efforts
• Oyo State paid a sum of N250M as state counterpart fund for the Accelerating Nutrition Results in Nigeria (ANRIN) World Bank project. The project commenced in March 2020.
• Oyo State paid a sum of N100M as state counterpart fund on Basic Health Care Fund project.
• Oyo State paid N19 million counterpart fund for the Integrated Medical Outreach Program by the National Primary Health Care Development Agency (NPHCDA).
The Ministry received 5.3% of budgetary allocation with other extra budgetary interventions. For example, N54,000,000 was approved for the Medical Mission in all LGAs. Also, an unlimited extra budgetary expenditure for the COVID-19 intervention.
12. Establishing appropriate job description and setting up workplace systems.
Oyo State in conjunction with HSCL- MSH for Health (GF) has commenced work on appropriate job description and setting up workplace system.
13. Developing policies backed by legislature on issues pertaining to job description, motivation and remuneration
• It has been done.
• Strategic establishments of department and units including the Directorate of Planning, Research and Statistics, Monitoring and Evaluation Unit, Client Services Unit, Quality Assurance Unit towards achieving the goals of the Oyo State Health Insurance to enrol residents of Oyo State and ensure improved quality of healthcare in the state.
• Development of Standard Operating Procedure (SOP) and Operational Guideline for the scheme.
14. Needs based distribution of personnel to health facilities.
• Work is in progress as Oyo State in conjunction with HSCL- MSH for Health (GF) has commenced work on needs-based distribution of personnel. One of the benefits of this assessment is the recruitment of 25 medical officers now working in OYSHIA accredited PHCs.
15. Appropriate job motivation.
• Government provides award to the best most efficient civil servant in the ministry.
• The best ministry award was given to the Ministry of Health.
• The ministry motivates some workers with materials during festivals.
• Prompt payment of salaries of all health workers.
16. Opportunities for training and retraining of personnel as job progression strategy.
• Specialised trainings were conducted before COVID-19 pandemic, this has continued during the pandemic and will continue afterwards.
• Training on New HMIS tools was conducted to 1500 health workers.
• Oyo State collaborated with Management Science for Health to establish Health Facility Registry, Human Resource for Health. They have also mapped CBOs and TBAs.
17. Legislation backing minimum budgetary allocation to and execution of released funds for health.
The Ministry of Budget and Planning is saddled with minimum budgetary allocation responsibility.
18. Establishing a budget implementation and execution committee within the ministry that reports to a state budget implementation and execution committee.
The Committee has been established and inaugurated. The work has commenced and the training of concerned workers will commence any moment from now.
19. Committee-based system of allocation of funds based on evidence of health reports, monitoring and evaluation of health programmes.
The Committee has been established, inaugurated and will partner with HSCL – MSH. The work has commenced and the training of concerned workers will commence any moment from now.
20. Introduction of health insurance scheme (CBHI to commence within the first six months of the administration).
Operationalisation of Community Based Health Insurance at the community level with the involvement of community leaders and religious leaders.
Enrolment of local government employees and informal sector including, but not limited to market women, associations and artisans into the state insurance scheme.
21. Fiscal policies to ensure that the amount budgeted will also be the amount released.
There is no fiscal policy. However, the Ministry of Budget and Planning always ensures that the amount budgeted is equal to amount released.
22. Elimination of kickbacks.
All transactions are done through the bank.
23. Budget monitoring.
The work is in progress with committee and HSCL –MSH on budget monitoring.
24. WDC and FDCs to be fully functional in all health facilities and local governments in Oyo State.
There are functional Ward Development Committees across the 351 political in the state. There are also Community Development Committee as well as the facility development committees in most of our primary health care facilities.
25. Everybody would be carried along and should know what to expect in all health care facilities in Oyo State i.e., patients’ bill of rights.
There is a continuous effort to educate the people at the grassroots on their expected roles in healthcare delivery as well as right to quality care. The State Primary Health Care Board, in Conjunction with NPHCDA, is organising an orientation training for the Chairmen of the Ward Development Committee. There are community social workers mobilizing across the various communities in the state supporting the service delivery at the grassroots.
26. Human Capital Development
• Human Capital Development through the political will and financial commitment for accreditation of programmes run by Health Institutions in the state.
• Accreditation of National Diploma in Dental Therapy, Dental Nursing, Nutrition and Dietetics and Health Information in Oyo State College of Health Science and Technology.
• Accreditation of post graduate training for doctors in Family Health and Obstetrics and Gynaecology.