Health Sector Reform in Jigawa State

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Muhammad Badaru Abubakar, Health Sector, Reform, Jigawa State
Jigawa State governor, Muhammad Badaru Abubakar

Health Sector Reform in Jigawa State

By Bala Chamo

Prudence, it was said, is a kind virtue that wards off many a calamity. Governor Badaru’s meticulous and judicious financing of laudable health projects and initiatives in Jigawa is worthy of emulation and commendation. No wonder he has a sobriquet ‘mai calculator’ – ‘the calculatorist’ by the good people of Jigawa state.

At the inception of Governor Muhammad Badaru’s government in 2015, Jigawa state’s health sector was bedeviled with dilapidated infrastructure, lack of hospital equipment, non-availability of some essential drugs at health facility level and absence of sustainable initiatives and health policies to secure the health of the citizens.

A commendable initiative taken by the government immediately was the adoption of Family and Youth Health Initiative. Under this enterprise, secondary schools were targeted, focusing on the future and the backbone of the state manpower – the youths. Sporting facilities were supplied to science schools to guide the students on hygiene and to confirm the maxim ‘sound body is sound mind’. Another initiative was the Society for Family Health, which treated students with low vision by issuing them eye-glasses.

This was under the programme of neglected tropical disease and for the purpose of carrying along those with special needs among the students. Another significant initiative was granting hospitals greater autonomy to carry out their functions. This has been part of the health reform agenda that His Excellency Governor Muhammadu Badaru’s administration embraced, The Ministry of health was likewise restructured to conform to the scheme of service in line with national civil service reform guidelines.

Furthermore, to have a healthy populace, the National Nutrition Policy ensured the implementation of the policy on compulsory HIV counselling and testing before marriage. In addition, other policy frameworks include the State Contributory Health Insurance scheme, which became operational in 2020.  Also, in an effort to contribute to the achievement of universal health coverage in the State, Governor Badaru’s administration established the Jigawa State Contributory Health Management Agency.

The agency is mandated to implement the State Health Insurance Scheme and serve as a key pathway for accessing the Basic Healthcare Provision Fund in the State.

An Executive Secretary and six (6) directors were appointed to run the Agency, which has since began enrolment of Civil Servants into the scheme and also commenced the identification and accreditation of service provision points across the State. To sum it up all, Sector Strategy and Operational Plans were reviewed and updated. The sector also contributed to the review and update of the State Poverty Reduction Strategy Paper, the Comprehensive Development Framework (CDF) II. Prior to 2015, the health sector was fairly funded but the funding did not translate to quality service delivery. There were no strategies for sustainable health care financing, which could withstand external shocks. Overall, Public Finance Management (PFM) was not optimal in the sector.

At the inception of his administration, Governor Badaru saw the need to reach more people with free maternal and child health services. Government leveraged on the Federal Ministry of Health/ World Bank funding, the Saving One Million Lives (SOML) Programme for Results to improve funding to the sector.  The state received and utilised judiciously $5.6Million Save One Million Lives (SOML) Performance for results grant from Federal Ministry of Health and World Bank Officials

Apart from instituting laudable and sustainable health initiatives, the government of Muhammad Badaru also ensured provision of essential drugs to the much needed populace of the state. The Jigawa Drug Management Agency (JIDMA) and domestication of National Task shifting and Task Sharing policy have been the major instruments for transforming the health status of the people in the state. Despite having Jigawa Medical Supply Company (JIMSCO), health facilities were challenged with insufficient stock of key tracer drugs. But the government of Muhammad Badaru confronted the challenge by introducing a youth empowerment programme, in which indigenes with health related certificates were supported with drugs seed stock to start patent medicine business. This gesture has dual purposes: the first was to increase access to quality drugs and the second was job creation. This experiment with JIMSCO has been a success story all along. Six (6) Health Facilities across the state also received Top Up from JIMSO and it recorded a turnover of ₦1.215 billion from ₦586 million in 2015. Moreover, it has a Capitalization of   ₦367 million from previous ₦272 million in 2015.

Despite the plethora of health service outlets in the state (over 600) in 2015, access was still limited, quality of services and management were poor and health ethics were not adhered to. The government of Muhammadu Badaru took deliberate step to overcome these challenges. The first step was decentralization of decision-making. The second step was improved financing, which resulted in greater autonomy and improved efficiency.

The number of Health Facilities (HFs) offering Free Maternal, New-born and Child Health (MNCH) Services in 2015 was only 22. But by 2020 the number rose to 160 under the watch of Governor Muhammad Badaru.

The margin is really wide. As Bill and Melinda foundation espoused, MNCH is an integrated continuum of care that delivers tools and treatments to mothers and their infants at critical points, and to the children in their first five years of life. Furthermore, the number of DRF Facilities (Capitalized) as at 2015 stood at 647, but by 2020 that also rose to 682. There was virtually no capitalised Lafiya Jari Shops in 2015, yet by 2020, Badaru established 221

No aspect of health sector in the state has been as glaringly improved as the infrastructure. This is obvious because structures are visible for both the political pundits and well-wishers to assess and comment. As noted, upon inception in 2015 the government met very deplorable health facilities in the state.  Hospitals had inadequate bed spaces, diagnostic centers and specialized clinics.

There were no sustainable water and electricity supplies and basic equipment such as operating table, patient beds and trolleys were lacking. Governor Badaru swiftly went into action. From 2015 to date, he has awarded contracts for infrastructural development in the health sector to the tune of ₦12,902,151,431.18. This was meant to improve health infrastructure across the state. Governor Muhammadu Badaru was able to achieve successes largely due to his financial discipline and prudence in managing public funds. His Healthcare financing should be a model for other states, especially in the North West region that share the same challenges.

At the time of inception of Governor Badaru’s administration, there were only 24 Health facilities offering 24 hour service in Jigawa state. By 2020, however, 150 were fully functional 24/7. There is no better aspect of human capital that should be enhanced more than the health sector. This is because nothing goes without health. Governor Badaru realised this right from inception of his administration and he deserves kudos for that.

Chamo writes from Dutse

 

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