From Gyang Bere, Jos

It was a day of hope and relief for babies born with cleft, as stakeholders who provides cleft care, under the umbrella of National Surgical, Obstetrics, Anaesthesia and Nursing Plan (NSOANP) and Cleft Care, converged on Abuja to strategize and improve surgical operations, obstetrics and anaesthesia in Nigeria.

The forum had representatives from the federal ministry of health, Smile Train, health associations and regulatory bodies, among other stakeholders in the health sector, and they had a robust brainstorming session where soul-lifting recommendations were made to improve cleft and obstetrics care in the country.

At the meeting, Daily Sun’s correspondent in Plateau State, Gyang Bere, emerged first prize winner of the 2022 Smile Train Media Award, Adenike Adebowale Tambe of Premium Times emerged second prize winner while Waliat Musa of the Guardian newspapers emerged third prize winner.

Nigerian Society of Anaesthesiatists (NSA), in collaboration with world Federation of Societies of Anaesthesiologist, also presented an award of excellence to Smile Train Nigeria for examplary leadership, dedication, selflessness and meritorious service to the society, received by the vice-president, Nkeiruka Obi.

Director, hospital services, represented by Dr. Abisola Adegoke (head, Federal Medical Centres Division) explained that NSOANP was birthed from the World Health Assembly (WHA) Resolution 68/15 of May 2015.

She said it mandated member states to ensure that emergency and essential surgical, obstetrics, anaesthesia and nursing care were integral component of Universal Health Coverage (UHC).

She said: “The NSOANP is hinged on these six pillars – infrastructure, service delivery, workforce/human resources, training and education SCAT-Hands, health information, metrics and research, finance surgical care and healthcare leadership and governance.

“Nigeria has since taken the lead in this campaign in the African sub-region through the development, launching and ongoing implementation of the NSOANP with several activities by both the federal ministry of health and partners/relevant stakeholders such as Smile Train. One of such activities was the dissemination of the NSOANP (2019 – 2023) to the 36 states and the FCT and nomination of NSOANP desk officers by the state ministries of health and federal tertiary hospitals.”

She explained that the first NSAONP and Cleft Care Stakeholders’ Forum held in December 2021 and several recommendations were raised to further enhance the continued implementation of NSOANP strategic plans and the expressed hope that the second forum will afford the opportunity to review actions/feedbacks/milestones arising from the last meeting as well as proffer realistic and achievable steps towards furthering the course of the NSOANP.

Reginal director, Africa, Smile Train, Mrs. Nkeiruka Obi, was elated at the realistic achievements recorded so far in the implementation of NSOANP and said Nigeria was taking the lead in Africa.

Mrs. Obi commenced her remarks with a quotation from writer Maya Angelou: “One is not necessarily born with courage, but one is born with potential. Without courage, we cannot practice any other virtue with consistency.”

She intimated the stakeholders that it was the power of consistency that wass driving the implementation of NSOANP and commended participants for their commitment so far, stating that the NSOANP implementation had become a flagship programme in Africa, with Nigeria at the lead.

Mrs. Obi appreciated the NSOANP team, comprising the development partners, implementation committee and other stakeholders and appreciated the Federal Ministry of Health for taking the lead position and ensuring that NSOANP works, and reiterated Nigeria’s recognition at the SOA conference in Dakar, Senegal.

She reassured the commitment of Smile Train and appealed for the continued efforts of participants during the conference and beyond towards the furtherance of the implementation of NSOANP.

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A communique issued at the end of the forum featured Prof. Emmanuel Ameh, who gave an overview of NSOANP, service delivery progress, infrastructure and finance progress, while Dr. Justina Seyi-Olajide talked on children’s surgery progress among others.

Dr. Briggs of NSOANP, Nigerian Society of Anaesthesiologist and WFSA, gave an overview of cleft care in Nigeria and state of cleft care in the zones: North East, North West, North Central, South East, South West and South South zones were equally represented.

However, following the identification of implementation gaps and unresolved issues, group four made recommendations for prompt action for the “establishment of one children’s hospital in each geopolitical zone.

“Paediatric surgery should be mandatory for the 3-months posting Pre-Part 1.

Adopt the Gills ORECS document on essential surgical list. Comprehensive children’s insurance (wide paediatric surgeries coverage).”

It encouraged First Ladies in the 36 states of the federation to advocate children’s surgery and strengthen referral system as well as geographical mapping (toll free numbers, effective networking between hospitals).

“Community health education (via churches, mosques, etc. on first aid, ambulance services, BLS). Creation of Paediatric ICUs, NICU, HODs should work with and advise Procurement Officers on specific needs.”

Meanwhile, group one on workforce and training and service delivery recommended that, “healthcare providers should be encouraged to support neighboring centres to treat more cases) and for value creation and remuneration should be performance based.

“Hospitals collaboration for the purpose of accreditations for training; incentives – rare allowance vs pay according to caseloads; skills acquisition and upskilling should be considered as criteria for job promotions and training of Medical Officers in bellwether procedures should be prioritized;

Development of the NSOANP training curriculum should be concluded in reasonable timeframe for prompt /implementation.

“Training of Nurse Anaesthetists/supervision of existing ones, FMoH should intensify efforts to improve service delivery vis a vis work attitude of the workforce and Government Hospitals across boards”

encourage privately owned blood banks/services, frequent advocacy on blood donation nationwide.

However, group two recommended, “Infrastructure and Financing

Effective and efficient structural and architectural design should be done in consultation with end users; modifications and redesigning of existing structure to optimize its usage.

“Communication gap should be bridged between end-users and policy makers in regard to standard benchmark to enhance effective communication within the facility such as intranet and intercom; provision of regular power supply and alternative such as solar panels, inverters and generators as backups in areas of critical care especially ICU, theater etc; supply and procurement of equipment based on end users’ specification, preferably same brands for compatibility of accessories among others”.