Dr Betta Edu, a postgraduate degree holder from the London School of Hygiene and Tropical Medicine, is the Director General, Cross River State Primary Health Care Development Agency, entrusted with the responsibility of addressing challenges confronting primary healthcare in the state. In this interview with Paul Obi, she stressed on the need for technical assistance for PHC, healthcare workers training, among others
How critical is the challenge of lack of technical assistance and support for Primary Health Care in Cross River State?
We have a lot of technical gaps both at the state, local government and even at the national level. We have places where people have come from the national to the state as state coordinators but are not able to help the state when it concerns technical assistance to improve primary healthcare, which is like the basis of the health system in Nigeria. So we hope that they can truly build the capacity of staff of NPHCDA to offer technical assistance and build the capacity of state management team to be able to offer leadership at the state level. Also, very important for me is the fact that the basic healthcare fund is about to start.
So how would Cross River State implement the healthcare fund?
We are about to start implementation and also direct health finance in one of the models which will be used for the basic healthcare fund. So a lot of capacity building, technical assistance at the state and local government level is needed. This will be like the first time that people will be managing funds directly at the primary healthcare facilities, so you need to build even the capacity of those in charge of that facility to be able to manage our funds. This is really innovative and we welcome it and we’ll support it as much as we can. Generally, Cross River State is taking the lead in vitalisation of primary healthcare in Nigeria. A lot has been done from improving the human resource angle, to improving our infrastructure and the quality of service delivery. Recently, I think as close as last week, about 54 health workers were sanctioned because they were collecting monies under the table and were doing a lot of sharp practices which should not be with this. We have people who we have to throw off our pay roll because they were ghost workers and they were not coming to deliver services to our people while the government went ahead to employ new ones. So a lot is being done to improve primary health care.
So how impactful is technical assistance to healthcare service delivery in the state?
It is very important. Healthcare is about quality of service, and for you to deliver that service you need some level of technical know-how. For instance, the ability of a Monitoring and Evaluation (M and E) Officer to do a proper job in the field and the ability of frontline health worker to input the right data which will be sent to the top and help, would further help health planning at the national, state and local government levels. The ability of even the staff to deliver quality healthcare to the client that walks through their door, all of these need some form of technical assistance, they can be technical assistants for on the job delivery of services, they can be technical assistants for M and E, they can be technical assistants for even the laboratory processes, data compilation, analysis and all of that. They all need technical assistants. So when those who are going to be trained are sent to the states they will do a step down training and then those trained will be sent to local governments to cascade this training down to their health facilities where the frontline health workers are and need the training.
You appeared to be so passionate about improving primary healthcare, what are the efforts your agency has put in place to improve the scale and reach of health services across the state?
A lot like I said, we have identified the gaps going forward. We have worked in each local government in Cross River State to make them hundred percent functional. As we speak, we have also improved our services our community out and our reach. We are working towards universal health coverage in Cross River State, we want to ensure that every woman has access to skilled attendant. We want to ensure that every child has access to vaccine, and immunization coverage has also been worked out so that we can improve it. All of these sectors which I’ve described all need technical assistants and that’s where today’s business play a role.
What efforts are on ground to make health workers in the state become more efficient and effective in rendering health services to the people?
We are increasing our monitoring at the facility level and local government level. Beyond that, we are about to introduce an E-system where people go to work, clock in with their thumb; which is a kind of biometrics verification to show that they have come to work. When they are leaving they clock out, so that we can be sure that they are at work, with the monitoring, other sharp practices will definitely and gradually fizzle out because when they know that you never can tell who’s going to walk through their doors in the next ten minutes to check up what they are doing, they will sit up.
How ready is Cross River in order to properly benefit from the healthcare fund?
Well, my state meets all the criteria for the basic health care fund. One of the criteria that you should have is a primary healthcare development agency. We have had that for two years now. Another criteria is that you should have a start up insurance scheme which we already have and it has been launched. We also have every other criteria which has been rolled out for is to access basic health care functions. Cross River meets those criteria. I think the Governor, Prof Ben Ayade is very pro-health and he has been concerned about delivery and how to improve it, so we are already ready for the basic healthcare fund. All we need is just the technical assistance. It is a learning process for everyone, every Nigerian is learning right now, so we too, we are ready to learn, we are ready to run with it and produce results.
How efficient is your agency in mapping out best strategies for immunisation coverage within the state?
Cross River State has one of the best indices as it concerns immunization coverage in Nigeria. We are one of the leading states in immunization and we have continued to deploy all our strategies. There are several, I’m not sure you want me to mention all of them but we will continue to deploy them and improve on them showing the process from the point where the vaccines get into the state. Before, it used to be a pool process where the local governments come together to the states to pick up the vaccines, but now we’ve changed it to a push process where we take the vaccines to them. Of course, coaching requests are going on from the center coast all the way to the local government. Provision of coaching equipment is still going on, so systems have been put in place to sustain the equipment in various facilities and then our people are being trained on how to go out for community mobilization and community engagement with the WDC to ensure that every child is immunized. Most importantly is the fact that we have been able to quail all the rumours about killer vaccines, and rumours that have actually work against immunisation in the state. The more knowledge mothers have to the fact that they need to protect their children from vaccine preventable diseases is very important and I’m very happy for that.