Sunday, July 15, 2012

Ondo to inaugurate N6bn medical village, meets MDGs’ targets on maternal, child health

As part of efforts to make qualitative healthcare affordable and accessible to inhabitants of Ondo State, the state government under the leadership of Governor Olusegun Mimiko plans to inaugurate a N6 billion modern Medical Village along Laje Road, Ondo West Local Council.

The Medical Village, which comprises of a 100-bed Mother and Child Hospital, Gani Fawehinmi Diagnostic Centre, Trauma Centre; General Hospital, Call Centre, Emergency Medical Services (EMS) Hospital, Heliport, staff quarters, staff school, shopping mall, and sports centre, is set to be opened to the public before month end.

The diagnostic centre with state-of-the-art medical equipment such as Magnetic Resonance Imaging (MRI), CT Scan, mammogram, auto analyzer, among others, and named after the late human rights activist and lawyer, Gani Fawehinmi, has been functional since February 2011.

Commissioner of Health, Dr. Dayo Adeyanju, at a recent media tour of health facilities in the state said Mimiko was motivated to set up the Medical Village because of the success the state recorded with the Abiye safe motherhood project in reducing maternal mortality ratio by 15 per cent in one year, between 2009 and 2010.

Adeyanju told reporters that the state is poised to set the pace in achieving the Millennium Development Goals (MDGs) 4 and 5 by reducing child and maternal mortality in the state by 67 per cent and 75 per cent by 2015.

The World Bank had in 2008 before the advent of Mimiko’s administration declared Ondo State as having the worst maternal and child health indices in the South West zone.

Adeyanju said the Abiye safe motherhood project, partly sponsored by the World Bank was launched in October 2009 and piloted in Ifedore Local Council with a mandate to develop sustainable, equity-based healthcare services that will provide universal access to the people.

The Health Commissioner said the Abiye project was a bold paradigm shift from what obtained previously because it sought to bring qualitative and effective services to people where they live, work and play.

He said healthcare service in Ondo State especially at the Mother and Child Hospitals under the Abiye safe motherhood programme is free for pregnant women, children under five, and elders above 70 years.

Adeyanju said: “The entire Medical Village costs a whole lot. The trauma centre alone is almost N4 billion. The Mother and Child is close to N700 million. Then Gani Fawehinmi Diagnostic Centre is another N700 million…For us in Ondo State this year, our budgetary provision for health is N8.9 billion. When you look at that against the total budget, we have not even achieved the World Health Organisation (WHO) recommendation of 15 per cent for health budget, which explains the reason why there is a lot out-of-pocket expenditure for health. That means if you and I fall sick, we will still have to pay from our pocket because government provision is not adequate.”

Medical Director of the Mother and Child Hospital, Akure (MCHA), Dr. Lawal Oyeneyin, said a baseline survey before the Abiye project was instituted showed among other things that only about 16 per cent of pregnant women who register at the public health facilities come back to deliver there.

To address the anomaly, Oyeneyin said the state started voluntary registration of all pregnant women in the locality.

He said the MCHA was set up as part of the strategies of the Abiye safe motherhood project to address the phases of delay contributing to maternal and child deaths in Ondo State and factors militating against achieving the MDGs 4 and 5.

The medical director said the MCHA was commissioned to mark the first year anniversary of the Mimiko administration on February 27, 2010 as the premier purpose-built state-of-the-art, 100-bed facility dedicated to the care of pregnant women and children less than five years of age, offering free tertiary level health services.

He said that having recognised the four phases of delay predisposing to maternal and child death, strategies were then instituted against each one.

The medical director said the delay in seeking qualitative care when complications arise was addressed by assigning each of the 50 health rangers that trained community health extension workers to track at least 25 registered pregnant women till delivery even if it meant visiting them in their homes. He said to facilitate communication, individual mobile phones on a toll free caller-user group platform were provided for the pregnant women and their care-givers.

Oyeneyin said the delay in reaching care when decisions are taken to seek care was addressed by equipping each ranger and health facility with means of vehicular movement and evacuation of patients ranging from customized motorcycles to tricycle and four-wheel ambulances and speedboat ambulances for riverine areas.

To overcome the delay in receiving care on arrival at a health facility, the medical director said 11 new health facilities were constructed and five existing ones were renovated; and all were optimally equipped and appropriately manned with healthcare professionals trained on safe delivery practices.

The delay in referring care from where it is initiated to where it can be continued or completed, according to Oyeneyin, was tackled by putting in place a functional two-way referral system with the construction of an apex tertiary care facility, the MCHA, to be able to attend complicated cases referred from the basic and comprehensive health centres as well as from the general hospitals, free of charge.

The Health Commissioner further stated: “Why we are investing hugely in the Medical Village is because in one year of operation of the Abiye and Mother and Child Hospital, we succeeded in reducing maternal mortality (MM) by 15 per cent between 2009 and 2010.

“So if you reduce by 15 per cent in one year that means by 2015 when we will be reviewing the MDGs, we must have reduced MM by 75 per cent. I might sound boastful but let me be modest: We will achieve the MDGs in Ondo State. It is unfortunate that they said Nigeria is among 40 countries that will not achieve MDGs. But we will be the saving grace for Nigeria because when we achieve MDGs, Nigeria has achieved MDG as far as we are concerned.

“In one year we registered 1,217 pregnant women and we have additional 2,600 registrations. Within this period, one patient died. The patient did not register with us but came in during labour. But we considered that as part of our statistics because mandatorily in Ondo State, there is what we call confidential enquiry into maternal death. You must report all cases of maternal death because it will enable us to track the number, and two, for better planning and policy formulation.”

Adeyanju further explained: “When the governor assumed office, he met ill-motivated workforce, poor infrastructure, poorly managed health sector; generally, very poor health indices. You will understand from the perspective here that Mimiko, being a medical doctor, had been a two-time commissioner for health in Ondo State, as a result, it is expected that he will do everything possible to revamp the health sector.

“So, he made a promise that he will provide exceptionally qualitative health care for the good people of Ondo State where they live, where they work and where they play…For maternal mortality and under-five mortality, they form the vulnerable group.

“Our investment in this category of people is deliberate, which is basically to improve the human development index.

“In Ondo State we know that there is usually the rural/urban disparity in terms of maternal mortality and under-five mortality. Sometimes the disease burden is in the rural area but the facilities are usually located at the urban centres, which informed the fact that when we wanted to reform our healthcare we took off from the Primary Health Care (PHC) angle.

“Besides the fact that the governor himself is a grass root man, he understands quite clearly that we must go to the rural area, which was why we launched the Abiye Safe Motherhood programme. Abiye literarily means safe motherhood, making pregnancy safe. It is a Yoruba word that says when you go in, you come back safely, when you are pregnant you deliver safely. But beyond that, Abiye is a wish, it is prayer in the sense that we must reverse the totally unacceptable but ever increasing maternal mortality.”

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