Wednesday, April 29, 2009
Monday, April 27, 2009
Health Alert : Swine Flu Epidemic
Health Alert : Swine Flu Epidemic
Background
On Friday 24th April, 2009, health officials in Mexico City, Mexico identified a new strain of Swine flu, which caused illnesses and deaths among its citizens. As at today, Monday 27th April 2009, there are so far 1614 suspected cases and 103 deaths recorded from the Flu in Mexico. However, only 22 cases had been clinically confirmed by laboratory tests as directly resulting from the swine flu.
The outbreak has also been reported in other countries of the world. In United States, 20 confirmed cases of Swine Flu had been identified in 5 cities (California, Kansas, New York City, Ohio and Texas) but with no fatality. Canada has reported 6 cases while Israel, New Zealand and Spain were investigating unconfirmed cases of Swine Flu.
The majority of cases have occurred in otherwise healthy young adults. Laboratory tests conducted in Canada have shown genetic linkage among the viruses identified in United States and Mexico, which might be indicative of an emerging pandemic. The virus has been described as a new subtype of A/H1N1 not previously detected in swine or humans.
Present Situation in Nigeria
So far, no suspected case of the Flu has been reported in Nigeria but the Federal Government is fully prepared to contain any outbreak of Swine Flu in the country.
Measures already put in place are:
We have strengthened surveillance at all ports of entry into the country – airports, seaports and all land borders. We have our surveillance officers present and fully ready in all Local Government Areas, States and at the Federal level.
We have in stock adequate quantities of Tamiflu, the drug of choice for treatment and we wish to by this inform all clinicians and health workers to report any suspected case of Swine flu to the Epidemiology Division, Department of Public Health, Federal Ministry of Health.
Contact persons:
Dr. J.Y. Jiya - 08034030212
Dr. A. Nasidi – 08037006349
Dr. Henry Akpan – 08037626718
Mr. John Kehinde - 08023210923
Prof. Babatunde Osotimehin
Honorable Minister of Health
Background
On Friday 24th April, 2009, health officials in Mexico City, Mexico identified a new strain of Swine flu, which caused illnesses and deaths among its citizens. As at today, Monday 27th April 2009, there are so far 1614 suspected cases and 103 deaths recorded from the Flu in Mexico. However, only 22 cases had been clinically confirmed by laboratory tests as directly resulting from the swine flu.
The outbreak has also been reported in other countries of the world. In United States, 20 confirmed cases of Swine Flu had been identified in 5 cities (California, Kansas, New York City, Ohio and Texas) but with no fatality. Canada has reported 6 cases while Israel, New Zealand and Spain were investigating unconfirmed cases of Swine Flu.
The majority of cases have occurred in otherwise healthy young adults. Laboratory tests conducted in Canada have shown genetic linkage among the viruses identified in United States and Mexico, which might be indicative of an emerging pandemic. The virus has been described as a new subtype of A/H1N1 not previously detected in swine or humans.
Present Situation in Nigeria
So far, no suspected case of the Flu has been reported in Nigeria but the Federal Government is fully prepared to contain any outbreak of Swine Flu in the country.
Measures already put in place are:
We have strengthened surveillance at all ports of entry into the country – airports, seaports and all land borders. We have our surveillance officers present and fully ready in all Local Government Areas, States and at the Federal level.
We have in stock adequate quantities of Tamiflu, the drug of choice for treatment and we wish to by this inform all clinicians and health workers to report any suspected case of Swine flu to the Epidemiology Division, Department of Public Health, Federal Ministry of Health.
Contact persons:
Dr. J.Y. Jiya - 08034030212
Dr. A. Nasidi – 08037006349
Dr. Henry Akpan – 08037626718
Mr. John Kehinde - 08023210923
Prof. Babatunde Osotimehin
Honorable Minister of Health
PRESENTATION BY THE SENIOR SPECIAL ASSISTANT TO THE PRESIDENT ONMDGs, HAJIYA AMINA J. IBRAHIM OFR, AT THE 52ND NATIONAL COUNCIL ON HEALTH MEETING
PROTOCOLS
It is indeed a privilege and my pleasure to be invited to this distinguished gathering to discuss issues that revolve around the strategic role that the key stakeholders in the Health Sector need to play in the achievement of the MDGs, within the national developmental framework of the Yar’Adua Administration. I am delighted by the choice of the theme “Meeting the challenges of the health Millennium Development Goals” as it is timely and this will afford the opportunity to critically analyze burning issues and key challenges as we strive to collectively achieve the Health MDGs in Nigeria.
As policy makers and implementers drawn from Federal, State and Local Governments, who are directly responsible for the formulation and implementation of policies, there cannot be a more auspicious audience for this discussion. I am optimistic that the outcome of our interaction today will impact positively on the realization of the Health MDGs, which is of great concern to this Administration and the United Nations, given the wider challenges of the global financial crisis on our economies and thus the knock on effect to our social agenda.
THE MILLENNIUM DEVELOPMENT GOALS- ORIGIN AND SUMMARY
It will be recalled that at the United Nations’ Millennium summit in September 2000, World leaders from 189 Nations reinforced the global development agenda by adopting the Millennium Declaration which informed the eight Millennium Development Goals (MDGs) as the minimum baseline which set clear targets for reducing: poverty, hunger, disease, HIV/AIDS, Illiteracy, environmental issues, and discrimination against women by 2015.
It was acknowledged that progress is based on sustainable economic growth, which must focus on the poor, with human rights at the centre. The objective of the Millennium Declaration is to promote "a comprehensive approach and a coordinated strategy, tackling many problems simultaneously across a broad front."
It is also a global compact between rich and poor nations to address the resource gaps.
The eight Millennium Development Goals (MDGs) – which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education promote gender equality, reduce maternal mortality, reduce child mortality, ensure environmental sustainability and develop a global partnership, all by the target date of 2015.
Goal 1- Eradication of extreme poverty hunger
Goal 2 – Achieve Universal Basic Education
Goal 3 – Promote Gender Equality & empower women
Goal 4 – Reduce child mortality
Goal 5 – Improve maternal health
Goal 6 – Combat HIV/Aids, malaria & other diseases
Goal 7 – Ensure environmental sustainability
Goal 8 – Develop a global partnership for development
These Goals constitute an ambitious rights based agenda to significantly improve the human condition by 2015. It is worthy to mention of the eight goals, three are health specific, namely: goals 4, reduce Child Mortality, goal 5, Improve maternal health and goal 6, Combat HIV/AIDs, Malaria and other diseases.
We are today, a little over the halfway mark to the target date of 2015. In September 2008 a mid-term assessment of where Nigeria and Africa stand in terms of achieving the MDGs was exhaustively discussed and key issues addressed in the outcomes of further commitments made by national governments, multilaterals and bilateral. New inflows also came from the private sector and Foundations such as the Bill & Melinda Gates Foundation.
Highlights of the findings of the Mid-term assessments include:-
• Worsening indices for child and maternal mortality
• Weakening health systems, management capacity and huge health worker resource gaps
• Inadequate infrastructure to support access and service delivery
• Insufficient resource flows for routine services
• Poor attendance of rural populace to healthcare
• Inadequate involvement of communities and key stakeholders
These challenges for Nigeria as a nation are daunting but not insurmountable. During the next 7 years our countdown strategy will have to clearly lay out a road map that has concrete milestones and articulate and define the roles and responsibilities of the 3 tiers of Government, the Private Sector, Civil Society and our International Development Partners. They must build on the current and past efforts of government while learning from the past strategies and investments that have not borne the desired fruit for our teeming population. They must be center and front of the 7 Point Agenda and integrated into the Vision 2020, in other words we must domesticate all the MDGs ensuring they are kept interdependent and mutually reinforcing.
For example we will continue to build on the gains of the Paris Club Debt Relief granted to Nigeria in 2005. This resulted in $1billion debt relief by the Paris club, out of these $750m represents funds accruing to the Federal Government, while $250 is for states affected by the debt relief. The Federal government committed its share of these savings to a Virtual Poverty Fund targeting and achieving the MDGs. Overall the debt relief gains support to the health sector since 2006 is in the sum of N57.3billion. Specifics of these are, between 2006 and 2008, the sum of N16 billion was expended for immunization activities through the National Primary Health Care Agency, the National Malaria Control Program of the Federal Ministry of Health was supported to the tune of over N4billion for the roll back malaria, while the HIV/AIDs was supported in the sum of N15billion. The sum of N1.089billion was also appropriated through the Federal Ministry of Health in 2008 for the take off of the Midwifery Service Scheme with an additional 3bn in 2009. The CHIS in 6 pilot States targets pregnant women and children under 5 with an investment of N5bn.
The Conditional Grants Scheme (CGS), which is another strategy for using debt relief, also provides a platform for partnership among the tiers of Government, and has reinforced issues that target maternal and child health projects, including Emergency Obstetrics Care (EMOC). In 2007, 19 States (including the FCT) accessed N18.4bn of these funds, out of this amount 40% was used for strengthening of Primary Health care systems. In 2008 N1.5bn under the CGS was provided for the November/December Polio eradication rounds in line with the Geneva Pledge. The “QUICK WINS” projects of the National Assembly which commenced last year and currently ongoing, also has as a component the construction and equipping of Primary health Care Centers nationwide.
We have been able to make significant progress in the area of HIV prevalence among 15-24 year old pregnant women which fell from 5.8% in 2002 to 4.3% in 2007. However, in other areas the indicators show that mid-point to the target year, our progress is too slow: Infant Mortality rate has risen from 81 per 1000 live births in year 2000 to 110 per 1000 in 2005/2006, which is farther away from the global target of 30 per 1000 live births ; Under- five mortality rate also increased from 184 per 1000 live births in 2000 to 201 per 1000 live births in 2007; maternal mortality has also risen from 704 per 100,000 in 2002 to 800 per 100,000 in 2007; the number of children orphaned by HIV/AIDs has increased in from 1.8m in 2004 to 1.9m in 2007.
So clearly investments have been made albeit concerns of coherence and strategic targeting are being raised.
The Health Millennium Development Goals In Nigeria
The Health MDGs address specifically; Child Mortality, Maternal Mortality, HIV AIDS, Malaria & other diseases. The key causes of mortality being measles, diarrhea, malaria, post partum hemorrhaging
The challenges of the Health sector are well known to almost all of us gathered here for this meeting. Over the years investments have been made, in some cases such as immunization, phenomenal amounts yet our indices worsened. Today we are burdened with some of the highest maternal mortality and child mortality rates in the world.
Without a healthy populace, of which the measure is our women (who should not be dying giving life) and without a knowledge society with relevant skills our vision will amount to nothing. As we strive to reposition our Health Sector under the able leadership of Professor Babatunde Osotimien, our investments in Primary Health Care Systems, revamping RBM, TB &HIV/AIDs, eradicating polio and providing relevant health care workers, will be re-addressed with a strategic vision and plan that reinforces local level actions on the ground. This can only succeed if the various stakeholders at this meeting buy into and own the vision.
There are clear concerns to the achievement of Health MDGs in Nigeria as they are clearly off track but understanding these challenges and placing them in our country reality means that they can be overcome. I would like to share a few of the key issues which I hope will be discussed at this National Council as I believe addressing them at all 3 tiers of government will pave a concrete path towards putting us back on track to meet and sustain the MDGs.
• A National policy framework not a Federal one….genuine inclusion the watchword
• Implementation strategies and plans that are smart and linked to an investment plan which has a budget behind it. Key investments for inputs such as data, statistics, mapping to improve the quality and relevance of our planning outcomes
• Genuine partnerships with clearly defined roles and responsibilities within given mandates and the constitution.
• Legal instruments to enable a robust primary health care system that delivers service to the populace at the local level
• Health reforms that address infrastructure, human resource gaps, health worker production, immunization and other vertical programs
• Financing strategy that goes beyond quick fix but looks at sustainable recurrent expenditure at local level
• Health systems and management challenges
• Governance and accountability
• Advocacy, Education, Monitoring & Evaluation
• IDP coherence and funding the gaps to achieve the MDGs
Meeting these health challenges of the MDGs is complex and collaboration intensive. It requires political commitment at levels going beyond communiqués into budgets. Our people not only deserve for us to serve them they have a right to basic healthcare. Our women do not deserve to be on the edge but mainstream, for only a healthy nation can deliver on the economic dividends. Remembering that half our population is female and therefore we cannot afford to neglect half our national assets.
We have the leadership, the resources, the political will, the demand and no excuse not to deliver on what is one of the most important dividends of democracy. In the MDG Office we will continue to work with the Federal Ministry of Health and the States to reinforce local strategies and scale up interventions that target the sustainable delivery of basic health care services to our people especially our women and children.
I sincerely believe that together we will be able to deliver the MDGs by 2015, so let us join hands firmly today towards a better health for all tomorrow.
Thank you and God bless Nigeria.
It is indeed a privilege and my pleasure to be invited to this distinguished gathering to discuss issues that revolve around the strategic role that the key stakeholders in the Health Sector need to play in the achievement of the MDGs, within the national developmental framework of the Yar’Adua Administration. I am delighted by the choice of the theme “Meeting the challenges of the health Millennium Development Goals” as it is timely and this will afford the opportunity to critically analyze burning issues and key challenges as we strive to collectively achieve the Health MDGs in Nigeria.
As policy makers and implementers drawn from Federal, State and Local Governments, who are directly responsible for the formulation and implementation of policies, there cannot be a more auspicious audience for this discussion. I am optimistic that the outcome of our interaction today will impact positively on the realization of the Health MDGs, which is of great concern to this Administration and the United Nations, given the wider challenges of the global financial crisis on our economies and thus the knock on effect to our social agenda.
THE MILLENNIUM DEVELOPMENT GOALS- ORIGIN AND SUMMARY
It will be recalled that at the United Nations’ Millennium summit in September 2000, World leaders from 189 Nations reinforced the global development agenda by adopting the Millennium Declaration which informed the eight Millennium Development Goals (MDGs) as the minimum baseline which set clear targets for reducing: poverty, hunger, disease, HIV/AIDS, Illiteracy, environmental issues, and discrimination against women by 2015.
It was acknowledged that progress is based on sustainable economic growth, which must focus on the poor, with human rights at the centre. The objective of the Millennium Declaration is to promote "a comprehensive approach and a coordinated strategy, tackling many problems simultaneously across a broad front."
It is also a global compact between rich and poor nations to address the resource gaps.
The eight Millennium Development Goals (MDGs) – which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education promote gender equality, reduce maternal mortality, reduce child mortality, ensure environmental sustainability and develop a global partnership, all by the target date of 2015.
Goal 1- Eradication of extreme poverty hunger
Goal 2 – Achieve Universal Basic Education
Goal 3 – Promote Gender Equality & empower women
Goal 4 – Reduce child mortality
Goal 5 – Improve maternal health
Goal 6 – Combat HIV/Aids, malaria & other diseases
Goal 7 – Ensure environmental sustainability
Goal 8 – Develop a global partnership for development
These Goals constitute an ambitious rights based agenda to significantly improve the human condition by 2015. It is worthy to mention of the eight goals, three are health specific, namely: goals 4, reduce Child Mortality, goal 5, Improve maternal health and goal 6, Combat HIV/AIDs, Malaria and other diseases.
We are today, a little over the halfway mark to the target date of 2015. In September 2008 a mid-term assessment of where Nigeria and Africa stand in terms of achieving the MDGs was exhaustively discussed and key issues addressed in the outcomes of further commitments made by national governments, multilaterals and bilateral. New inflows also came from the private sector and Foundations such as the Bill & Melinda Gates Foundation.
Highlights of the findings of the Mid-term assessments include:-
• Worsening indices for child and maternal mortality
• Weakening health systems, management capacity and huge health worker resource gaps
• Inadequate infrastructure to support access and service delivery
• Insufficient resource flows for routine services
• Poor attendance of rural populace to healthcare
• Inadequate involvement of communities and key stakeholders
These challenges for Nigeria as a nation are daunting but not insurmountable. During the next 7 years our countdown strategy will have to clearly lay out a road map that has concrete milestones and articulate and define the roles and responsibilities of the 3 tiers of Government, the Private Sector, Civil Society and our International Development Partners. They must build on the current and past efforts of government while learning from the past strategies and investments that have not borne the desired fruit for our teeming population. They must be center and front of the 7 Point Agenda and integrated into the Vision 2020, in other words we must domesticate all the MDGs ensuring they are kept interdependent and mutually reinforcing.
For example we will continue to build on the gains of the Paris Club Debt Relief granted to Nigeria in 2005. This resulted in $1billion debt relief by the Paris club, out of these $750m represents funds accruing to the Federal Government, while $250 is for states affected by the debt relief. The Federal government committed its share of these savings to a Virtual Poverty Fund targeting and achieving the MDGs. Overall the debt relief gains support to the health sector since 2006 is in the sum of N57.3billion. Specifics of these are, between 2006 and 2008, the sum of N16 billion was expended for immunization activities through the National Primary Health Care Agency, the National Malaria Control Program of the Federal Ministry of Health was supported to the tune of over N4billion for the roll back malaria, while the HIV/AIDs was supported in the sum of N15billion. The sum of N1.089billion was also appropriated through the Federal Ministry of Health in 2008 for the take off of the Midwifery Service Scheme with an additional 3bn in 2009. The CHIS in 6 pilot States targets pregnant women and children under 5 with an investment of N5bn.
The Conditional Grants Scheme (CGS), which is another strategy for using debt relief, also provides a platform for partnership among the tiers of Government, and has reinforced issues that target maternal and child health projects, including Emergency Obstetrics Care (EMOC). In 2007, 19 States (including the FCT) accessed N18.4bn of these funds, out of this amount 40% was used for strengthening of Primary Health care systems. In 2008 N1.5bn under the CGS was provided for the November/December Polio eradication rounds in line with the Geneva Pledge. The “QUICK WINS” projects of the National Assembly which commenced last year and currently ongoing, also has as a component the construction and equipping of Primary health Care Centers nationwide.
We have been able to make significant progress in the area of HIV prevalence among 15-24 year old pregnant women which fell from 5.8% in 2002 to 4.3% in 2007. However, in other areas the indicators show that mid-point to the target year, our progress is too slow: Infant Mortality rate has risen from 81 per 1000 live births in year 2000 to 110 per 1000 in 2005/2006, which is farther away from the global target of 30 per 1000 live births ; Under- five mortality rate also increased from 184 per 1000 live births in 2000 to 201 per 1000 live births in 2007; maternal mortality has also risen from 704 per 100,000 in 2002 to 800 per 100,000 in 2007; the number of children orphaned by HIV/AIDs has increased in from 1.8m in 2004 to 1.9m in 2007.
So clearly investments have been made albeit concerns of coherence and strategic targeting are being raised.
The Health Millennium Development Goals In Nigeria
The Health MDGs address specifically; Child Mortality, Maternal Mortality, HIV AIDS, Malaria & other diseases. The key causes of mortality being measles, diarrhea, malaria, post partum hemorrhaging
The challenges of the Health sector are well known to almost all of us gathered here for this meeting. Over the years investments have been made, in some cases such as immunization, phenomenal amounts yet our indices worsened. Today we are burdened with some of the highest maternal mortality and child mortality rates in the world.
Without a healthy populace, of which the measure is our women (who should not be dying giving life) and without a knowledge society with relevant skills our vision will amount to nothing. As we strive to reposition our Health Sector under the able leadership of Professor Babatunde Osotimien, our investments in Primary Health Care Systems, revamping RBM, TB &HIV/AIDs, eradicating polio and providing relevant health care workers, will be re-addressed with a strategic vision and plan that reinforces local level actions on the ground. This can only succeed if the various stakeholders at this meeting buy into and own the vision.
There are clear concerns to the achievement of Health MDGs in Nigeria as they are clearly off track but understanding these challenges and placing them in our country reality means that they can be overcome. I would like to share a few of the key issues which I hope will be discussed at this National Council as I believe addressing them at all 3 tiers of government will pave a concrete path towards putting us back on track to meet and sustain the MDGs.
• A National policy framework not a Federal one….genuine inclusion the watchword
• Implementation strategies and plans that are smart and linked to an investment plan which has a budget behind it. Key investments for inputs such as data, statistics, mapping to improve the quality and relevance of our planning outcomes
• Genuine partnerships with clearly defined roles and responsibilities within given mandates and the constitution.
• Legal instruments to enable a robust primary health care system that delivers service to the populace at the local level
• Health reforms that address infrastructure, human resource gaps, health worker production, immunization and other vertical programs
• Financing strategy that goes beyond quick fix but looks at sustainable recurrent expenditure at local level
• Health systems and management challenges
• Governance and accountability
• Advocacy, Education, Monitoring & Evaluation
• IDP coherence and funding the gaps to achieve the MDGs
Meeting these health challenges of the MDGs is complex and collaboration intensive. It requires political commitment at levels going beyond communiqués into budgets. Our people not only deserve for us to serve them they have a right to basic healthcare. Our women do not deserve to be on the edge but mainstream, for only a healthy nation can deliver on the economic dividends. Remembering that half our population is female and therefore we cannot afford to neglect half our national assets.
We have the leadership, the resources, the political will, the demand and no excuse not to deliver on what is one of the most important dividends of democracy. In the MDG Office we will continue to work with the Federal Ministry of Health and the States to reinforce local strategies and scale up interventions that target the sustainable delivery of basic health care services to our people especially our women and children.
I sincerely believe that together we will be able to deliver the MDGs by 2015, so let us join hands firmly today towards a better health for all tomorrow.
Thank you and God bless Nigeria.
SPEECH OF THE HON. MINISTER OF STATE FOR HEALTH DR ALIYU IDI HONG AT THE 52ND NATIONAL COUNCIL ON HEALTH: APRIL, 2009 AT THE AFFICENT, KANO, KANO STA
SPEECH OF THE HON. MINISTER OF STATE FOR HEALTH, DR ALIYU IDI HONG AT THE 52ND NATIONAL COUNCIL ON HEALTH:
APRIL, 2009 AT THE AFFICENT, KANO, KANO STATE.
P R O T O C O L
I am delighted to welcome you all to this 52nd National Council on Health which is the first my-self and my colleague, Hon Minister of Health Prof. Babatunde Osotimehin, OON will be participating in as Ministers of the Federal Republic of Nigeria. This meeting is coming at a most auspicious time in our national and political life. The theme of this meeting; Meeting the Challenges of the Health MDGs in Nigeria is also most appropriate. This is because Health is at the heart of the Millennium Development Goals. And meeting the challenges of the Health MDGs is at the heart of meeting the challenges of MDGs globally.
2. The timing is auspicious for two important reasons namely: the World-wide economic crises and financial meltdown which means that our march towards the accelerated achievement of the Health MDGs is taking place at a time of great challenges; when financial resources are not only in crises and in decline but also not guaranteed. The depth and extent of this financial crises cannot be underestimated and has necessitated the just concluded G-20 Heads of Government Summit in London in which the heads of Government of the twenty leading economies of the world came together to discuss ways of stemming the world economic recession and bringing the economy of the world back on track. The rancour, outrage and outcome of that meeting including the attendant protests which sometimes turned violent show just how deep the crises run and how passionate people feel about its effect on their daily living. The name-calling, disharmony, confusion and discord again underscored that no-one has the answers and that it is not yet uhuru. These are facts that will have a lot of impact on financing of health MDGs world-wide as it also comes with added political challenges for the heads of Government at home on just how much they can commit to Overseas Development Assistant (ODA) and will also affect the attention and commitment towards the MDGs in developing countries such as ours. We must therefore necessarily re-focus, re-strategise and re-tool in order to rise to these new and emerging challenges in our already challenged circumstance. For this reason alone, this meeting is very critical.
3. In addition, the timing is also most auspicious due to the spate of epidemics and avoidable public health challenges we have been faced with in the recent past. An illustration can easily be done with the issue of CSM which remain with us and seem to continuously overwhelm our system despite the fact that this is not only preventable, it is also predictable. Issues such as this continue to underscore a greater challenge of our Health System. It is this greater challenge of the system that the present leadership in the Federal Ministry of Health is most mindful of and determined to tackle more strategically than have been done before. We want to institutionalize anticipation, prevention, response and not reaction. This is part of what has informed our decision to use the opportunity of this our first NCH to look at the challenges of the MDGs in order to meet it. It is our hope and prayer that by the special grace of God, this NCH is therefore a great opportunity and a timely decision that can only and will serve us well.
4. Achieving the MDGs is one of the critical elements that the President’s seven-point agenda mandates us to ensure. And as we are all already aware of, out of the eight goals of the MDGs, three (Goals 4, 5 and 6) are health specific and all the other five goals are health-related. Health is therefore at the heart of the MDGs and since the MDGs are critical to the seven point agenda, it therefore means that Health is not only at the Heart of the MDGs but Health MDGs are critical to the seven point agenda of the President. So without health, the MDGs can never be achieved and without Health MDGs, the President’s seven point agenda cannot be realised. This is again another important reason we have adopted this theme for our first ever National Council on Health.
5. Health MDGs and human capital development are inter-linked like the case of the egg and the chicken; it is difficult to say exactly which one comes first but we do know that without good health, every effort at human capital development will be a colossal failure. The ability to be economically productive will be impinged upon; children will not go to school and when they do go, will not get the maximum benefit of the education due to ill health. All these will result in illiteracy, poverty and hunger. One so affected cannot pursue any education or acquire skills for employment resulting again in ill-health and under-development. So ill-health, poverty and illiteracy form a vicious cycle which results in underdevelopment. The Health MDGs if achieved will address these issues thus resulting in human capital development. The direct inverse relationship between the Infant Mortality Rate (IMR), Under-5 Mortality Rate (U5MR) and Maternal Mortality Rate (MMR) to the education and economic status of the mother is also noted here.
6. We are also mindful not to be the enfant-terrible of health-MDG worldwide as we may have inadvertently become in the case of Polio. Mindful of our size and population and our contribution to the worldwide IMR and MMR, we know again that without Nigeria, the MDGs cannot be achieved worldwide. We must therefore ensure that ours is not the generation that sets the world back in its march to achieve the Health MDGs worldwide. So we must seize the call of history to achieve the health MDGs in Nigeria at a time like this. Nigerians also are tired of excuses; they want action, action that can be measured in improved health outcomes for the generality of the populace.
7. We however cannot achieve the Health MDGs without forging and sustaining critical partnerships and alliances and that is why this gathering must be further strengthened. We are very grateful for your presence here today and also your ever prompt response each time we call on you. We will be calling on you as often as is necessary and I wish to use this opportunity on behalf of my colleague and myself to say thanks and to appeal to you to bear with us.
8. There have been challenges most of which remain. But we must not be daunted; instead we must see these as critical opportunities presented to us by God to be leaders in the generation that will make a difference and we do have no choice but to succeed. Failure is not an option at all. We recognise that the journey is far and the times are very difficult but we are committed, we are enthusiastic, and we are lucky we also have the appropriate political environment.
9. I have been careful not to go into specifics because my colleague, the Hon Minister, Prof. Babatunde Osotimehin will give the details of what we have agreed to do in order to arrive at our destination. I however must reiterate that we feel a high sense of duty and responsibility as the Ministers of Health to improve the quality of health services provided by our Health systems, improve the efficiency of service delivery, and to ensure equitable access to health care services and we are committeds toward building a responsible, responsive, reliable, result-oriented, and evidence-based health system in our march towards achieving the MDGs.
10. I do hope that we have been able to underscore the importance of actions required, and the urgency that is necessary to tackle the issues militating against our march towards the achievement of the Health MDGs and also respond to Mr. President’s marching orders to pull the health sector out of the woods. We really therefore do not have any time to loose, hence the theme and the urgency with which we are tackling these issues.
11. Your Excellency, the Governor of Kano State, Hon. Commissioners of Health, Permanent Secretaries, Directors, Development partners (Local and International), distinguished participants, ladies and gentlemen of the Press, Ladies and Gentlemen, I thank you all for your attention and I look forward to fruitful Council deliberations.
APRIL, 2009 AT THE AFFICENT, KANO, KANO STATE.
P R O T O C O L
I am delighted to welcome you all to this 52nd National Council on Health which is the first my-self and my colleague, Hon Minister of Health Prof. Babatunde Osotimehin, OON will be participating in as Ministers of the Federal Republic of Nigeria. This meeting is coming at a most auspicious time in our national and political life. The theme of this meeting; Meeting the Challenges of the Health MDGs in Nigeria is also most appropriate. This is because Health is at the heart of the Millennium Development Goals. And meeting the challenges of the Health MDGs is at the heart of meeting the challenges of MDGs globally.
2. The timing is auspicious for two important reasons namely: the World-wide economic crises and financial meltdown which means that our march towards the accelerated achievement of the Health MDGs is taking place at a time of great challenges; when financial resources are not only in crises and in decline but also not guaranteed. The depth and extent of this financial crises cannot be underestimated and has necessitated the just concluded G-20 Heads of Government Summit in London in which the heads of Government of the twenty leading economies of the world came together to discuss ways of stemming the world economic recession and bringing the economy of the world back on track. The rancour, outrage and outcome of that meeting including the attendant protests which sometimes turned violent show just how deep the crises run and how passionate people feel about its effect on their daily living. The name-calling, disharmony, confusion and discord again underscored that no-one has the answers and that it is not yet uhuru. These are facts that will have a lot of impact on financing of health MDGs world-wide as it also comes with added political challenges for the heads of Government at home on just how much they can commit to Overseas Development Assistant (ODA) and will also affect the attention and commitment towards the MDGs in developing countries such as ours. We must therefore necessarily re-focus, re-strategise and re-tool in order to rise to these new and emerging challenges in our already challenged circumstance. For this reason alone, this meeting is very critical.
3. In addition, the timing is also most auspicious due to the spate of epidemics and avoidable public health challenges we have been faced with in the recent past. An illustration can easily be done with the issue of CSM which remain with us and seem to continuously overwhelm our system despite the fact that this is not only preventable, it is also predictable. Issues such as this continue to underscore a greater challenge of our Health System. It is this greater challenge of the system that the present leadership in the Federal Ministry of Health is most mindful of and determined to tackle more strategically than have been done before. We want to institutionalize anticipation, prevention, response and not reaction. This is part of what has informed our decision to use the opportunity of this our first NCH to look at the challenges of the MDGs in order to meet it. It is our hope and prayer that by the special grace of God, this NCH is therefore a great opportunity and a timely decision that can only and will serve us well.
4. Achieving the MDGs is one of the critical elements that the President’s seven-point agenda mandates us to ensure. And as we are all already aware of, out of the eight goals of the MDGs, three (Goals 4, 5 and 6) are health specific and all the other five goals are health-related. Health is therefore at the heart of the MDGs and since the MDGs are critical to the seven point agenda, it therefore means that Health is not only at the Heart of the MDGs but Health MDGs are critical to the seven point agenda of the President. So without health, the MDGs can never be achieved and without Health MDGs, the President’s seven point agenda cannot be realised. This is again another important reason we have adopted this theme for our first ever National Council on Health.
5. Health MDGs and human capital development are inter-linked like the case of the egg and the chicken; it is difficult to say exactly which one comes first but we do know that without good health, every effort at human capital development will be a colossal failure. The ability to be economically productive will be impinged upon; children will not go to school and when they do go, will not get the maximum benefit of the education due to ill health. All these will result in illiteracy, poverty and hunger. One so affected cannot pursue any education or acquire skills for employment resulting again in ill-health and under-development. So ill-health, poverty and illiteracy form a vicious cycle which results in underdevelopment. The Health MDGs if achieved will address these issues thus resulting in human capital development. The direct inverse relationship between the Infant Mortality Rate (IMR), Under-5 Mortality Rate (U5MR) and Maternal Mortality Rate (MMR) to the education and economic status of the mother is also noted here.
6. We are also mindful not to be the enfant-terrible of health-MDG worldwide as we may have inadvertently become in the case of Polio. Mindful of our size and population and our contribution to the worldwide IMR and MMR, we know again that without Nigeria, the MDGs cannot be achieved worldwide. We must therefore ensure that ours is not the generation that sets the world back in its march to achieve the Health MDGs worldwide. So we must seize the call of history to achieve the health MDGs in Nigeria at a time like this. Nigerians also are tired of excuses; they want action, action that can be measured in improved health outcomes for the generality of the populace.
7. We however cannot achieve the Health MDGs without forging and sustaining critical partnerships and alliances and that is why this gathering must be further strengthened. We are very grateful for your presence here today and also your ever prompt response each time we call on you. We will be calling on you as often as is necessary and I wish to use this opportunity on behalf of my colleague and myself to say thanks and to appeal to you to bear with us.
8. There have been challenges most of which remain. But we must not be daunted; instead we must see these as critical opportunities presented to us by God to be leaders in the generation that will make a difference and we do have no choice but to succeed. Failure is not an option at all. We recognise that the journey is far and the times are very difficult but we are committed, we are enthusiastic, and we are lucky we also have the appropriate political environment.
9. I have been careful not to go into specifics because my colleague, the Hon Minister, Prof. Babatunde Osotimehin will give the details of what we have agreed to do in order to arrive at our destination. I however must reiterate that we feel a high sense of duty and responsibility as the Ministers of Health to improve the quality of health services provided by our Health systems, improve the efficiency of service delivery, and to ensure equitable access to health care services and we are committeds toward building a responsible, responsive, reliable, result-oriented, and evidence-based health system in our march towards achieving the MDGs.
10. I do hope that we have been able to underscore the importance of actions required, and the urgency that is necessary to tackle the issues militating against our march towards the achievement of the Health MDGs and also respond to Mr. President’s marching orders to pull the health sector out of the woods. We really therefore do not have any time to loose, hence the theme and the urgency with which we are tackling these issues.
11. Your Excellency, the Governor of Kano State, Hon. Commissioners of Health, Permanent Secretaries, Directors, Development partners (Local and International), distinguished participants, ladies and gentlemen of the Press, Ladies and Gentlemen, I thank you all for your attention and I look forward to fruitful Council deliberations.
ADDRESS BY: PROFESSOR BABATUNDE OSOTIMEHIN, OON THE HONOURABLE MINISTER OF HEALTH AT THE 52ND NATIONAL COUNCIL ON HEALTH (NCH) MEETING HELD ON APRI
1. Distinguished delegates, I am very delighted to welcome you to this 52nd National Council on Health (NCH) Meeting. You would recall that the last NCH 51st took place in November 19-23, 2007, in Lagos, during which we took the decision to hold the 52nd NCH Meeting in Kano, Kano State in May 2008. We regret that due to circumstances beyond our control, partly due to the very challenging and unsavoury developments at the leadership level of the Federal Ministry of Health, for most of the year 2008, we did not have the necessary and sufficient conditions to hold the 52nd NCH as earlier planned, until now. We thank God that we are here at last. We remain also very grateful to the Kano State Government, through the Kano State Ministry of Health for their steadfastness and understanding in (still) keeping fate with our collective decisions to host this meeting at this time period. On behalf of the Hon. Minister of State for Health and the rest of us, I say a BIG thank you to the Kano State Government. The status reports of our state of readiness for this meeting, which was given to me yesterday on my arrival, has played glowing tributes and commendations of the excellent and elaborate preparations made by the Kano State Government for this NCH meeting.
2. In February, during our maiden meeting as Ministers of Health with the Hon. Commissioners for Health, I highlighted the need to revitalize the nation’s Health System. At that meeting, we discussed various issues relating to the state of the health system which we all agreed is in dire need of fixing. I intimated you of the agenda and direction of the Federal Ministry of Health in the new dispensation to achieve a people-oriented and responsive health system that will achieve the Human Capital Development Program of Mr. President’s 7-Point Agenda. You would recall that we put before you as our major partner in health development in Nigeria, two very important issues for discussion and inputs: The Agenda for Health 2009; and the National Strategic Health Development Plan.
3. The Agenda for Health 2009 has the following strategic thrusts which were discussed in the group session during the meeting: Enhancing the Stewardship Role of the Ministry; Revitalizing the Health System with Emphasis on Delivery of quality health services through Primary Health Care and strengthening referrals with Secondary and Tertiary Institutions to reduce the disease burden and improve the health status of Nigerians; Enhancing Financial Resource Mobilization through the expansion of the NHIS and other Private Public Partnership (PPP) arrangements; Enhancing the Coordinating Role of the Ministry and its interface with States, Local Governments and Donors; Human Resources for Health; Strategic Information Management & Research; Communication and Public Relations Management. I believe the discussions were very rich and implementation of some of the recommendations will enhance the efforts we are all making to impact positively on our health system.
4. As we intimated you during our last meeting, the Minister of State for Health and I feel very strongly about interacting more closely with the States, hence the creation of the State Coordination Unit in my office. Also, because of the great potentials in working with the private sector, which are yet to be tapped, I have also created a Public-Private Partnership (PPP) Unit in my office. If we all, at federal, state and local government levels, unify our efforts with those of the private sector, I believe the health system will be strengthened.
5. We also intimated you about the National Strategic Health Development Plan (NSHDP) which would serve as the ONE Reference Plan for all - with an associated consolidated national health investment plan. I have since inaugurated the Technical Working Group (TWG) and they have been working tirelessly towards the mandate given. Presently, as we meet, the TGW is also meeting in Abuja to develop the Zero-Draft of the National Strategic Health Development Framework. At the end of the process work, a National Strategic Health Development Plan, consisting of three (3) parts would have been produced: indicating the Priority Areas; Goals; Strategic Objectives; Strategies; and Activities including various stakeholders’ roles and responsibilities; Monitoring Evaluation indicators; costing/health investment dimensions and timelines for deliverables between now and 2015. As we have agreed, I shall be holding our next meeting with the Hon Commissioners in Abuja on April 27/28, 2009 to look specifically the draft NSHDP framework. We shall endeavors to circulate copies of the framework ahead of time to ensure meaningful discussion. While I recognize the huge demand and commitment of your time, I believe it is important we set the framework right now in order to get on with producing the respective health plans for our collective accountability for health development in this country.
6. The theme of our deliberations at this National Council on Health meeting is on “Meeting the Challenges of Health-Related Millennium Development Goals”. This is unquestionably an appropriate for these times in our health development. Let me take this opportunity to remind ourselves once again of the eight Millennium Development Goals (MDGs) endorsed at the UN Millennium Summit in September 2000, by 147 countries (Nigeria inclusive) for poverty reduction and social progress to be attained by the year 2015. These are to: (1) Eradicate extreme poverty and hunger, (2) Achieve universal primary education, (3) Promote gender equality and empower women, (4) Reduce child mortality, (5) Improve maternal health, (6) Combat HIV/AIDS, malaria and other diseases, (7) Ensure environmental sustainability and (8) Develop a global partnership for development. As we can see, out of the eight goals, three of the goals (4, 5 and 6) are directly health-related while three others (1, 7 and 8) are health and nutrition dependent.
7. We are six years down the line to the year 2015 when we are supposed to have achieved the MDGs. How far have we gone to realizing these goals? How have we assessed ourselves? Progress in achieving the health millennium development goals has been quite minimal as shown below:
a. Infant mortality rate was 97 deaths/1,000 live births in 2000 and appears to have worsened to 113 deaths/1,000 live births, as against the MDG 4 targeted improvement to 30 deaths/1,000 live births by 2015.
b. Under 5 mortality rate was 230 per 1,000 in 1990; 191/1,000 in 2006 and would require a 60% reduction to bring to 77 per 1,000 in 2015 in order to achieve a 1/3rd reduction from the 1990 level and meet the MDGs goal.
c. Maternal mortality rate was 1,000 per 100,000 in 1990; and 800 per 100,000 in 2006 and would require about 70% reduction to bring it to 250 per 100,000 in order to achieve 704 per 100,000 live births, a 1/3rd reduction from 1990 in order to meet the MDG goal for maternal mortality.
8. Health, we all know, is central to the achievement of the MDGs and requires major improvements in health systems and health outcomes across the country. It is said that “health is wealth” and “a healthy country is a wealthy country”. It is therefore very important that we all work towards improving our health status in this country. Indeed, achieving the health MDGs is a complex and challenging task but it is a task that must be done. Some countries have made impressive gains and are "on track," but many more are falling behind. The situation is not encouraging for goals related to lowering infant and maternal mortality as well as infectious diseases, especially in sub-Saharan Africa (which, of course includes Nigeria). This is 2009, where can we say we are in realizing these health specific MDG goals? We need to know where we are and where we are going.
9. Just recently we all witnessed the March 2009 National Immunization Plus Days (NIPDs) which took place between 27th and 30th March in all the States of the Federation. Mr. President flagged off the Polio Vaccination campaign in Abuja and all the State Governors also flagged it off in their various States. These NIPDs are dedicated days when every child aged 0-5 years is expected to receive two (2) drops of Oral Polio Vaccines (OPV) irrespective of previous vaccination status, as well as the administration of other high impact child survival interventions. The flag-off by His Excellency, Mr. President came at a time when the commitment given by the administration to the global polio eradication initiative activities in Nigeria is being transformed to improved program performance; and obviously the highest moral and political boost to the polio campaign in the country. The campaign will save thousands of Nigerian children from avoidable deformities and deaths; a campaign for the survival and development of our children who are the future of this nation.
10. The number of polio endemic countries has reduced from over 125 to only 4 countries by 2008: Nigeria, Pakistan, Afghanistan and India. Nigeria is the only country in the world with all the three types of wild polio viruses in circulation. Although Nigeria has made considerable progress towards achieving the interruption of wild polio virus transmission, there are challenges that remain. In 2008 the country experienced an upsurge in cases linked to sporadic cases reported in some of our neighboring countries (Niger, Benin, Togo, Ghana, Burkina-Faso and Mali). So, the world community has become more worried that we are now serving as exporters of the polio virus to our neighbors. Beside the global concern, Nigerian children continue to be paralyzed due to the virus. In 2008, 806 Nigerian children were paralyzed or deformed by Polio disease. That is nearly three times as many as the year before! Just two drops of Oral Polio Vaccine administered at least four times to each of these children would have prevented these overwhelming deformities and, sometimes deaths, among the children so affected and spared their families the hardship. Already, in 2009, at least 68 children have been affected and 18 of them paralyzed as of February 11, 2009. In previous years, the cases were mostly concentrated in the north. Now they are occurring as far south as Ogun, Lagos and other states.
11. Nigeria joined a synchronized, cross-border immunization campaign in February 2009 in which 40 million children were vaccinated; 25 million of those children were Nigerians. This round targets over 47 million children below the age of five (5) years. This campaign demonstrates the organization and commitment of thousands of healthcare workers, volunteers, community organizers and parents. Eradicating Polio is also an act of international citizenship. It is the duty of all to eradicate polio. If we all - governments, community leaders, the media, teachers, parents and other partners - do our part, we could stop polio in its tracks, NOW! You may recall the thrust of the collective commitment to polio eradication, routine immunization and primary health care at the Governors’ Forum during the February 2009 visit of Mr. Bill Gates in order to further translate our desire and determination to interrupt wild polio virus in Nigeria and bequeath a legacy of optimal health to our children. I believe that the momentum generated from such a consideration will drive the campaign to unprecedented levels of coverage in terms of numbers and quality.
12. I believe that the challenges of meeting the health-related MDGs include: (i) Getting national governments to increase health spending significantly (ii) Developing better policies toward households as producers and demanders of care (iii) Improving health service delivery (iv) Strengthening core public health functions (v) Getting additional financial resources in a sustainable way, and (vi) Coordination of donor actions. All these fall within the purview of key thematic areas such as Healthcare Financing, Service Delivery, Communications/Health Promotion, Knowledge Management, Donor coordination, Monitoring & Evaluation/Health Management Information System, Logistics, Research, Public-Private Partnerships, Governance/Stewardship, Social Development and the very critical issue of Human Resources for Health.
13. As we all know, accessible, affordable, acceptable and accountable qualitative healthcare delivery depends on various components (i.e. infrastructure, equipment, etc.) but most importantly on human resources. The human resources for health play a key role in our prospects of achieving the health-related millennium development goals. It is in recognition of importance of this component that I take a pause at this juncture, to propose that we convene an Extraordinary National Council on Health primarily to deal with HUMAN RESOURCES FOR HEALTH with all the complex issues involved with a view to finding lasting and sustainable solutions to the challenges we face year in year out.
14. During the course of this Council meeting, there will be group discussions on the theme of the meeting which was given by the Senior Special Assistant to the President on MDG, Mrs. Amina Ibrahim. We need to brainstorm and find solutions to which we all shall commit ourselves to implementing in order to ensure their realization. At the end of the discussions, we should be able to come up with concrete decisions, resolutions and time-bound action plans for accelerating the achievement of the health MDGs by 2015. It is my hope that at the end of this Council meeting, we shall definitely move the improvement of our health system and the health status of our people forward thereby realizing our national health goal and the objectives of our reforms.
15. Distinguished Ladies and Gentlemen, I am hopeful that this Council meeting will pay attention to the current situations of all the issues to be discussed and make general recommendations on the best way forward.
16. I wish you all fruitful deliberations and God bless. Thank you.
Professor Babatunde Osotimehin, OON
Honourable Minister of Health
April 6, 2009.
2. In February, during our maiden meeting as Ministers of Health with the Hon. Commissioners for Health, I highlighted the need to revitalize the nation’s Health System. At that meeting, we discussed various issues relating to the state of the health system which we all agreed is in dire need of fixing. I intimated you of the agenda and direction of the Federal Ministry of Health in the new dispensation to achieve a people-oriented and responsive health system that will achieve the Human Capital Development Program of Mr. President’s 7-Point Agenda. You would recall that we put before you as our major partner in health development in Nigeria, two very important issues for discussion and inputs: The Agenda for Health 2009; and the National Strategic Health Development Plan.
3. The Agenda for Health 2009 has the following strategic thrusts which were discussed in the group session during the meeting: Enhancing the Stewardship Role of the Ministry; Revitalizing the Health System with Emphasis on Delivery of quality health services through Primary Health Care and strengthening referrals with Secondary and Tertiary Institutions to reduce the disease burden and improve the health status of Nigerians; Enhancing Financial Resource Mobilization through the expansion of the NHIS and other Private Public Partnership (PPP) arrangements; Enhancing the Coordinating Role of the Ministry and its interface with States, Local Governments and Donors; Human Resources for Health; Strategic Information Management & Research; Communication and Public Relations Management. I believe the discussions were very rich and implementation of some of the recommendations will enhance the efforts we are all making to impact positively on our health system.
4. As we intimated you during our last meeting, the Minister of State for Health and I feel very strongly about interacting more closely with the States, hence the creation of the State Coordination Unit in my office. Also, because of the great potentials in working with the private sector, which are yet to be tapped, I have also created a Public-Private Partnership (PPP) Unit in my office. If we all, at federal, state and local government levels, unify our efforts with those of the private sector, I believe the health system will be strengthened.
5. We also intimated you about the National Strategic Health Development Plan (NSHDP) which would serve as the ONE Reference Plan for all - with an associated consolidated national health investment plan. I have since inaugurated the Technical Working Group (TWG) and they have been working tirelessly towards the mandate given. Presently, as we meet, the TGW is also meeting in Abuja to develop the Zero-Draft of the National Strategic Health Development Framework. At the end of the process work, a National Strategic Health Development Plan, consisting of three (3) parts would have been produced: indicating the Priority Areas; Goals; Strategic Objectives; Strategies; and Activities including various stakeholders’ roles and responsibilities; Monitoring Evaluation indicators; costing/health investment dimensions and timelines for deliverables between now and 2015. As we have agreed, I shall be holding our next meeting with the Hon Commissioners in Abuja on April 27/28, 2009 to look specifically the draft NSHDP framework. We shall endeavors to circulate copies of the framework ahead of time to ensure meaningful discussion. While I recognize the huge demand and commitment of your time, I believe it is important we set the framework right now in order to get on with producing the respective health plans for our collective accountability for health development in this country.
6. The theme of our deliberations at this National Council on Health meeting is on “Meeting the Challenges of Health-Related Millennium Development Goals”. This is unquestionably an appropriate for these times in our health development. Let me take this opportunity to remind ourselves once again of the eight Millennium Development Goals (MDGs) endorsed at the UN Millennium Summit in September 2000, by 147 countries (Nigeria inclusive) for poverty reduction and social progress to be attained by the year 2015. These are to: (1) Eradicate extreme poverty and hunger, (2) Achieve universal primary education, (3) Promote gender equality and empower women, (4) Reduce child mortality, (5) Improve maternal health, (6) Combat HIV/AIDS, malaria and other diseases, (7) Ensure environmental sustainability and (8) Develop a global partnership for development. As we can see, out of the eight goals, three of the goals (4, 5 and 6) are directly health-related while three others (1, 7 and 8) are health and nutrition dependent.
7. We are six years down the line to the year 2015 when we are supposed to have achieved the MDGs. How far have we gone to realizing these goals? How have we assessed ourselves? Progress in achieving the health millennium development goals has been quite minimal as shown below:
a. Infant mortality rate was 97 deaths/1,000 live births in 2000 and appears to have worsened to 113 deaths/1,000 live births, as against the MDG 4 targeted improvement to 30 deaths/1,000 live births by 2015.
b. Under 5 mortality rate was 230 per 1,000 in 1990; 191/1,000 in 2006 and would require a 60% reduction to bring to 77 per 1,000 in 2015 in order to achieve a 1/3rd reduction from the 1990 level and meet the MDGs goal.
c. Maternal mortality rate was 1,000 per 100,000 in 1990; and 800 per 100,000 in 2006 and would require about 70% reduction to bring it to 250 per 100,000 in order to achieve 704 per 100,000 live births, a 1/3rd reduction from 1990 in order to meet the MDG goal for maternal mortality.
8. Health, we all know, is central to the achievement of the MDGs and requires major improvements in health systems and health outcomes across the country. It is said that “health is wealth” and “a healthy country is a wealthy country”. It is therefore very important that we all work towards improving our health status in this country. Indeed, achieving the health MDGs is a complex and challenging task but it is a task that must be done. Some countries have made impressive gains and are "on track," but many more are falling behind. The situation is not encouraging for goals related to lowering infant and maternal mortality as well as infectious diseases, especially in sub-Saharan Africa (which, of course includes Nigeria). This is 2009, where can we say we are in realizing these health specific MDG goals? We need to know where we are and where we are going.
9. Just recently we all witnessed the March 2009 National Immunization Plus Days (NIPDs) which took place between 27th and 30th March in all the States of the Federation. Mr. President flagged off the Polio Vaccination campaign in Abuja and all the State Governors also flagged it off in their various States. These NIPDs are dedicated days when every child aged 0-5 years is expected to receive two (2) drops of Oral Polio Vaccines (OPV) irrespective of previous vaccination status, as well as the administration of other high impact child survival interventions. The flag-off by His Excellency, Mr. President came at a time when the commitment given by the administration to the global polio eradication initiative activities in Nigeria is being transformed to improved program performance; and obviously the highest moral and political boost to the polio campaign in the country. The campaign will save thousands of Nigerian children from avoidable deformities and deaths; a campaign for the survival and development of our children who are the future of this nation.
10. The number of polio endemic countries has reduced from over 125 to only 4 countries by 2008: Nigeria, Pakistan, Afghanistan and India. Nigeria is the only country in the world with all the three types of wild polio viruses in circulation. Although Nigeria has made considerable progress towards achieving the interruption of wild polio virus transmission, there are challenges that remain. In 2008 the country experienced an upsurge in cases linked to sporadic cases reported in some of our neighboring countries (Niger, Benin, Togo, Ghana, Burkina-Faso and Mali). So, the world community has become more worried that we are now serving as exporters of the polio virus to our neighbors. Beside the global concern, Nigerian children continue to be paralyzed due to the virus. In 2008, 806 Nigerian children were paralyzed or deformed by Polio disease. That is nearly three times as many as the year before! Just two drops of Oral Polio Vaccine administered at least four times to each of these children would have prevented these overwhelming deformities and, sometimes deaths, among the children so affected and spared their families the hardship. Already, in 2009, at least 68 children have been affected and 18 of them paralyzed as of February 11, 2009. In previous years, the cases were mostly concentrated in the north. Now they are occurring as far south as Ogun, Lagos and other states.
11. Nigeria joined a synchronized, cross-border immunization campaign in February 2009 in which 40 million children were vaccinated; 25 million of those children were Nigerians. This round targets over 47 million children below the age of five (5) years. This campaign demonstrates the organization and commitment of thousands of healthcare workers, volunteers, community organizers and parents. Eradicating Polio is also an act of international citizenship. It is the duty of all to eradicate polio. If we all - governments, community leaders, the media, teachers, parents and other partners - do our part, we could stop polio in its tracks, NOW! You may recall the thrust of the collective commitment to polio eradication, routine immunization and primary health care at the Governors’ Forum during the February 2009 visit of Mr. Bill Gates in order to further translate our desire and determination to interrupt wild polio virus in Nigeria and bequeath a legacy of optimal health to our children. I believe that the momentum generated from such a consideration will drive the campaign to unprecedented levels of coverage in terms of numbers and quality.
12. I believe that the challenges of meeting the health-related MDGs include: (i) Getting national governments to increase health spending significantly (ii) Developing better policies toward households as producers and demanders of care (iii) Improving health service delivery (iv) Strengthening core public health functions (v) Getting additional financial resources in a sustainable way, and (vi) Coordination of donor actions. All these fall within the purview of key thematic areas such as Healthcare Financing, Service Delivery, Communications/Health Promotion, Knowledge Management, Donor coordination, Monitoring & Evaluation/Health Management Information System, Logistics, Research, Public-Private Partnerships, Governance/Stewardship, Social Development and the very critical issue of Human Resources for Health.
13. As we all know, accessible, affordable, acceptable and accountable qualitative healthcare delivery depends on various components (i.e. infrastructure, equipment, etc.) but most importantly on human resources. The human resources for health play a key role in our prospects of achieving the health-related millennium development goals. It is in recognition of importance of this component that I take a pause at this juncture, to propose that we convene an Extraordinary National Council on Health primarily to deal with HUMAN RESOURCES FOR HEALTH with all the complex issues involved with a view to finding lasting and sustainable solutions to the challenges we face year in year out.
14. During the course of this Council meeting, there will be group discussions on the theme of the meeting which was given by the Senior Special Assistant to the President on MDG, Mrs. Amina Ibrahim. We need to brainstorm and find solutions to which we all shall commit ourselves to implementing in order to ensure their realization. At the end of the discussions, we should be able to come up with concrete decisions, resolutions and time-bound action plans for accelerating the achievement of the health MDGs by 2015. It is my hope that at the end of this Council meeting, we shall definitely move the improvement of our health system and the health status of our people forward thereby realizing our national health goal and the objectives of our reforms.
15. Distinguished Ladies and Gentlemen, I am hopeful that this Council meeting will pay attention to the current situations of all the issues to be discussed and make general recommendations on the best way forward.
16. I wish you all fruitful deliberations and God bless. Thank you.
Professor Babatunde Osotimehin, OON
Honourable Minister of Health
April 6, 2009.
NATIONAL HEALTH INSURANCE SCHEME; LIST OF ACCREDITED HMOS
CODE NAME OF HMO/ADDRESS TELEPHONE NUMBER
1. HYGEIA HMO LIMITED
11A Idejo Street, Off Ademola Odeku Street Victoria Island, Lagos. 01-4517071
01 -4617073
08036710207 Adebajo (Abuja)
2. TOTAL HEALTH TRUST LIMITED
2 Marconi Road Palmgrove Estate, Lagos
01-4701813
01-7737150
3. CLEARLINE INTERNATIONAL LIMITED
16 Oyefe Avenue, Off Ikorodu Road,
Savoil B/Stop/Halimark Assurance Plc.
Obanikoro, Lagos. 01-7741092, 4977542
09-675605, 2730839
0806006004
4 HEALTHCARE INTERNATIONAL LIMITED
308A Murtala Mohammed Way, Yaba, Lagos
Abuja Office: 3rd Floor
UACN Commercial Complex
Plot 272/273, Beside Arewa Suites
Central Business District, Abuja. 4739099, 4799099
09-6709099, 6739099
6724509, 08033151956
5. MEDIPLAN HEALTHCARE LIMITED
Plot 286B, Ajose Adeogun Street
Victoria Island, Lagos.
Abuja: Suite 42-44, God’s Own Plaza
Takun Close, Off Nkwere Street
By Ahmadu Bello Way
Behind Unity House (Rochas Foundation) 01-2611012
01-2614828
08033081650
6. MULTI SHIELD NIGERIA LIMITED
17A Commercial Avenue, Yaba, Lagos
Abuja: Metro Plaza
Suite F18, 1st Floor (Opp. Nat. War College
Central Area, Abuja 01-7737579
01-7910807
09-4619127
09-4619128 Fax
08032916251 (Amana)
7. UNITED HEALTHCARE INTERNATIONAL LIMITED
NICON Plaza, 2nd Floor, Abuja. 08034086095
8. PREMIUM PRIVATE HEALTH TRUST LIMITED
31b, Itafaji Road, Dolphin Estate
Ikoyi, Lagos
Abuja: No. 5B Kabo Street
Garki II Opposite Eddy Vic Hotel
Abuja 01-4614498
08023387494
9. RONSBERGER NIGERIA LIMITED
Plot 359,Mambolo Street, Zone 2, Wuse
District, Abuja 09-5234162
09-6709889
08035053179
(Mr. Ben. Chukwu)
CODE
NAME OF HMO/ADDRESS
TELEPHONE
10. INTERNATIONAL HEALTH MANAGEMENT SERVICE LTD
2, Joseph Street, Off Broad Street, Lagos 01-4736933
11. EXPATCARE HEALTH INTERNATIONAL LIMITED.
39A, Sura Mogaji Street, Off Coker Road, llupeju, Lagos
Abuja Office: IGI House 3, Gwani Street, Wuse Zone 4, Abuja 08055890010, 08055274020
08055890025, 08025240194
08025240418
12. SONGHAI HEALTH TRUST LIMITED.
Ground Floor, Nigeria Re-Insurance Building
Beside Unity Bank, Plot 78a Herbert Macaulay Way, Central Area, Abuja. 09-2223636, 08033571011
13. INTERGRATED HEALTHCARE LIMITED
12 Jos Street, Area3, Garki, Abuja 09-2342199
09-2342299
14. PREMIER MEDICAL LIMITED
Olive House, No. 6/53 Fajuyi Road
Adamasingha, Ibadan
Abuja Office: No. 4 Takum Close
Area 11, Garki, Abuja 01-2410052
08037866956
Steve Auta
08063446465
15. MANAGED HEALTHCARE SERVICES LIMITED
16 Obokun Street, Off Coker Road
IIupeju, P.O Box 641, Oshodi, Lagos
Abuja: 1st Floor Tofa House
Central Business District, Abuja 01-4931629-32
08059705441
08033206673
16. PRINCETON HEALTH GROUP
25, Mogaji-Are Road, Opposite D-Rovans Hotel
Ring Road, P.O. Box 23512, Mapo, Ibadan.
Abuja Office: Plot 1133 Aminu Kano Crescent
Opp. Ihnobe Filling Station
Wuse II, Abuja. 08033219941
08023928579
08034306380 – Olalekan (Abuja)
17. MAAYOIT HEALTHCARE LIMITED
1, IIofa Road, G.R.A, P.O Box 5504
IIorin, Kwara State.
Abuja Office: No. 5 Mahathma Gandhi Street
Off Shehu Shagari Way
Asokoro Extension, Abuja 031-229898
08058026841
09-3145815
08050825957
08023240467
08050825957 Adesuyi P. R.O
18. WISE HEALTH SERVICES LIMITED
Plot 533, Durban, Off Adetokunbo Ademola
09-6723065 09-5238935
01-2623114
09-5238925
09-5238923 (08023355000)
Mr. Ayo Rabiu (o8o36339696)
19. WETLANDS HEALTH SERVICES LIMITED
4TH Street, 4th Block, Elekahja Housing Estate
Port Harcourt, Rivers State
084-750952
771691
08023373103
08033551351, 08050981840
(Praise Jimoh) Abuja
20. ZENITH MEDICARE LIMITED
No. 65 Usuma Street,
Off Gana Street, Maitama
Abuja
09-4133870-1
Fax: 09-4131660
21. DEFENCE HEALTH MANAGEMENT LTD.
No. 4 Ikole Street, Off Gimbiya Street
Area 11, Garki, Abuja.
09-2348096
22.
UNITED COMPREHENSIVE HEALTH MANAGERS LTD.
Suite 40, 24 Old Aba Road, Rumuogba
P.O. Box 6150, Trans Amadi, Port Harcourt, Rivers State
08033419470
08036194392 – Rita (Abuja)
23. HEALTHCARE SECURITY LTD.
3 Kanta Road (Near NNDC), P.O. Box 8318
Kaduna.
Abuja: Bannex Plaza
BPS 6, 750 Aminu Kano Crescent
Wuse II, Abuja 08052745337
08033148050
Augustine Igomu
08055121516
24. STRATEGIC HEALTH PLANNERS CO. LTD.
BK International House
SPC Junction, Murtala Mohammed Highway
P.O Box 3047, Calabar, Cross River State. 08050233249
08037091628
08037871484 Mr. Ezete – Abuja
08055353370
25. ROYAL HEALTH MAINTENANCE SERVICES
24 Wetheral Road, Owerri, Imo State. 08037956689
083-231053
26. AREWA HEALTH MAINTENANCE SERVICES
Plot 645, Alex Ekwueme Street, Jabi, Abuja 09-2908529, 08067184058
09-5231162, 08027128412
27. ZUMA HEALTH TRUST
1235, No. 6 Sapele Street,
Opp. NSMP Quarters, Garki, Abuja. 09-5236159
Dr. C.D. Ali
08033147249
28. MARKAFEMA NIGERIA LTD.
4A Gurara Street
Ibrahim Abacha Estate
Zone 4, Abuja 09-5238945
6725510
08033109117 Dr. Femi Onimole
08054472099
29. PREPAID MEDICAL SERVICES LTD.
9A Ganges Street
Off Alvan Ikoku Way
Ministers Hill, Maitama, Abuja 09-4131225, 4136877, 4138192-3
08023447150, 08060665572
Mr.Lekan Ewenla
08060665572
30. CIGNAET HEALTH LIMITED
15 Admiralty Way
Lekki Phase I, Lagos
Lagos State 01-2706697, 5555603, 5555567
01-2706697 Hon. Jeff
31. FORTECARE LIMITED
303 Nnebisi Road
Asaba Delta State 056-280855, 282157, 282164
08033185341 Dr. Onyia I. Odaniba
08033085205 Valentine – Abuja
32. GTI HEALTHCARE LIMITED
39A Sake Tinubu Street
Victoria Island, Lagos 01-4610266, 2625682, 2625684-5
08034963464 Mr. Martin Chukwu
1. HYGEIA HMO LIMITED
11A Idejo Street, Off Ademola Odeku Street Victoria Island, Lagos. 01-4517071
01 -4617073
08036710207 Adebajo (Abuja)
2. TOTAL HEALTH TRUST LIMITED
2 Marconi Road Palmgrove Estate, Lagos
01-4701813
01-7737150
3. CLEARLINE INTERNATIONAL LIMITED
16 Oyefe Avenue, Off Ikorodu Road,
Savoil B/Stop/Halimark Assurance Plc.
Obanikoro, Lagos. 01-7741092, 4977542
09-675605, 2730839
0806006004
4 HEALTHCARE INTERNATIONAL LIMITED
308A Murtala Mohammed Way, Yaba, Lagos
Abuja Office: 3rd Floor
UACN Commercial Complex
Plot 272/273, Beside Arewa Suites
Central Business District, Abuja. 4739099, 4799099
09-6709099, 6739099
6724509, 08033151956
5. MEDIPLAN HEALTHCARE LIMITED
Plot 286B, Ajose Adeogun Street
Victoria Island, Lagos.
Abuja: Suite 42-44, God’s Own Plaza
Takun Close, Off Nkwere Street
By Ahmadu Bello Way
Behind Unity House (Rochas Foundation) 01-2611012
01-2614828
08033081650
6. MULTI SHIELD NIGERIA LIMITED
17A Commercial Avenue, Yaba, Lagos
Abuja: Metro Plaza
Suite F18, 1st Floor (Opp. Nat. War College
Central Area, Abuja 01-7737579
01-7910807
09-4619127
09-4619128 Fax
08032916251 (Amana)
7. UNITED HEALTHCARE INTERNATIONAL LIMITED
NICON Plaza, 2nd Floor, Abuja. 08034086095
8. PREMIUM PRIVATE HEALTH TRUST LIMITED
31b, Itafaji Road, Dolphin Estate
Ikoyi, Lagos
Abuja: No. 5B Kabo Street
Garki II Opposite Eddy Vic Hotel
Abuja 01-4614498
08023387494
9. RONSBERGER NIGERIA LIMITED
Plot 359,Mambolo Street, Zone 2, Wuse
District, Abuja 09-5234162
09-6709889
08035053179
(Mr. Ben. Chukwu)
CODE
NAME OF HMO/ADDRESS
TELEPHONE
10. INTERNATIONAL HEALTH MANAGEMENT SERVICE LTD
2, Joseph Street, Off Broad Street, Lagos 01-4736933
11. EXPATCARE HEALTH INTERNATIONAL LIMITED.
39A, Sura Mogaji Street, Off Coker Road, llupeju, Lagos
Abuja Office: IGI House 3, Gwani Street, Wuse Zone 4, Abuja 08055890010, 08055274020
08055890025, 08025240194
08025240418
12. SONGHAI HEALTH TRUST LIMITED.
Ground Floor, Nigeria Re-Insurance Building
Beside Unity Bank, Plot 78a Herbert Macaulay Way, Central Area, Abuja. 09-2223636, 08033571011
13. INTERGRATED HEALTHCARE LIMITED
12 Jos Street, Area3, Garki, Abuja 09-2342199
09-2342299
14. PREMIER MEDICAL LIMITED
Olive House, No. 6/53 Fajuyi Road
Adamasingha, Ibadan
Abuja Office: No. 4 Takum Close
Area 11, Garki, Abuja 01-2410052
08037866956
Steve Auta
08063446465
15. MANAGED HEALTHCARE SERVICES LIMITED
16 Obokun Street, Off Coker Road
IIupeju, P.O Box 641, Oshodi, Lagos
Abuja: 1st Floor Tofa House
Central Business District, Abuja 01-4931629-32
08059705441
08033206673
16. PRINCETON HEALTH GROUP
25, Mogaji-Are Road, Opposite D-Rovans Hotel
Ring Road, P.O. Box 23512, Mapo, Ibadan.
Abuja Office: Plot 1133 Aminu Kano Crescent
Opp. Ihnobe Filling Station
Wuse II, Abuja. 08033219941
08023928579
08034306380 – Olalekan (Abuja)
17. MAAYOIT HEALTHCARE LIMITED
1, IIofa Road, G.R.A, P.O Box 5504
IIorin, Kwara State.
Abuja Office: No. 5 Mahathma Gandhi Street
Off Shehu Shagari Way
Asokoro Extension, Abuja 031-229898
08058026841
09-3145815
08050825957
08023240467
08050825957 Adesuyi P. R.O
18. WISE HEALTH SERVICES LIMITED
Plot 533, Durban, Off Adetokunbo Ademola
09-6723065 09-5238935
01-2623114
09-5238925
09-5238923 (08023355000)
Mr. Ayo Rabiu (o8o36339696)
19. WETLANDS HEALTH SERVICES LIMITED
4TH Street, 4th Block, Elekahja Housing Estate
Port Harcourt, Rivers State
084-750952
771691
08023373103
08033551351, 08050981840
(Praise Jimoh) Abuja
20. ZENITH MEDICARE LIMITED
No. 65 Usuma Street,
Off Gana Street, Maitama
Abuja
09-4133870-1
Fax: 09-4131660
21. DEFENCE HEALTH MANAGEMENT LTD.
No. 4 Ikole Street, Off Gimbiya Street
Area 11, Garki, Abuja.
09-2348096
22.
UNITED COMPREHENSIVE HEALTH MANAGERS LTD.
Suite 40, 24 Old Aba Road, Rumuogba
P.O. Box 6150, Trans Amadi, Port Harcourt, Rivers State
08033419470
08036194392 – Rita (Abuja)
23. HEALTHCARE SECURITY LTD.
3 Kanta Road (Near NNDC), P.O. Box 8318
Kaduna.
Abuja: Bannex Plaza
BPS 6, 750 Aminu Kano Crescent
Wuse II, Abuja 08052745337
08033148050
Augustine Igomu
08055121516
24. STRATEGIC HEALTH PLANNERS CO. LTD.
BK International House
SPC Junction, Murtala Mohammed Highway
P.O Box 3047, Calabar, Cross River State. 08050233249
08037091628
08037871484 Mr. Ezete – Abuja
08055353370
25. ROYAL HEALTH MAINTENANCE SERVICES
24 Wetheral Road, Owerri, Imo State. 08037956689
083-231053
26. AREWA HEALTH MAINTENANCE SERVICES
Plot 645, Alex Ekwueme Street, Jabi, Abuja 09-2908529, 08067184058
09-5231162, 08027128412
27. ZUMA HEALTH TRUST
1235, No. 6 Sapele Street,
Opp. NSMP Quarters, Garki, Abuja. 09-5236159
Dr. C.D. Ali
08033147249
28. MARKAFEMA NIGERIA LTD.
4A Gurara Street
Ibrahim Abacha Estate
Zone 4, Abuja 09-5238945
6725510
08033109117 Dr. Femi Onimole
08054472099
29. PREPAID MEDICAL SERVICES LTD.
9A Ganges Street
Off Alvan Ikoku Way
Ministers Hill, Maitama, Abuja 09-4131225, 4136877, 4138192-3
08023447150, 08060665572
Mr.Lekan Ewenla
08060665572
30. CIGNAET HEALTH LIMITED
15 Admiralty Way
Lekki Phase I, Lagos
Lagos State 01-2706697, 5555603, 5555567
01-2706697 Hon. Jeff
31. FORTECARE LIMITED
303 Nnebisi Road
Asaba Delta State 056-280855, 282157, 282164
08033185341 Dr. Onyia I. Odaniba
08033085205 Valentine – Abuja
32. GTI HEALTHCARE LIMITED
39A Sake Tinubu Street
Victoria Island, Lagos 01-4610266, 2625682, 2625684-5
08034963464 Mr. Martin Chukwu
ADDRESS BY THE HONOURABLE MINISTER OF HEALTH , PROFESSOR BABATUNDE OSOTIMEHIN AT HEALTH PARTNERS COORDINATION COMMITTEE MEETING HELD AT THE TRANSCORP
Honourable Minister of National Planning,
Honourable Minister of Foreign Affairs,
Permanent Secretary,
Directors and Members of the Top Management of FMOH,
Chief Executives of Parastatals,
Your Excellencies, Head of International Agencies/Partners,
Members of the Press,
Distinguished Ladies and Gentlemen,
1. It is my pleasure to address you all at this meeting of Health Partners Coordination Committee (HPCC). I welcome you all and I sincerely thank you for honouring our invitation at a very short notice. This is my very first meeting with Development Partners as the Hon. Minister of Health. I am therefore taking this opportunity to introduce myself and the Hon. Minister of State for Health, to you and to kick start our sincere desire to interact more closely with you.
2. As you are all aware, the HPCC is a statutory forum that provides the Federal Ministry of Health and her International partners/donor agencies the opportunity to interact on issues of importance and concern to all stakeholders in the Nigerian Health Sector.
3. This meeting offers me a great opportunity to present the agenda and direction of the Federal Ministry of Health under the new dispensation.
4. It is a well known and indeed an over-flogged statement that the Nigerian health system and the health status of its citizens are poor with overall health system performance struggling in the bottom among member states of the World Health Organization. The reasons for this dismal performance are also well known, and these include:
1. Inadequate stewardship function of government
2. Fragmentation of health service delivery
3. Inadequate, inefficient and inequitable health financing
4. Mal-distribution of health workforce
5. Poor infrastructure in health care delivery system
6. Poorly motivated workforce
7. Inadequate utilization of the private sector and a
8. Health Ministry that is not structured to provide needed leadership and stewardship roles
5. While there have been some efforts in the recent past to address these challenges and to reverse the trend (the most recent being the Health Sector Reform Programme 2004-2007) only very modest achievements have been recorded.
HEALTH MINISTER'S STRATEGIC AGENDA
6. To address the challenges confronting the Nigerian Health system and to lay a foundation for a sustained reform of the system, in line with current and emerging challenges, the new leadership of the Federal Ministry of Health is adopting the following strategic agenda in order the deliver on the Human capital development programme of the president’s 7 point agenda. The overall theme and slogan for this strategy and the fulcrum of the change is “Working Together to Improve Our Health”. The elements of our strategic focus are:
1. Enhancing the Stewardship role of the Ministry:
The Ministry will work hard to change the current perception role of that of service delivery to that which provides the much needed enabling environment and leadership for all stakeholders to contribute to the goals and objectives of the health sector optimally.
2. Revitalize the Health System with Emphasis on Delivery of quality health services through Primary Health Care and strengthen referrals with Secondary and Tertiary Institutions to reduce the disease burden and improve the health status of Nigerians.
The Ministry will work with the new management of NPHCDA to reposition and assist the agency to provide leadership in this regard. On its part, the Ministry will engage in proactive advocacy with all relevant stakeholders, particularly with States ad LGAs, civil societies, communities and agencies on key reform issues of the PHC system in Nigeria.
Given the urgent need to interrupt the wild polio virus in Nigeria and to control measles and other vaccine preventable diseases, the Ministry will lead the concerted efforts of all stakeholders through the NPHCDA, high risk states, LGAs and our development partners to ensure the eradication of the virus in the shortest possible time.
3. Enhancing Financial Resource Mobilization through the expansion of the NHIS and other Public Private Partnership (PPP) arrangements:
It is obvious that the public sector alone cannot adequately finance and deliver health care services. We will explore more vigorously how the public and private sector can share the financing, risks and benefits of projects, initiatives and plans. And because PPP has grown worldwide as a tool for management and financing, we would be calling on your assistance to help build requisite skills of practitioners within the Ministry, to inform them of new capacity building activities such as the exposure to the Global PPP Core Learning Program that the World Bank Institute and other multilateral partners are planning to deliver sometime in 2009. We are ready and willing to explore other available health care financing opportunities. The Ministry has set up a PPP Unit to oversee, promote and monitor all PPP initiatives.
4. Enhancing the Coordinating Role of the Ministry and its interface with states and Local Governments.
There are some significant peculiarities of the health sector that must be addressed for the Ministry to deliver on its mandate. Some past efforts at identifying the problems revealed the Ministry as an institutional arrangement that is inadequate for “management effectiveness, human resource distribution, transparency and efficiency”. The new leadership at the Ministry intends to work sincerely and transparently with all major stakeholders to examine all the past efforts at repositioning the Ministry to deliver on its mandate with a view to making recommendations for effecting the needed changes.
5. Human Resource for Health:
For the Nigerian Health System to provide the much needed improvement in its overall performance, the requisite human resource must be available in the right quantity, mix and distribution. There is a challenge regarding the skewed distribution of the workforce in the urban areas compared to the rural areas, the private sector as against the public and the south more than the north. In this regard, the FMOH has developed a national Human Resource for Health Policy and a national strategic plan to guide its implementation
6. Strategic Information Management and Research:
One of the key weaknesses in the Nigeria’s health system is the lack of data to guide planning, resource mobilization and effective implementation of policies and programmes. A strengthened Health Management Information system is necessary to provide this needed data and the Federal Ministry of Health will take urgent steps to strengthen HMIS.
7. Communication and Public Relation Management:
For the successful implementation of the strategic agenda of the new leadership, it is important to mobilize and galvanize public support for increased personal responsibility for health through utilization of preventive and health promotive services. The media will be crucial in this role. The Ministry will utilize several media to ensure that timely and comprehensive evidence based information about its activities are made available to build broad based understanding of and foster acceptance and support for the new strategic agenda of the Ministry and government programme as a whole.
7. For the avoidance doubts, the above elements of our stewardship over the next 24 months or so are also being worked into the much broader and long-term national strategic health development plan.
National Strategic Health Development (Framework) Plan (NSHDP):
8. You will recall that last year we started the process of developing a costed National Health Investment Plan. At the same time, we were embarking on a parallel initiative, a follow-on program to the Health Sector Reform Program (2003-2007), as the health sector contribution to NEEDS2, this was just before NEEDS2 was re-christened by Government as the National Development Plan (NDP). The 2 initiatives: Health Investment Plan; and the Health Sector/NEEDS2 initiatives have now been harmonized into the preparation a National Strategic Health Development Framework and Plan (NHSDP) process that us being lead by the Federal Ministry of Health working with all the States, development partners, non-state actors, etc… This process is currently being managed via the Health Systems Forum in which most of you have been participating.
9. The NSHDP is aimed at ONE single country health plan; ONE single results framework; ONE single policy matrix; ONE costed plan that will be the basis for funding; ONE single mutual monitoring and reporting process; ONE single country-based appraisal and validation process for country health plan; ONE single fiduciary framework; Benchmarks for Government performance, Benchmarks for development partner performance; agreement on aid modalities; and process for resolution of non-performance and disputes. These are the cross-cutting principles of the IHP+ built on the Paris Declaration on Aids Effectiveness.
10. A series of processes to develop the NSHDP will culminate in a framework that will guide the states and LGAs in developing their own plans, with assistance from partners working at the State level. We will make a presentation at this meeting on the process steps towards producing the NSHD framework and related plans at Federal and State levels.
11. The NSHDP is indeed for us, a call to action, and in working together to meet the goals of our national health systems. We recognize that mobilizing additional resources in these times is a major challenge…but that is precisely the reason why the development of the NSHDP becomes even more urgent. We are therefore calling on you to identify with this process and make commitments accordingly to take the process to its logical conclusion. When finalized, the document will serve as the country level compact that commits development partners and government to support one results-based National Health Plan, in a harmonized and aligned way, and improve resource mobilization and outcome through ensuring a predictable long-term financing. At the end we will have a product that we have jointly developed and jointly owned.
International Health Partnership +Related Initiatives:
12. As you are all aware, the IHP+ is a Country-led and Country-driven initiative that calls for all signatories to accelerate action in order to scale-up coverage and use of health services and to deliver improved outcomes against the Health-MDGs as well as honour commitments to improve universal access to health. The process calls for pooling of expertise and resources to drive the initiative, especially for aids effectiveness.
13. As you are also aware, countries that signed up to IHP+ are committed to developing “Country Compacts” with International development partners. These compacts are expected to result in: increased focus of national resources for health and AIDS strategies and plans on health-related MDGs; improved harmonization and alignment of aid; and in long term predictable financing.
14. Nigeria signed unto membership of the IHP+ in May 2008 during the 61st Session of the World Health Assembly in Geneva. In the process, Nigeria committed to addressing Health Systems bottlenecks in the country. Under the leadership of the Federal Ministry of Health, we have worked with our partners to re-conceptualize the National Strategic Health Development Plan, which will serve as the reference context for IHP+ compacts.
15. However, and more importantly is the challenge that we now face in the midst of financial crisis – how do we rise up to the challenges of making and delivery on financial commitments. It is a common knowledge that our national budget is facing unprecedented challenges as we struggle through a combined global financial crisis and more particularly the instability in oil revenues.
16. We recognize that domestic funding should make a significant contribution in meeting the challenges for Health-MDGs. Thus, the Government has steadily improved on its funding support for Health-MDGs in recent years: =N=15 Billion in 2007; =N=17 Billion in 2008; and =N=22.5 Billion proposed for 2009. We are internally challenged by issues of efficiency and in spending wisely…and we are thus looking for technical assistance in this regards, especially in building capacity for proper costing for Health-MDGs, and in innovative mechanisms that offer tremendous potential to save lives through new and creative solutions. Domestic funding alone is unlikely to meet all the challenges of funding Health-MDGs. We also remain concerned on whether or not we are making real progress in terms of the indicators.
17. Arguably, the greatest burden of disease in Nigeria is attributable to the index diseases of HIV/AIDS, Malaria, and Tuberculosis (ATM), and the diseases are at the heart the Health-MDGs Global compact. As mentioned above, the level of resources, both from within and external, to fight these diseases has increased steadily. However, the national response remains complex and confusing with multiple overlaps and poor coordination. Progress has been very slow. We certainly can do far more, and we intend to do so. For this reason, a Task Force on ATM has been established, under my direct supervision, as part of a renewed spirited effort to ensure visible progress on Health-MDGs.
18. Membership of the Task Force are drawn from the Federal Ministry Health, other Federal Ministries (National Planning, Ministry of Finance/Budget Office), and representative of States MOHs, members from Cooperating Partners active in ATM, representatives from Civil Society, and representatives from private sector bodies. The Committee has focal point persons from the Federal Ministry of Health to assist in both technical and administrative work of the Committee. The Hon. Minister of Health shall be the Chairman, with the Hon. Minister of State for Health serving as Alternate Chairman and Member of the Committee.
1. The Terms of Reference (TORs) includes: to take responsibility for the development and overall performance in the implementation of a coordinated ATM plan of action in meeting established Key Performance Indicators (KPIs) for ATM;
2. Develop and use a common validation/appraisal framework for planning and implementing ATM activities, with a strong M&E component.
3. Discuss and approve allocation of resources and related expenditures
4. Identify the bottlenecks that prevent the fulfillment of commitments and identify national level action that is required to address these bottlenecks
5. Make recommendations for focus of activities in ATM
6. Review existing programmes and activities to determine which ones should be continued, modified and, where necessary, suggest new programmes and activities
7. Ensure that development assistance for ATM implementation is in full compliance with the principles of Paris Declaration on Aids Effectiveness and the Accra Agenda for Action and the IHP+ principles...
8. Identify institutional, legal and administrative frameworks for effective and efficient implementation of ATM programmes and activities.
9. Where necessary, establish specialized technical sub-committees to work on specific areas of concern.
10. Establish a secretariat to be responsible for the preparation of working papers for endorsement by the Task Force, at least 7 days before the date of the Task Force meeting. The secretariat shall include ATM Program Managers a representative of cooperating partners.
11. The Task Force shall meet at least once a month, in the first instance, and thereafter quarterly. Ad hoc and/or Emergency Meetings may be called by the Chairman as deemed necessary. However, technical working groups which may be established will meet on a more frequent basis. Further, the Task Force shall participate in an annual Health Sector National Conference.
19. The Task Force will have its first inaugural meeting next week, and further details will be shared in due course.
20. With regards to mitigating the likely impacts of the twin forces of global financial crisis and dwindling oil revenues on the health sector, we are looking for ways and means of handling this, and we are counting on you for innovative approaches. In this particular regards, I want to solicit your understanding in permitting fiscal space for flexible response within your respective framework of engagements, to take cognizance of these unexpected worsening global financial crisis. I believe we may need to re-prioritize areas of technical and financial assistance to the health sector within existing support programs.
21. We have a secretariat within the Ministry to anchor the IHP+ activities. In addition as will be shown in the NSHDP presentation, I will soon re-inaugurate a single Technical Working Group that would serve as the Country Health Sector (strategy development) Team. The Ministry, through my predecessor had earlier committed to review some of the existing structures such as the HPCC and the HSF and Health Recipients Forum and align these with the IHP+ implementation processes. We shall soon prepare and share a draft concept paper on a Coordinating Mechanism for the health sector.
22. For us in the Federal Ministry of Health, will push to sign a compact with our partners, starting with the development of the NSHDP to which I urge you to support and fund the process agenda that will provide the mechanism and road map and context for follow-on compacts for delivering on results.
23. Like many other countries, we are opened to work with our partners to deepen our understanding and domestication of the IHP+ process to avoid setting up confusing institutions and structures. We believe that the IHP+ is not a project but ways of working together to deliver results together. We believe that there is a large scope for us to improve on aids effectiveness in Nigeria. In addition we need to begin to work now to anticipate how we shall respond to the country compact process once the NSHDP is finalized and ready for implementation. I will welcome concept papers on this issue. I will also want to urge you to begin to anticipate and think how to harmonize your assistance with the NSHDP, in terms of what needs to change and how, and also including your expectations from us on improving country systems.
24. Finally, because the NSHDP holds the key for implementing the change-management process for aids effectiveness that the IHP+ stands for, it may appear too early for us to assess IHP+ impact in the Nigeria health sector. But I want to say that our joint articulation of the NSHD process agenda so far is itself an achievement. And I am confident as the actual plans documents at Federal and State levels are completed, momentum will be poised for greater success.
25. We intend to attend the International Health Partners (IHP+) meeting coming up in Geneva from 4-5 February 2009. We shall use that opportunity to explore further how to rise to the challenges of country compact mechanisms in the face of the global financial crisis.
26. In conclusion, ladies and gentlemen, I wish to note that this forum is of great value and it should continue to hold quarterly, more so since we are going to be using it to monitor and review the implementation of the NSHDP and our joint monitoring exercises. Honourable Minister of state, permanent secretary, your Excellencies, distinguished Ladies and gentlemen, I thank you all for your attention.
Professor Babatunde Osotimehin, OON
Hon. Minister of Health
January 30, 2009
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