The north, especially the northeast is one region that has suffered untold infrastructural gap over the years. While succeeding governments since the return of democracy have tried to bring a measure of succor to the state by way of various social interventions, it is on record that such interventions have not particularly made a mark in the life of the people as envisaged. It is therefore gladdening to note that Yobe State is greatly consolidating its gains of development since the declaration of State of Emergency in the health sector, to be the subject of modern citizen centered leadership that epitomizes sincerity and strategic direction.
It is on this pedestal that one begins to consider the invaluable inputs of the current administration in Yobe State towards creating a new narrative for a state that is once battered because of insurgent destructive activities and portrayed negatively by social commentators.
Yobe State under His Excellency Governor Mai Mala Buni (Chiroman Gujba) has recorded measurable progress in various sectors, viz- the health sector, Education, Agriculture, and other social and economic empowerment initiatives.
To start with, records show that upon his inauguration into office, Governor Buni had set out to create an educated and a well secured and empowered society with access to healthcare services both in terms of demand, geography, and finance. To realize this, the administration launched a roadmap aimed at providing functional and standard PHC systems at ward level, secondary healthcare systems at LGA headquarters, Specialist care at zonal levels and tertiary care in the state capital. The target as would be seen, was to achieve Universal Health Coverage that will ensure qualitative healthcare for all citizens of the state, no matter the terrain where they stay.
It was to also ensure this without exposing them to financial hardship or catastrophic expenditure. Instructively, the administration rolled out one functional and standard Primary Health Centres (PHCs) systems in each ward, one General hospital in each LGA headquarters, policy of employment of indigenous health workers which came alongside provision of incentives during and after training for affected personnel. Others are; selection of committed professionals to man the affairs of the health sector with commiserate authority.
A policy on Private-Public-Partnership in Medicines and medical consumables which captured infrastructure and service delivery, infrastructure and equipment consisting of the following listed under the primary healthcare category: Construction, Rehabilitation, and upgrade of over 70 Primary Health Centers (PHC) in the wards, and ongoing similar projects in the remaining wards at various levels.
Another milestone in constructing a new narrative in social development for the state include but not limited to furnishing and equipping of the PHCs to the extent of providing staff accommodation at the PHCs, renovating/Rehabilitating the multi-purpose store at Primary Health Care Management Board Damaturu. In the same vein, the administration, as part of its mandate also set out to ensure the establishment of secondary healthcare derivatives for citizens. These include an ongoing Rehabilitation of Doctors quarters along Potiskum road Damaturu, Ongoing construction of Staff accommodation at GH Jakusko and Yobe State Specialist Hospital (YSSH) Gashua through Direct Facility Financing schemes. Plus, the deployment a state-of-the-art equipment to enhance the state Newborn Survival Program at YSSH Potiskum and Gashua.
Supply of 4D Ultrasound Scan Machines to YSSH Damaturu, Potiskum, Gashua and Supply of state-of-the-art Medical equipment to the Yobe state Women and Children Hospital and YSSH Buniyadi.
Added to the above is the ongoing upgrade of 6 laboratories with state-of-the-art laboratory equipment at YSSH Damaturu, Potiskum, Gashua, Geidam, Buniyadi GH Damagum and the Government House Clinic under an innovative cost recovery scheme.
Remodeling of special Baby Care Unit (SBCU) at YSSH Potiskum and Gashua, procurement of one Computerized Radiography systems to state specialist Hospital, Damaturu, Digital Radiography systems to YSSH Potiskum, Gashua, Geidam, Buniyadi and the procurement of Basic Laboratory Equipment to the Government House Clinic.
At this point it would be immodest to continue writing this piece without emphasizing on a list of the achievements (if you would) of the Yobe State government as led by His Excellency Hon Mai-Mala Buni. The administration procured Intensive Care Unit Medical Equipment for the Establishment of ICU at State Specialist Hospital, Damaturu, and the complete remodeling and upgrade of the YSSH Buniyadi.
Similarly, the administration has also created other quick but solid interventions in the state’s tertiary healthcare sector aimed at ameliorating the pains of accessing tertiary healthcare service delivery, while consolidating on the gains already achieved in earlier interventions.
As a result, other states surrounding Yobe State such as Bauchi, Borno, Gombe, and Jigawa, have found respite as they access the medical services provided by the Governor Buni led administration. Listed under are some of the achievements of the state government in TERTIARY HEALTHCARE.
Construction of a gigantic Maternal, Newborn and Child Health Complex with fully packaged facilities that will meet all the needs of training, research and tertiary service delivery Ongoing construction of a 30-room self-contained apartment for House officers at the Yobe State University Teaching Hospital (YSUTH).
Construction of a 200-bed capacity isolation center at YSUTH and a 20 bed capacity isolation centers in Potiskum, Gashua and Geidam, procurement of a 5000 liters sewage disposal truck to the YSUTH.
Installation of a 1.5 Teslar MRI machine, Upgrade of 128 slide CT scanning machine to carry out advanced investigations such as CT renal and coronary angiography and CT colonoscopy and the upgrade of the laboratory department to carry out various additional investigations.
However, and having realized the monumental obligation of providing the requisite workforce to man the world class facilities it had put in place, the administration quickly deployed institutions to build relevant human capacity to man these facilities. This ingenuity allowed for the construction of roads and drainages at the Shehu Sule College of Nursing and Midwifery and the Yobe state Specialist Hospital Damaturu.
Another is the construction of a one-storey-200 Beds Capacity Students Hostel at SSCON, Damaturu, renovation/rehabilitation of Medical stores at Damaturu, Gashua and Potiskum. Also, acquiring of the Yobe State Contributory Healthcare Management Agency (YOCHMA) and YOBE Drugs and Medical Consumables management Agency (YODMA) offices complex, plus the renovation of YSCHMA and YODMA office complex.
Also, the government procured 2 No. Toyota Hilux 4WD 2020 Model & 1 Toyota Hiace 18-seater Bus 2019 Model for the PSU, while also making sure that a MIKANO Soundproof Generator was procured for the YODMA Zonal warehouse stores. In the same vein it constructed, renovated, upgraded and furnished the state Epidemiology Unit.
Another area of critical importance on the priority schedule of the Governor Buni administration is service delivery. For this, the Buni led government, to ensure the provision of high-quality services for all facilities in the state public and private sectors, it set up a committee on Standards, Quality and Regulations.
Flowing from these, it earned marked improvements in quality of services and responsiveness of health workers in the pilot facilities of YSSH Damaturu, YSUTH and Women and Children Hospital and has since scaled up to General Hospital Damagum and YSSH Potiskum. The improvements as underscored were closely followed with the procurement of 60 additional customized tricycle ambulances to enhance emergency referrals and transport schemes, establishment of Intensive Care Unit and a Trauma Center at the YSSH Damaturu and the signing of an MoU with five (5) Pharmaceuticals manufacturers and International Manufacturers representatives.
The commencement of YODMA operations at Gashua and Nguru warehouses was targeted at serving Health facilities around that axis. On this note, the administration went further to procure and distribute of drugs, reagents, and medical consumables to Health facilities across the State. Added to this, it adopted and domesticated a National supply chain blueprint by YODMA, which was linked to the government’s concerted effort at sustaining and enhancing the Free MNCH and accident victims’ program and the free dialysis program.
This as it launched the integration of these into the Contributory healthcare and Drug Revolving Fund schemes with a view at ensuring increased scope, coverage, and sustainability. Having established the foregoing, perhaps and as a guide, it is worthy of note to visit the administration’s intervention in the provision of medicines, vaccines, and supplies for these healthcare facilities.
From 2020 – 2021, the state government initiated and supported the following sustainable Drugs and Medical Consumables goals of the state. In 2020;
Renovation and equipping of the Central Medical Stores in Damaturu.
Renovation and equipping of the Zonal Warehouses in Gashua and Nguru.
Development, validation, and printing of operational guidelines for the Agency, Health Facilities at the various levels and the Sustainable Health Commodities Supply System Committee.
Deployment of Staff from other MDAs to the Agency for operations.
Signing of Memorandum of Understanding with the Pharmaceutical Manufacturing Group of the Manufacturers’ Association of Nigeria in a Public Private Partnership to provide drugs at distributor price with flexible payment terms.
Successful roll out of Drugs, Reagents and Medical Consumables Revolving Fund Scheme (DRF) in 11 Secondary and 3 Tertiary Health Facilities across the state.
Roll out of DRF in 125 primary health care facilities
Inauguration of the various committees for the supply chain system in the state by the state Commissioner for Health in December
Procurement of RUTF as per MoU BETWEEN Yobe State and UNICEF.
Procurement of 880 units of customized Mama Kits Bags.
In 2021, the state further expanded the state government strategic scopes in the following areas;
Coverage of 97% of target health facilities for the DRF achieved (198 public health facilities reached with the DRF across the state.
Starting operation in Gashua and Nguru Zonal Warehouses to bring the drugs, reagents, and medical consumables closer to the health facilities thereby reducing travel time and overhead for the health facilities.
Added two more manufacturers to the MoU with PMG-MAN to provide for competition and wider range of products.
Also signed an MoU with Phillips Pharmaceuticals, an international distributor for pharmaceutical manufacturers to further widen the range of products available to the Agency and further reduce price of commodities due to more competition.
Established the Supply as the electronic software for inventory management and adapted the national blueprint for supply chain management system to Yobe State.
Capacity building for improvement: Working with Africa Resource Centre for Excellence, trained 3 staff on supply chain management and also enrolled 15 staff for Online Kaizen Module training.
Procurement of 8800 units of customized Mama Kits ad Bags.
Against this background, it was essential to create the necessary flow of capital to ensure the proper takeoff, operations, and sustenance of these social interventions.
In this sense, the government facilitated a one hundred percentage (100%) takeoff grant for the agency, followed by the procurement, renovation and furnishing of office building, the approval of fund for the establishment of ICT center, and the approval of Monthly 3.25% Gross Consolidated Salaries and Wages as State formal Sector Contribution.
Another is the setting aside of support fund for poor and vulnerable citizens under informal sector programme. It is further on record that the Yobe State government under the considered leadership of Governor Mai Mala Buni as of 25th April 2021 enrolled Two Hundred Thousand, Four Hundred and Twenty-Three (200,423) beneficiaries under the formal sector programme. This figure represents an estimate of 93.6% of formal sector coverage target in Yobe State and all enrollees are successfully accessing healthcare services across 202 health care providers within the state.
Accordingly, the agency continues to provide sustainable alternative source of fund to the state health sector by regularly and monthly making fund available to the health facilities through capitation and fee-for-service for continuous health financing strategic purchases of service Delivery across the state.
To allow for wider coverage of the government’s healthcare programme, the administration through the Basic Healthcare Provision Fund programmes, enrolled 10,182 poor and vulnerable citizens across the 85 political wards. Again, the figure account for 45.3% of total BHCPF target coverage for 2021, while enrolment for the remaining 93wards has since commenced on the 24th of May 2021. Added to this, the agency has completed and validated design for the informal sector programme and ready to commence implementation towards coverage expansion in the state.
On the area of building relevant specialist human resources for health, His Excellency approved sabbatical for five senior consultants in addition to the enhancement of regular visitation arrangements by specialists from nearby federal tertiary institutions partnered by the state. Furthermore, government facilitated the return of over 30 indigenous doctors sponsored by the state, approved for the engagement of over 200 medical students on GL 7, employed over 50 indigene house officers around the country, 28 of which as first sets in the YSSH Damaturu. This is in addition to the approval for employment of medical officers in the YSUTH.
In the same sense, it initiated other moral boosters for health officials, including, post graduate residency training for Medical doctors, Promotion of 416 Staff to various cadres and Grade Levels, Recruitment of over 150 Nurses, and scale up of specialist visitation arrangement to the 5 Specialist hospitals and YSUTH.
Important to state is that the state established the first ever data emergency operations center/data control room to strengthen accountability and address the lingering problem of data quality across the system. Since then, data quality has improved significantly as seen in the changes in data quality indices; plus, the gap between survey and administrative data closed by over 60%.
The negative impact of the COVID-19 pandemic has been reduced thanks to the leadership and vision of His Excellency. Right from the early days, he put up a multisector committee led by His Deputy. Context specific Interventions aimed at prevention and control were implemented. The state recognized the value of the community structures and as such focused on a community-based approach to the control of the pandemic. Furthermore, despite the lockdowns and its effects on equipment and reagents importation, Yobe state established its own molecular diagnostic laboratory majorly funded by the government even before receiving support from external sources. The state had already proactively procured equipment such as ventilators, ICU beds, a commercial oxygen plant had been installed and functioning in addition to the prepositioning of drugs, Infection Prevention and Control supplies chiefly because of efforts at ensuring availability of needed medical facilities and lessons learnt from the Ebola Virus Disease, Lassa Fever and other epidemics and disasters.
Worthy of mention and commendation is the collaborative working relationship and team spirit fostered by His Excellency among the Ministries, Departments and Agencies across the state best described as a family.
In conclusion, no doubt and it is verifiable that Yobe State health sector under his excellency the progressive, committed and action-oriented Governor has within the last two years remained totally focused on the health and wellbeing of our citizens and Inshaa Allah we will continue to consolidate on all our past achievements in the sector for the benefit of Yobe State in line with His Excellency’s determination and the administration’s political aspiration of putting the state at par with global best practices. We in the health sector are so proud of His Excellency’s forward-thinking leadership and collectively assured to pursue health development as a multi-dimensional and integrated approach, encompassing the infrastructure, Human Resource for Health and Service Delivery for the benefit of teeming citizens of Yobe State.
Dr Gana is the Yobe State Commissioner for Health and Human Services.
