Health Sector Reform: A Promise Kept



By Bilikis Bakare

At the inception of the Fashola administration in Lagos State, the Governor promised a Brighter Rewarding Future (BRF) for the residents, an acronym coined from his name Babatunde Raji Fashola. To actualize his vision of making the state Africa’s model mega city and global economic and financial hub through the eradication of poverty, sustainable economic growth and aggressive infrastructure renewal and development, the Governor evolved a development blueprint called the Ten Point Agenda, TPA.

This document has been able to serve as a compass for the implementation of policies, programmes and projects of his administration. The TPA groups the State’s development focus into Power and Water Supply, Roads and Transportation, Public Security, Food Security, Health, Education, Housing, Environment Management and Physical Planning, Employment Generation and Revenue Enhancement.

However, worthy of note are the giant strides the administration has been able to attain in the health sector. Through the Eko Free Health Mission, the Lagos State Government has been providing free screenings, consultations and treatments for various ailments, as well as surgeries. The Mission covers the primary, secondary and tertiary levels of medical care. The most important goal of the programme is the shift in medical attention to the grassroots, especially to the young and aged, as well as those citizens who, due to financial constraints and transportation, cannot access government health facilities.

They are deliberately targeted at tackling the high rate of poverty that prevents the citizens from accessing quality health care services, thereby reducing high mortality rates resulting from non-communicable diseases but silent killers such as hypertension, diabetes and malaria as well as those disease conditions that require surgeries like the goitre surgery carried out in Badagry, when survey carried out indicated that the ailment is common in that part of the state.

In line with the Health Sector Reform Law of 2006, the State’s Primary Health Care Board was created and the first board inaugurated in 2009 to coordinate the planning, budgeting, monitoring and evaluation of all primary health care centres in the state. It is as a result of this that the state has been placing emphasis on the revitalization and upgrading of the Primary Health Care Centres to bring the provision of health care closer to the people at the grassroots at affordable costs. Some of the health centres, referred to as Flagship Health Centres, now operate for 24 hours with full complements of medical and non medical staff to run 3 shifts per day. The Health Centres regularly give free immunization to children between ages 0-5 years against childhood and preventable diseases such as yellow fever, tetanus, tuberculosis, poliomyelitis, measles and hepatitis.                         

Prior to now, a lot of burden was placed on the secondary and tertiary health facilities in the state but through the upgrading, revitalization and rehabilitation of the near comatose primary health care system, the citizens now patronize the primary health care centres for minor ailments that were hitherto managed at the secondary and tertiary health facilities (General and Teaching Hospitals). This has largely reduced the number of patients in the aforementioned facilities, thereby giving them room to carry out their specialized duties for which they were set up.

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Although global statistics depicting maternal and child health status has not fared better, the Lagos State Government has adopted the health vision enunciated in the Millennium Development Goals as the state’s minimum starting point for the health sector. Therefore, in realization of the enormity of this problem, coupled with the attention the problem is getting, the State Government evolved the Integrated Maternal and Child Centres Policy in line with the Millennium Development Goals of the United Nations.

The State now went a step further to construct and commission for use Maternal and Child Care centres, equipped with the latest medical and other facilities to reduce maternal and child mortality level to zero and to enhance and ensure optimal performance across the state. The centres are located in the premises of the General Hospitals at Surulere, Ifako-Ijaye, Amuwo- Odofin, Ikorodu, Isolo, Eti-Osa, Ajeromi/Ifelodun and Alimosho General Hospital, Igando.

Each of the centres has five clinics for mothers, babies and children. The 100-bed facility also has neonatal unit for premature babies, labour ward with delivery room, emergency clinic, a theatre for caesarean sections in complicated deliveries and much more. These centres, aside being primarily equipped to reduce maternal and child mortality, also serve as training grounds for staff. Child survival intervention, especially immunization, apart from constituting part of the rights of a child, had been acknowledged as a veritable strategy towards achieving the Millennium Development Goals. This is the reason the state government conceived the idea of National Immunization Plus Days (NIPDs) which it has been adhering strictly to. It has equally gone further by working with neighbouring Ogun State and the Republic of Benin, along the border towns, in finding more effective ways to eradicate the scourge of poliomyelitis in the two countries.

With the realization that the state is potentially a key contributor to national development, the present administration in Lagos has committed quite a large chunk of its resources to improving the health status of all residents, particularly women and children. In collaboration with the state Ministry of Women Affairs and Poverty Alleviation, screening programmes for breast and cervical cancers are being carried out and those with palpable lumps are being referred for further management. The Lagos State Government, through its Eye Care Health System Development Initiative has put in place measures aimed at reducing to the barest minimum, the high rate of preventable blindness in the state, especially at the grassroots level. Pursuant to this, the Fashola administration has enhanced capacity building in the continuous training of primary health care personnel for eye care and provision of enough personnel to man the over 141 primary eye care units in the state.

Being a state surrounded by water, the state government has in realization of the threat malaria poses, put in place necessary machinery to tackle the scourge of malaria in the state through the provision of each household at least two Long Lasting Insecticide Nets (LLIN). This is an effort aimed at promoting and instituting its malaria prevention strategy. Additionally, government has adopted as policy on the treatment of malaria, with adults, children and pregnant women reporting with malaria in any health facilities in the state free treatment under the Eko Free Malaria Programme. Similarly, over 8000 Lagosians have benefitted from the Lagos State Government Limb Deformity Corrective Surgery Programme for patients who suffer deformity as a result of poliomyelitis. The programme was conceived to ameliorate the suffering of the very poor who cannot afford the cost of surgery. The programme, which is run in line with the Free Health Policy of the State Government, has recorded lots of successes.

Undoubtedly, Fashola has kept faith with his promise to bring health to all in Lagos. Though there are still more grounds to cover, the key thing is that a solid foundation for a healthy Lagos has already been laid for the incoming government to build on. This is what visionary leadership is all about. This is what makes Lagos tick.

•Bakare is of Features Unit, Lagos State Ministry of Information and Strategy.