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Alamieyeseigha is being victimised for not
supporting alleged third term
bid?
For Enugu, It’s New
Path to Rural Healthcare
By Emmanuel
Ugwu, 12.12.2005
Like in every other state in Nigeria, the health
sector was in bad shape in Enugu State prior to the democratic
government in 1999. To bring the healthcare system out of the woods,
Governor Chimaroke Nnamani came up with the idea of District Health
System (DHS). It was put forward as part of policy and system review
in the reform process aimed at reviving the poor health status of
the citizens. After scrutinising the modalities of the DHS the
State Council on Health recommended it as a framework for a totally
new approach to health care. And in January2004, the State
government adopted the project. Since then, the system has undergone
series of developmental stages. The necessary technical assistance
and expertise, which was not available in the state at the initial
stage, was provided by the Partnership for Transforming Health
Systems (PATHS). According to the state team leader of PATHS,
Angie Roques, Enugu is already on the spotlight for the fact that it
is currently the only state operating the DHS. Because of the
inherent effectiveness of DHS in healthcare delivery, other states
of the federation would most likely borrow a leaf from Enugu just as
some states have done in copying community policing, which Enugu
State government said it pioneered. Everything about the
healthcare sector reform in Enugu revolves around the DHS; hence the
state commissioner for health, Dr Festus Uzor described it as â??the
foundationâ?? and â??the compassâ?? which not only supports the
reform process but also points to its direction. Basically the
District Health System provides for a pro-poor healthcare service,
an integration of primary, secondary and tertiary health care. It is
also characterised by a strong partnership between public and
private health care providers, and devolution of management
structure to the point of service delivery. â??With these as our
fundamental principles underpinning all service delivery, we are
aiming at making health care more accessible, affordable and of high
quality for the people of Enugu State,â?? Uzor said. The
commissioner exudes passion and commitment to DHS implementation,
and has indeed, infected other stakeholders with this unbridled
enthusiasm. The pro-poor factor of the DHS has made it attractive
to the rural dwellers, who are the worst hit in lack of access to
quality healthcare. At every stage of the planning and delivery, the
community participation was evident. Both the health ministry and
PATHS, the driving force of DHS recognise the indispensable
involvement of health workers, traditional and religion leaders,
civil society groups and community development committees in the
successful execution of the project. For effective coordination,
control and accountability, three layers of authority have been
created. The State Health Board and the policy Directorate are
concerned with policy development, monitoring and evaluation of the
activities of District Health Boards. The seven District Health
Boards are located at Awgu, Udi, Enugu Ezike, Nsukka, Enugu
Metropolis, Isi-Uzo and Agbani. The DHBs are responsible for the
overall service delivery within their respective health districts
and management of the local health authorities.
There are 56 Local Health Authorities across the
state and they are saddled with management of all health facilities
primary and secondary facilities. All the service delivery
structures namely SHB, DHB and LHA have representatives of the state
and local governments, private health sector and community
representation. This mode of composition provides for private
sector participation and partnership in service delivery arid the
strong community representation adds strong community views to
healthcare planning and delivery. All the stakeholders are
already keyed into the DHS and its implementation. On November 29,
2005 the DHS was formally introduced to the Local Health Authorities
at a workshop in Enugu. It was an opportunity for Uzor and Rogues to
explain every aspect of DHS to the people on the primary level of
the implementation structure. The integration of primary,
secondary and tertiary health care system creates an interface of
health facilities within the state. In the existing structure, the
apex state tertiary health facility is the ESUT Teaching Hospital at
Park Lane, Enugu with a reference model laboratory. There are six
district hospitals, 36 cottage hospitals and 366 primary health care
centres, including comprehensive health centres, health centres,
health clinics and health posts. In addition, available statistics
from the health ministry show that Enugu has about 700 private
health facilities comprising private and non-profit, private for
profit, including faith-based facilities. DHS has expectedly
engendered capacity building in the health sector, as well as
rehabilitation and provision of drugs and equipment through the
intervention of PATHS, which is supported and funded by the British
Department for International Development (DFID). The development
partner has done a lot in this aspect. Roques said that PATHS has
committed over 800,000 pounds sterling to the Enugu health sector
reform project. All the district hospitals and many health
centres are being rehabilitated. Many hospitals and health centres
are now taking delivery of quality drugs and equipment including
emergency obstetric care kit that will address the problem of high
maternal mortality rate in the state. The Park Lane Specialist
Hospital has undergone unprecedented transformation in line with the
new direction of healthcare delivery. The rehabilitated
hospitals and health centres would soon take delivery of drugs and
equipment worth 600,000 pounds sterling procured by DFID-PATHS in
the first installment. Though DHS is a novel health care model, the
stakeholders have already assured its success. The state health
administrator, Dr Callistus Offiah even forecast that with the DHS,
Enugu would be the first state to breast the tape in the race to
meet the target of the Millennium Development Goals (MDGs) in the
next 24 months. Weâ??re going to be the first to reach millennium
development goals within the two yearsâ?? he said, adding, â??the
people in the health sector are the ones to do it.â??
