Concerned about Nigeria achieving universal healthcare coverage, members of the National Association of Community Health Practitioners of Nigeria (NACHPN) and PACFaH@Scale, a non-governmental organisation, will on Thursday join other health workers and policy makers for a technical session on provision of quality healthcare for Nigerians in the rural area.

The event which is part of NACHPN’s 2018 annual Scientific Conference is holding at the Katsina State local government service commission conference hall in Katsina.

The event is put together by NACHPN in conjunction with PACFaH@Scale.

The conference this year focuses on communicable diseases. The theme of the summit scheduled to begin at 10 a.m. is “Containing the spread of emerging communicable diseases in Nigeria.”

Organisers say the summit aims to galvanise discussions on why the government should prioritise engaging more health workers with adequate knowledge in the primary healthcare centres which are being revitalised in the country.

In order to achieve the desired development in the sector, PACFaH@Scale has been working in partnership with NACHPN through its (PAS) project to advocate on strengthening advocacies and providing evidence (through researches) in four areas including Primary Health Care Under One Roof (PHCUOR), Routine Immunisation, Family Planning, and Child Killer Diseases/pneumonia & diarrhea.

PAS is a health accountability reinvestment project that strengthens capacities of indigenous civil society organisations in holding decision makers in all arms of government to deliver on their financial commitments and other service compacts with the people, especially the poor and most vulnerable. The programme is being implemented by the Development Research and Project Center (DRPC).

This project is implemented through national and community-based CSOs as sub-grantees, each sub-grantee having its own thematic areas of focus.

The NACHPN, one of the sub-grantees, operates at the national level, to conduct advocacy on the inadequacy of the health budget to implement PHCUOR, and thus drawing attention of government to its policy commitments on PHC.

President Muhammadu Buhari as part of his administration’s goals had promised to revatlise 10,000 primary health care centres across the country.

Part of the revitalisation effort included employment of more health workers to the centres.

According to the association, “Curiously enough is the misalignment in the fact of having many CHWs trained, qualify, yet unengaged.”

PREMIUM TIMES brings you live update of the event.


9:45 am – It’s a beautiful sunny morning here in Katsina, the capital of Katsina State.

9:50 am – Members of the association from across the country are beginning to arrive. Members of PACFaH@Scale are also on ground.

Meanwhile outside the hall, some traders are taking advantage of the conference and have set up their wares. Some of the things on the stands are bags, clothes, shoes among others. ‘

The Community Health Workers are a group of people who work in the primary healthcare centres across the country. They are tasked with the responsibility of getting healthcare closer to the people. They work at the PHCs.


10:00 a.m. The hall is gradually filling up. Currently, there are about 170 people seated and more people are still walking in.


10:27 am – The event has started.

The MC is calling dignitaries to the high table. Some of the people on the high table include the president of the association, Akoh Jude; Kabiru Mustapha of the NPHCDA Kano, Emmaunel Abanida PACFaH@Scale, Hassan Karofi among others.


10 : 30 am The National president of the association welcomed everybody to the last day of the conference and introduced the PACFaH@Scale members to the association.
he explained that the PACFaH@Scale decided to work in partnership with the assocation to advocate for better health services for nigerians. Mr. Akor said the NGO has been supporting them in advocacy.

“Last year through them we were able to conduct our first national press conference last year december. We were able to meet with the minister of health Isacc Adewole and also the NPHCDA executive director Faisal Shuaib. they are here to train us and we believe we have a lot to learn from them


10:43 am – The welcome address is given by Emmanuel Abanida who welcomed the people to the 24th annual national scientific conference


10 : 47 am –

The conference is about to begin. It is a special capacity building session on community health practitioners as advocates in routine immunisation and primary health care under one roof in the PACFaH@Scale project

Mr. Abanida graded Nigeria’s health system as bad.

Looking at the life expectancy, routine immunisation, under five mortality and maternal mortality rate in the country , the country has been performing woefully, he said.

He said despite all interventions from international development partners, things are not improving. What is missing? he asks.

He said NACHPN can do advocacy for health development more than any other health association in the country because they have direct contact with the rural people

PACFaH@Scale is encouraging and partnering with health organisations to advocate more for health financing in Nigeria, he said. It is not the only association in the health sector but it is an organisation that we have identified can achieve tremendous improvement in the health sector.

Mr Abanida identified some of the gaps in healthcare delivery in Nigeria as financing, low political will among others.

He said CHW needs to fight for the national health table as this is the only way they can achieve progress.


11: 03 Speaking now is Kabiru Mustapha representing Adamu Nuhu, a pubic health communication and advocacy expert and the North-west zonal director of NPHCDA.

Speaking on challenges and opportunities for community health practitioners within the PHUCUOR national policy, he said the constitution recognised the primary health care system.

Unfortunately the system has been having a lot of challenges because Nigeria is good at planning but not implementing, he said.

He said there is a need to rethink what the country is doing in order to have a good PHC health delivery. He said the PHCs are very important because they cater for the needs of the poor and vulnerable in the rural area.

Mr Mustapha said some of the factors fueling the weak PHC systems in Nigeria are fragmentation in service delivery, low financing, lack of proper strategy and planning.


11:15 am Mr. Mustapha said a challenge for community health care practitioners is capacity building.

He explained the need for staff to go for continuous capacity building.

He said there is a need for CHW to sustain collaborations throughout the nation. He said they need to sensitize policymakers from time to time and seek their support.

He said the professionals understand the terrain of healthcare delivery better as they work with in the rural areas were most health interventions are needed; so they will know how to push for intervention


11: 25 am – Mr Mustapha is delivering his second presentation on financing implication for funding routine immunisation within an integrated primary health care system under PHCUOR.

He is representing Weyimi ogbe, head of financing in NPHCDA, abuja

He said there are lots of challenges in achieving effective routine immunisation in the country. He said financing immunisation is the responsibility of the Federal Government of Nigeria. He said routine immunisation has been hampered due to financing.
Immunisation is one of the effective public health intervention made, especially reducing morbidity and mortality due to vaccine preventable diseases.

FGN is responsible for the procurement of traditional routine vaccines for the country. While other aspect receives funding from both tiers of government and development partners.

The existing sources of immunisation are government, states and development partners.

He said the FGN is paying 52 per cent of the vaccine procurement .

He said part of the challenges in effective utilisation of vaccine in the country is the lack of personnel to administer some of the vaccines in most primary health care centres.

He said this is due to the fact that most of the workers have no job satisfaction because there are no equipment such as thermometer, gloves among others to do their work.


11:34

He said this has made many health worker seek greener pastures in cities and secondary health institutions.

Speaking on the bottlenecks affecting routine immunisation (RI)finance, he identified inadequate funds, delay in fund releases (budget implementation challenges, corruption, appropriation of RI designated funds for non RI projects among others.)

He said budget implementation challenge has been affecting adequate implementation of immunisation routine in Nigeria. Many developmental partners have been the ones coming to the rescue of the country.

He listed other challenges as the late passage of budgets, economic recession due to low price of crude oil, delayed/non release of appropriated funds, delayed/ non retirement of expended funds, non-prioritisation of health and immunisation by policymakers.

He said though the government has been looking for ways to reduce the funding gaps, more still needs to be done.


10: 59 – The first session has come to an end.

11:00: The moderator has taken over the podium and thrown the conference open for a question and answer session.


11:02 One of the questions asked is the reason the government is training new set of health workers under the aegis of CHIPS when there are CHW members who have been trained and are yet to be employed. Looking at the roles, they are quite similar, the questioner said.

Mr. Abadina said CHIPs is a strategic move to drive improvement in immunisation, He said they are a strategic response force put together for a special duty.

Question 2 – What is the government doing in terms of local vaccine production and bridging the gaps of immunisation financing.


Mr Abanida said it seems Nigeria is not yet ready yo absorb the responsibility of vaccine financing; that is why it has pleaded with GAVI to extend its deadline.
He said local vaccine production in the country is very important because this will help reduce cost. He said progress is on in local production and it is one of the best ways to go for the government and the country

A participant complained about the capacity building for CHW and the increment in salaries for CHW in PHCs. He lamented that one of the reasons why PHCs have not been working is the poor amenities in most of the facilities. most of the PHCs have no light, water and good road network.

Another participant complained about the falsification of data by superior personnel. He said he noticed that they do not want accurate data from the field but always alter it to suit the international data with them. He said no matter how accurate the information given by the CHW agent in some states, the data are often times re-adjusted and this has affected the accuracy of data and necessary intervention needed in most places.


12:12 pm – A participant asked why protective gears are not in PHCs when workers there detect most infectious diseases before referral to the tertiary health centres. He said Nigeria cannot effectively practice PHCUOR if it is selective in equipping health centres

Mr. Abanida however explained that most of the equipment to be used in the PHCs are meant to be provided by states and local governments. He said this is where the association needs to come in to do more advocacy especially in their states on the need for policymakers and state governments to invest more in PHCS.

Another participant complained on data falsification especially in immunisation campaigns. He said there seems to be ineffective monitoring of vaccines disbursement and usage.

He complained that most times, number of children recorded are not as much as the coverage, the people sit down and formulate data that are not corresponding to what is on ground.

Mr. Mustapha said effective monitoring of the immunisation data starts from the CHW and to know if there are discrepancies in what is being submitted to the government. He said most of the data are often gotten from CHW who are also members of the health workers who submit the data.


Another participant laments professional rivalry in some states, saying this has made it difficult for CHW to be efficient. He asks how this can be rectified to place CHW at its right place knowing the importance of CHW to PHCs

Mr. Abanida said this situation is not new to them alone. He sympathised that people working in places where they don’t have professional satisfaction would not perform to full capacity at their places of work.

He however said problem of work rivalry cuts across all the cadre in the health sector. He said the association can rectify that by capacity development. He said this will give them a cutting edge in the health sector.

He said a strong association the can make a lot of changes in the profession and the way they are perceived in the community.


11:03 Speaking now is Kabiru Mustapha representing Adamu Nuhu, a pubic health communication and advocacy expert and the North-west zonal director of NPHCDA.

Speaking on challenges and opportunities for community health practitioners within the PHUCUOR national policy, he said the constitution recognised the primary health care system.

Unfortunately the system has been having a lot of challenges because Nigeria is good at planning but not implementing, he said.

He said there is a need to rethink what the country is doing in order to have a good PHC health delivery. He said the PHCs are very important because they cater for the needs of the poor and vulnerable in the rural area.

Mr Mustapha said some of the factors fueling the weak PHC systems in Nigeria are fragmentation in service delivery, low financing, lack of proper strategy and planning.


12:39 pm – The moderator calls on the next presenter

This presentation is on case finding in infectious diseases and disease outbreaks in the community. The study was conducted by a lecturer of public health.

The presenter explained what happens doing disease outbreak. He said there are the three types of people to look out for during contact tracing: the index, those who got in contact with the index and the reservoir.

He said conditions that favour contact infections are overcrowding, poor housing, insecurity among others. He explained that reasons for contact tracing is to reduce infection, stop transmission to persons, reduce community incidence of infection as well as identify previously unrecognised symptomatic virus.

Some of the diseases which needs case tracing are TB, Lassa fever, Ebola


12:55 pm: The presenter used the session to teach on important step on case tracing in disease outbreak and management. This is very important especially in terms of infectious diseases which have a tendency of reaching an epidemic alert if not quickly attended to, he said.




















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