By Owolabi Bandele
It is without doubt that a healthy citizenry is a highly productive one, and this recognition comes into bolder significance at this crucial juncture in our national experience in Nigeria when the need to re-harness the human potential has become painfully urgent. It is a point in which the traditional sources of financing government and governance through oil receipts have hit an all time low and lapsed into the crisis of expectations, in which more is demanded of government in its social provisioning mandate.
It equally also makes more sense for governments seeking to boost the wealth creation profiles of their domains of service, to look a lot more inward and tap into the most resilience of resources â€“ the human resource â€“ as a way of boosting productivity and, certainly, the capacity to generate more revenue to fulfil the purposes of governance.
This appears to be the defining basis for the massive investments into health care that the Abiola Ajimobi government in Oyo State has embarked upon in the past six years. This is to not only make the state as independent as possible in terms of wealth creation and hence its capacity to generate revenue, but to build a sturdy backbone for a future in which the state is set to become one of the top ten leading economies of Africa, which its demography and human resource base is primed to pull through in due course.
Remarkable instances of this massive programming and investment in health care in Oyo State by the government appear evident in the recently launched N50 billion Health Endowment Fund hosted on the 3rd of August, alongside the State Health Insurance Scheme established in 2015 to shore up access to health care, and reputed as being unprecedented by a State government in the country.
Governor Abiola Ajimobi who recognises that one of the fundamental purposes of government â€œis to enhance the health care of the peopleâ€, is also practical enough in his approach to the funding of health, whether through the setting up of an health insurance scheme or an endowment to drive health care delivery. As he put it, â€œOur administration has also realised the fact that we cannot fund the health sector alone without the active support of, and assistance from, the private sector and corporate bodies. We must, therefore, do all within our capacity to promote and achieve healthy living in our State.â€
To this end, in terms of the health insurance programme, with as low as N650 per person in a month, Oyo State would provide highly subsidised and qualitative health care to its over 7 million people, many of who are routinely burdened by health challenges including malaria, typhoid, pneumonia and bronchitis, etc. Interestingly, the Health Insurance Scheme is also taking on surgeries on hernia, goitre and hydrocelectomy, which are becoming preponderant in the population.
This is coming from a background in which the Ajimobi administration has run a hugely successful free health mission in the state since 2012, which so far has been accessed by over 1 million beneficiaries of medical, surgical and ophthalmology services traversing the six zones of the State. It also couples with the medical support services that have been rendered by the government to civil servants in the past few years. These have beckoned to a more sustainable model, which the government has presently sought after.
In speaking to the impact of the healthcare interventions in the state in the past six years, the renown Harvard trained medical pundit and surgeon, who the governor brought in to administer healthcare delivery in the State, Dr. Azeez Adeduntan, observed that: â€œBefore this government came on board, the health sector in Oyo State was in total shambles; hospital operating rooms were non-existent, for instance. But since the governor assumed office, he has done a fantastic job. The number one achievement of this administration has being the treatment of about 1.5 million people through the free health programme of Governor Ajimobi, which started in 2012.â€
With an economy presently described as the fourth largest in the country with a GDP estimate of $16.21 billion, and which had once averaged a 14 percent annual growth in the past decade, and a population spread over 28,454 square kilometres of some of the most arable lands in the country, Oyo State certainly evinces the basis for major economic growth. Hence the understanding of why healthcare investment is crucial to the government to unlock potentials for the near and distant future.
The 622 primary healthcare centres and 57 general and specialist hospitals across the 33 local government and 35 local council development areas of the State have witnessed some of the heaviest human traffics in the country in the past six years, with hundreds of thousands of people utilising these health establishments, in a rate thatâ€™s second to only that of Lagos State in the entire federation.
Health care statistics of the State show clear outcomes of the governmentâ€™s huge investments, making it possible for about 140,000 in-patient admissions in these health facilities last year alone. There has also been the rapidly declining incidence of maternal mortality in Oyo State, by over 60%, from about 526 deaths per hundred thousand births to 256 deaths per hundred thousand now, and a reduction in the infant mortality rate by as much as 70%. Equally, polio has been eradicated, while a significant aspect of the burden of malaria has been contained by 43% (with the State government having distributed 3.4 million treated mosquito nets in 2016), and measles has dropped to less than 10%.
Further to the foregoing, the full functioning of the Stateâ€™s 484 HIV
Counselling and testing centres, 21 anti-retroviral treatment centres, and 175 prevention of mother to child transmission centres has led to a huge lowering of the HIV prevalence rate in Oyo State to 1.9%.
The fairly high incidence Vesico-Vaginal Fistula (VVF) in Nigeria today also made Oyo State to be designated, by the Federal Government, as location for the establishment of an Obstetrics Vesico-Vaginal Fistula Centre serving the entire South-Western states of Nigeria. This is in recognition of the traditional reputation of the State as a hub of medical institutions and skilled manpower, having the capacity to help in containing this social malady. The Centre would definitely assist in the considerable reduction of the morbidity and mortality that come about as a result of VVF.
With a concerted and holistic intervention in the health care space, it is certain that the government of Senator Abiola Ajimobi in Oyo State is creating the environment for the human resources of the State to harness the fullness of their potentials. This has not only been bolstering a healthy workforce hale enough to explore its skills in newer innovative directions, but also reducing the number of man hours lost to sickness.
An understanding of health as the matrix and crucial pillar for the creation of wealth has seen the government restructure and reposition the health care service delivery in the state through institutional reformation and introduction of vital legislation, such as that on the Primary Health Care Centres. The independence this has given to the health sector has both removed the erstwhile basis of contention between the Ministry of Health and the Local Service Commission, and guaranteed the funding for these PHCs.
The governance of health in the past six years of the Ajimobi administration has involved the taking of valiant strides, including the reorganisation of processes to make for more effective outreach, delivery and impact. These involved crucial undertakings, including the setting up of the State Primary Health Care Board in February 2017, which is focused on bringing the administration and coordination of primary health care in the State under a single umbrella. Also, the creation of a health insurance agency in December 2015 â€“ as mentioned earlier â€“ to foster the delivery of an all-inclusive health care to every member of the State. More so, there have been the establishment of a task force on the regulation of practice in private health care facilities in the State.
This institutional reformation process has equally included the revival and restructuring of key health establishments, such as the LAUTECH Teaching Hospital in Ogbomoso and the Jericho Specialist Hospital in Ibadan, which now have their post-graduate training facilities re-accredited.
In improving on health care delivery in Oyo State, the Abiola Ajimobi government not only established 27 primary healthcare centres, while renovating 124 other PHCs across the 33 Local Government Areas (LGAs) and 35 Local Council Development Areas (LCDAs) of the State, it has also engaged in the unprecedented feat of constructing and equipping a prototype of four Maternal and Paediatric Centres in Oyo State. Three of these facilities are located in Ibadan, with the last situated in Saki.
In similar vein, the efforts of the administration towards the delivery of health care attracted the MTN Foundation Maternal Ward Support Project, which is renovating and equipping maternal wards at the Adeoyo Maternity Hospital, Ibadan; the State Hospital in Oyo; General Hospital, Igbeti; and General Hospital, Eruwa.
These are endeavours that have changed the nature of health care in the State, in a manner that has been reinforced by the procurement of N635 million worth of medical equipment for the State Hospital, Ring Road, Ibadan, and the procurement of 37 ambulances to deliver emergency services in the State. These include four, 4-wheel and 33 tricycle ambulances.
In addition, institutions of health training are being brought up to international standards with the upgrade of the Schools of Nursing and Midwifery to the College of Nursing and Midwifery in March 2014, of which the erstwhile School of Basic Midwifery in Kisi became a campus of the College in March 2017. Likewise, the School of Hygiene became the Oyo State College of Health Science and Technology in April 2016, with a satellite campus of the school established in Okeho in 2016.
In a corresponding fashion, over 2,000 health care professionals have been recruited into the health services of the State, comprising many workers across different cadres, and including the YES-O cadets who are trained in basic life support services, etc.
Possibly one of the most radical gestures involved in the building of a healthy state and society has been the launching of the N50 billion Health Endowment Fund â€“ possibly an unprecedented feat in the country â€“ embarked upon to complement the State Governmentâ€™s funding of health care service. The Fund is designed to assist with the task of renovating and equipping many of the critical health establishments in Oyo State and bringing them up to a global level.
While the Health Endowment Fund will, in particular, support the renovation of the State Hospital in Ring Road, Ibadan and facilitate the establishment of a cardiovascular centre in it, it is equally conceived along the lines of a sustainability model, through which it will transform into a Health Trust.
Presently being managed by a board led by the renowned cardiovascular physician and administrator, Professor Olu Akinkugbe, the Endowment Fund, and anticipated Health Trust, will take a direct line funding charge from the activities of the state government, in addition to the continuous donations of public-spirited individuals. Hence, this should enable it to fund and subsidise health care delivery in the state in perpetuity.
An affirmation of the progressive nature of the architecture of health care in the State, and its resolve to enhance human productivity, has been the support for it by international multilateral agencies. Besides the World Health Organisation (WHO) seeking to supplement the Health Endowment Fund with a $20 million grant in the next few months, in the past WHO and UNICEF have equally engaged in technical partnership on health with the State.
Also, while the Damien Foundation of Belgium assisted with the renovation and reconstruction of the Chest Hospital, Jericho and the Leprosy Colony at Ogbomoso, agencies such as the AIDS Prevention Initiative In Nigeria (APIN) have facilitated the upgrading of 3 Laboratories and 9 facilities across the State, and the scaling up of the Prevention of Mother To Child Transmission of HIV (PMTCT) services in 86 facilities, etc.
With the enhancement of productivity and human resources in the State as a primary driver of its very bold health care investments and interventions, the programmes of the Abiola Ajimobi government â€“ such as the setting up of a unique cardiovascular centre modeled after the best in the world, with the complements of a VVF, etc. â€“ appear indicative of a positioning of Oyo State as a health care and medical ecosystem, and a regional centre for medical tourism.
As Health Commissioner, Dr. Adeduntan put it, â€œBefore the terminal date of the administration in 2019, the Ajimobi administration would have brought Oyo State hospitals and healthcare delivery centres into international best standards, meaning that when patients come they will get the best care available in any part of the world.â€ Moreover, for him, â€œI am glad we have an able Governor who is the leader of a new Oyo State and I am thankful to him that he has brought me in to make a difference, in terms of moving health care delivery forward in Oyo State.â€
Â· Bandele, a public affairs analyst, writes from Ibadan