By Abubakar Mohammed
Primary health care service delivery becomes complex and challenging all over the world, especially when gauge against the rapid population growth and compared with the infrastructural neglect, decay, and the gap between skill and knowledge which has clearly emerged as the bane of primary health care systems.
The needs for sustainable, holistic and effective health care service definitely prompted the then Administration of vice Admiral Murtal Hammanyero Nyako to established Primary Health Care Development Agency in Adamawa State.
As enacted and passed by the Adamawa State House of Assembly, the
The agency commences operation on 30th Day of July, 2011 with the Mission “To provide leadership in the promotion and implementation of high quality sustainable Primary Health Care for all supporting delivery through resource mobilization, partnership collaboration, development of community Based System and functional infrastructure.” And Vision “Committed to Achieving Universal service Coverage Through the provision of comprehensive, qualitative and sustainable Primary Health Care Services toward attaining highest level of Health.”
As contained in the gazette law responsible for its establishment, the Agency is Saddle with the following responsibilities
ü To formulate primary health care policy and Assist the state and Local Government Primary Health Care Authorities in resource mobilization
ü Support the monitoring and evaluation of all primary health care Programmes at Local Government area level and training and re-training of all cadres of health workers with proper reorientation to community participation and development.
ü To support directly the strengthening of school of health technology and community participation in primary health care.
ü To carryout studies in health systems research as a tools for finding better ways for the provision of essential care as a component of health for all at the Local Government area level.
ü To stimulate Universities, non-governmental organizations and international agencies to work with Local Government areas in nurturing their capacity for problem solving using locally available means.
ü To support inter-sectoral collaboration in the primary health care system especially amongst line Ministries and development of strategies to strengthen the referral systems and encourage at all-time its utilizations.
The Governing Board of the Agency is headed by a full time Chairman assisted by two permanent Members and Secretary. Dr. Abdullahi Dauda Belel was appointed as pioneer Chairman to man the Agency on August 2011. The journey which began four years ago; under the leadership of Dr. Belel, the Agency has been full of memorable events and achievements which receive commendation from both national and international agencies.
Primary health care system is moving fast forward in adamawa state, the fear and speculations of failure as experienced in the past has gone as the quest of people to enjoy modern health care service in the state is now visible and in full practice throughout the state. The story that is unfolding is a new glossy and colorful page of activities and initiative of Dr. Belel, Within the four years of its existence, Dr. Belel assisted by a vibrant teams has successfully brought Primary Health Care family under one roof and also enabling environment for donor agencies and partner support in Adamawa state; PHCUOR has three ones basic Principles
ü One management body, one plan and one monitoring and evaluation system.
ü Single management body with control over services and resources (human and ﬁnancial)
ü Enabling legislative framework
ü Decentralized authority, responsibility and accountability with appropriate span of control.
ü Integrated supportive supervisory system managed from a single source.
ü Integration of all PHC services under one authority.
ü Effective referral system between/across the different levels of care.
Presently, the agency is implementing two laudable project supported by World Bank and EU/UNICEF. The World Bank project is $171 Million USD five year program implemented through Nigeria State Health Investment Project (NSHIP) in Adamawa, Nasarawa and Ondo state. NSHIP uses Performance Based Financing approach to implement the project. Performance Based Financing for Health Service delivery was introduced in many developing countries; the aim is to increase efficiency, effectiveness, quality and equity of Health Services rendered to people especially at grass root level in which results achieve at all levels are rewarded.
The UNICEF project is a 15Million euro four year project with funding support from European Union. The project is aimed at reducing the unacceptably high maternal, newborn and child mortality rate in the state by implementing proven based high impact maternal newborn and child health interventions to scale up maternal and newborn outcomes in 226 Health Facilities in all the 226 Political Wards in the State. The project has five key objectives
ü Increase proportion of women who are able to correctly recognize pregnancy complications and seek timely intervention through community for development approach.
ü Increase proportion of poor and marginalized rural women with increase financial access to seek health care through innovative social protection mechanism
ü Improve the functionality of the health service provision through training of health workers, adequate supply of drugs and equipment’s. So far close to 1000 health workers including community health volunteers have been trained on various interventions. Medical supplies and equipment worth over two million euros have procured and distributed
ü Improve nutrition for women and children along continuum of care, 25 OTP centers have been established to implement Community Based of Acute Malnutrition program (CMAM) in which over 2,600 severely malnourished children were treated successfully.
ü Strengthen the capacity of the State and LGA PHC Authority to manage and decentralized PHC system for improves accountability and transparency in the delivery of health care services.
undoubted, Primary Health Care under Dr. Abdullahi Dauda Belel within the period of its establishment with sustain pace setting agenda; has instructively enlisted itself as a reference point in terms of Excellence Service Delivery, prudent management of resources, projects conception and execution. Some of the achievements are:
ü Fully immunize children by one year is now 62.1 % percent compare to baseline period of 34.2% in 2011
ü Exclusive breastfeeding of children from 0-6 months has increase from 12.8% to 22.3%
ü Children with pneumonia receiving timely care as per iCCM guidelines rose from 35.6% in 2011 to 55% in 2014
ü Over 110 PHC facilities have had no stock-out of essential commodities such as ORS, antibiotics, anti-malaria etc, compare to 16 during baseline in 2011
ü 21 health facilities are upgraded to become Centers of Excellent to provide Basic Emergency Obstetric Care
ü Construction permanent administrative office complex at kofare industrial layout Jimeta
ü Renovation of health facilities in both urban and rural areas
ü Construction of Maintenance workshop
ü Procurement and distribution of 21 sienna buses to 21 PHC Authorities in the State etc
Been a major player in the review of process that facilitated successful Primary Health Care reforms in Adamawa state; he was appointment as a Board Member National Primary Health Care Development Agency.