Desmond Mgboh/Kano

The performance of the health system strengthening programmes in Kano State was the subject of review at the 2019 mid- year meeting involving state government, co-Chair of Bill and Melinda Gates Foundation, Mr Bill Gates, billionaire businessman, Alhaji Aliko Dangote, alongside some development partners and representatives from the National Primary Health Care Development Agency. 

The bi-annual review tele-conference offers an opportunity for the donors and the state government to jointly assess the progress made measure the limitations and proffer implementable solutions and timeline for their implementations.

Executive Secretary, Kano State Primary Health Care Management Board, Dr Tijjani Hussaini, revealed that the system strengthening effort is aimed at improving the Primary Health Care (PHC) service delivery system in the state. He explained that the strengthening program, begun with the routine immunization program, has broken into other broader health issues in the agencies under the Ministry of Health.

He was optimistic: “By 2021, most public health programmes would have been covered by the Kano health system strengthening efforts.” He revealed that within the first half of the year, their focus was targeted at scaling up the fruitful synergy between the primary and secondary health facilities, which he said, “ultimately resulted into rolling out Phase 1 referral linkage between the two stages of the health facilities.”

He disclosed that areas of priority included assessing facilities operating the Drug Revolving Fund (DRF) scheme to validate their compliance with the state’s guidelines, adding that they have conducted assessment in 132 health facilities with highest DRF transactions.

According to him, another milestone recorded by the state in the period under review was the implementation of the Smart Integrated Community Engagement Plan in all 44 local government areas. He added that community personnel have already been co-opted to support other important health programmes that work beyond the immunization space.

In response to complaints raised by the Chairman of the Dangote Foundation over the quality of data: “The state is committed to further increase the quality of administrative data and its use for programmatic decision making.”

Hussaini declared that the state has not recorded any Wild Polio Virus case since 2014: “Only three environmental cVDPV cases were identified in Tarauni LGA since the outbreak in July 2018. A total of seven mOPV2 campaigns and one state wide campaign have been conducted since July 2018. Additionally, a fractional IPV campaign was conducted in November 2018. It has now been 16 weeks since the last environmental sample was identified in Tarauni LGA.”

In the area of financial management, discipline, openness and accountability, Hussaini disclosed that the FWG Team Analysis of Kano State Annual Budget awarded Kano State 71 per cent as its earned status. He listed their priorities to include the operationalization of the Minimum Service Package (MSP) Implementation Plan.

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He added that they would conduct a landscape analysis of the human resources in the health sector as well as engage the Data Management Team (DMT) with the aim of improving service delivery in the areas of data collation, harmonisation, analysis and use as SHFs and HMB headquarters.

He explained that the state planned to develop the 2020 Health Sector Annual Operational Plan (AOP) in addition to achieving another six months with no detection or circulation of Vaccine Derived Polio Viruses (cVDPV.

Governor Umar Ganduje said: Despite the current challenges in the health system, we have continued putting the backbone structures, which ensure that the on going MOU partnership is on course to deliver the expected results across various work streams within the State Primary Health Care Management Board, Hospitals Services Management Board and Drugs and Medical Consumables Supply Agency.

“Since the last review, we have made remarkable progress beyond few programmatic areas of focus to additional scope in doing more around strengthening two-way hospital referrals, maternal health and malaria program coordination.

“This is in addition to the already on going work of strengthening the existing areas of focus and consolidating gains made in operating our coordination platforms and the cross-agency linkage between the various MDAs under the State Ministry of Health.”

Ganduje promised that hospitals in the four newly created emirates in the state would be standardized with more beds spaces, as act of his administration’s determination to maintain the tempo in improving the quality of care for the primary health care services, sustain the quality integrated supportive supervision, and scale up strengthening of two-way referral linkages between primary and secondary health care facilities.

Gates stressed the need for sufficient and timely funding as well as better coordination of the anti-polio program. He appreciated the improvement recorded in coverage across the Primary Health Care indicators: “Kano’s coverage for Penta Three has improved from 19 per cent in 2013 to 46 per cent in 2018 but more needs to be done in terms of strengthening the primary health care system.”

Although he noted that no case of Wild Polio Virus was recorded in Kano since 2014: “The critical need to strengthen key process components of Primary Health Care such as supply chain, to make the goal of total eradication of Polio achievable.”

Dangote similarly expressed satisfaction with the improvement recorded in the quality of data, but stressed the need for the state health team “to work towards developing a robust data quality improvement plan before the end of the year. This is targeted towards reducing the discrepancy administrative and survey data for all key health indices.”

The Emir of Rano, Alhaji Tafida Abubakar Ila (Autan Bawo), expressed satisfaction with the performance of the state government with the management of the primary health care delivery system.