ENSPHCDA: Delivering Ugwuanyi’s Vision for Quality and Affordable Healthcare to Rural Dwellers

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By Nkemdilim Udeh

On assumption of office in 2015, Governor of Enugu State, Rt. Hon. Ifeanyi Ugwuanyi, made it clear that his vision was to take good governance and development to the rural areas to touch lives at the long-neglected and abandoned grassroots.

After a lot of tinkerings and proper plannings on the issue, Ugwuanyi swung into action to touch the lives of the rural dwellers, especially the children with good healthcare system, good roads, electricity, security and others.

To deliver qualitative, affordable and efficient healthcare to the rural dwellers, who are in vast majority and resides in a very wide and stretched land mass in the state, Ugwuanyi saw that it was only the Enugu State Primary Health Care Development Agency (ENS-PHCDA) that have the mandate and capacity to fulfill his vision for the people.

Ugwuanyi then quickly moved into action by repositioning and strengthening the ENS-PHCDA.

Some of the far reaching steps and decisions taken by Ugwuanyi’s administration to strengthen the capacity and effeciency of the ENS-PHCDA included amendment of the law establishing the Agency to give it relative autonomy and the constitution of a technocrat board to supervise the activities of the agency. The Governor also appointed a seasoned, vibrant and health-passionate expert in the person of Dr. George Ugwu, as the new Executive Secretary of the Agency.

Dr. Ugwu who was a former Chairman of Nigerian Medical Association (NMA) also served as Associate Dean and Consultant at the College of Medicine University of Nigeria before his appointment by the Gov. Ugwuanyi.

To ensure effective and healthy operation of the agency, Gov. Ugwuanyi relocated it agency to a befitting and well-furnished office complex with generating sets and well-furnished conference room.

The required N100million counterpart fund to enable Enugu State participate in the Basic Healthcare Provision Fund of the Federal Government was also graciously paid to the Ministry of Health.

With these massive supports and revitalisation of some existing Primary Health Care (PHC) centres by the Ugwuanyi-led administration, the governor had pushed the little known agency that had before now struggled to meet its mandates, to that which is the centrepiece of the health sector service delivery in the state.

Within a year, the management of the agency aligning with the governor’s vision had overturned every known poor previous record and performance of the agency to make massive improvements and breakthroughs. The agency has rapidly improved its programmes, especially the day-to-day running of the Primary Health Care (PHC) centres, setting of three special therapy feeding centres (centre for acute management of malnutrition) to tackle infant/child malnutrition as well as routine and continuous immunisation exercises.

On immunisation, which is a cardinal function of the agency; the state government had set-up State Task Force on Immunisation (TFI) headed by the Deputy Governor, Hon. Cecilia Ezeilo, to ensure 100 per cent mobilisation and coverage of all routine and special immunisation exercises.

The abysmal record of 63 per cent of coverage per exercise about a year ago has been upturned to 100 plus per cent coverage per exercise. This was attested to by the wife of the Governor, Her Excellency, Mrs Monica Ugwuanyi and others who were beneficiaries of the exercise.

The national PHCDA, WHO and other partners had applauded the Governor Ugwuanyi, the State TFI team, the governor’s wife, Her Excellency, Mrs Monica Ugwuanyi, who is also known as Polio Immunisation Champion, the executive secretary and the entire PHC workers for the renewed zeal and result-oriented immunisation programmes in the state.

These routine and special immunisation exercises included that of pneumonia, measles, tetanus etc as well as Polio and recently added Meningitis A which was flagged off by the Governor at Abakpa Health Centre.

Ugwuanyi’s administration had through the agency added additional two days for mop-up in areas that failed to achieve 100 per cent target in each immunisation carried out in the last one year to ensure that no child was left out in the statewide vaccination/immunisation.

According to the executive secretary of Agency, Dr. Ugwu, “this time the Sub-National Immunisation Plus Days we just-concluded and other special immunisation have always been very successful. I can categorically say we recorded 101 per cent, even exceeding the numerical mathematical 100 per cent each immunisation. “Our national supervisors, partners and other stakeholders were so impressed with the success and vast reach of our immunisation teams during immunisation exercises recently. The national supervisors were particularly impressed with our overwhelming and steady improvement.

“They lauded Gov. Ugwuanyi for his uncompromising support to healthcare matters especially vaccination exercises.’’

Ugwu, however, said that part of the success could be attributed to the renewed enthusiasm among local government vaccination officials/teams to compete with each other and to outperform each other in their reach and target of the children to be immunised. The ENS-PHCDA boss, however, thanked UNICEF, WHO, and other partners for their trainings and technical supports towards the huge success of the various immunisation exercises.

However, in a bid to reposition the agency and its PHC workers on maintaining target on routine and special immunisations, Ugwuanyi has ensured extensive and continuous training and retraining of PHC workers within the state and at the national level. Meanwhile, stipend payment for immunisation and other programmes of the agency had been enhanced and paid timely.

Mr. Thomas Agbo, Local Immunisation Officer in-charge of Enugu North Local Government Area, attested that Ugwuanyi’s commitment in the payment of the stipend was a huge incentive for immunisation officers and field workers. Agbo said the governor and the executive secretary had added fresh impetus and zeal in the way immunisation was being carried out in the state.

“The stipend given to the field immunisation officers on time has been a great motivation for them to carry out the immunisation willingly and religiously,’’ he said.

Mr Jude Nweze, Ward Focal Person for Immunization in Okpuje-Okutu Ward in Nsukka LGA, said: “Immunisation field workers and their supervisors were happy over the prompt and regular payment of their stipend.

“Recently, the state government through the agency carried out comprehensive training and sensitisation of all the PHC workers in case definition, temporary isolation/holding bay and quick referral as well as local contact tracing for cases of COVID-19 pandemic, especially as the virus has entered community transmission stage. There had been series of training and re-training of the PHC workers at four levels – state, senatorial, council area and ward, by various health professionals within the state and national through direct contact or virtual (Internet) training platforms. The agency also made the training on virtual meetings and workshops through their android phones or computers mandatory to adapt to the new life-style of maintaining social distancing as demanded by COVID-19 prevention protocols.

In a nutshell, the sterling performance and achievements of the ENS-PHCDA in the last one year include moving into a new office complex at No. 30 Coal City Garden Estate, G.R.A., Enugu, as required by National Primary Health Care Development Agency (NPHCDA) for state participation in the Basic Health Care Provision Fund (BHCPF).

Although, it still maintains its office at No. 28 Okpara Avenue, as Annex Office, because the new office cannot accommodate its entire staff presently at its Head Office, taking over the supervision and oversight in November, 2019 of all the staff of LGA PHC departments, including 518 public Primary Health Care facilities in Enugu State and their staff as part of the efforts to reposition Primary Health Care in the State in line with the National Policy on Primary Health Care Under One Roof (PHCUOR), developing in December, 2019, State-specific Minimum Service Package (MSP) for PHC in Enugu State,
developing the draft Operational Guidelines for PHC in Enugu State and to satisfy part of the requirements for the state to participate in the Basic Health Care Provision Fund (BHCPF).

Others were developing the draft Regulations for PHC in Enugu State, securing approval to post some relevant staff from different MDAs to the agency in order to strengthen human and institutional capacity of the Agency, developing the maiden edition of the 2020 Annual Operational Plan for PHC in Enugu State in order to provide a road map for the effective implementation of PHC activities in the State, facilitating the setting up of the State Task Force on Immunisation (TFI) with Her Excellency, the Deputy Governor, as the Chair Person, facilitating the constitution and inauguration of the Enugu State Primary Health Care Development Agency Board by Her Excellency, the Deputy Governor of Enugu State, as a requirement for PHCUOR and BHCPF, carrying out successfully the National Immunization Days Plus (NIPDs) in July, 2019, with 96% coverage, conducting two rounds of Outbreak Response (OBR) in Uzo-Uwani LGA between August and November, 2019, with 98% coverage of target population, introducing in December, 2019, Measles second dose, into Routine Immunisation schedule with 98% coverage of target population, conducting successfully Meningitis (Men-A) Vaccination Campaign in December, 2019, with 99% coverage of target population, which was graciously flagged-off by His Excellency, the Governor, conducting Sub-National Immunisation Plus Days (SNIPDs) in January, 2020, with 100% coverage of the set target, carrying out National Immunization Plus Days (NIPDs) Campaign in January, 2020, with 100% coverage of the set target, commencing the implementation of the Integrated Medical Outreach Programme (I-MOP) in the State with the completion of State and Local level training. Further implementation of the programme was stalled by the outbreak of COVID-19 pandemic and its associated consequences, carrying out successfully in January, 2020, in collaboration with U-TOLF, 2018 second round of Maternal and Newborn Child Health Week (MNCHW).
This was massively supported by Her Exellency, the Wife of the Governor, Her Excellency, Mrs Monica Ugochi Ugwuanyi who is exceptionally dedicated to the health of the rural dwellers, especially the women and children.

Following the approval of His Excellency, The Governor of Enugu State, the agency, in collaboration with the Accountant-General of the State, is facilitating the opening of Bank Accounts by public PHC facilities in the State as part of the BHCPF requirements and to ensure proper accountability. Establishing, in collaboration with the Federal Ministry of Health (FMOH), National Primary Health Care Development Agency (NPHCDA) and UNICEF, three (3) Community Management of Acute Malnutrition (CMAM) sites in three (3) recently revitalized health centres at Abakpa-Nike, Obollo-Afor and Oji-River for the three senatorial zones of the State.

These designated centres are meant to address the problem of acute malnutrition among under-5 year-old children as well as eliminate or reduce the adverse consequences of malnutrition in children. The agency has formed three monitoring and supervision teams for the purpose of monitoring and supervising PHC workers across the 17 LGAs and 518 public PHC facilities in the State.

…Udeh wrote from Independence Layout, Enugu State.