By Progress Godfrey, Abuja
The National Surgical, Obstetrics, Anaesthesia and Nursing Plan (NSOANP) and Cleft Care Stakeholders, having identified implementation gaps and unresolved issues, have made recommendations to better improve service delivery in the NSOANP coverage.
The recommendations were contained in a communique issued after an exhaustive two-day stakeholders’ forum held in Abuja from 30th November – 1st December 2022, with 70 participants including representatives from the Federal Ministry of Health (FMoH), Smile Train, Health Associations & Regulatory Bodies and other stakeholders of the health sector.
The Forum commenced with a Welcome Address from the Director, Hospital Services represented by Dr. Abisola Adegoke, Head, Federal Medical Centres Division. In her address, she reiterated the origin of the NSOANP, outlined its pillars as well as highlighted several implementation activities of the NSOANP. She recalled the last meeting of the forum which gave rise to several recommendations and concluded by expressing optimism about positive outcomes of the second forum.
In her goodwill message, Mrs Nkeiruka Obi, Vice President and Regional Director Africa, Smile Train started by quoting Maya Angelou as saying, “one is not necessarily born with courage, but one is born with potential. Without courage, we cannot practice any other virtue with consistency.” She intimated that it is the power of consistency that is driving the implementation of NSOANP and commended participants for their commitment so far and stated that NSOANP implementation has become a flagship programme in Africa with Nigeria taking the lead.
She appreciated the NSOANP Team (comprising the Development Partners, Implementation Committee and other Stakeholders) and the FMoH for taking the leadership position and ensuring that NSOANP works and restated Nigeria’s recognition at the SOA Conference in Dakar, Senegal. She concluded by reassuring the commitment of Smile Train and appealed for the continued efforts of participants during the conference and beyond, towards the furtherance of the implementation of NSOANP.
A part of the recommendation on children’s surgery as contained in the communique, reads thus: “Establishment of one Children’s Hospital in each Geopolitical Zone, comprehensive children’s insurance (wide paediatric surgeries coverage). First Ladies of States can be encouraged to advocate for children’s surgery.” The communique also recommended the strengthening of the referral system as well as geographical mapping; toll-free numbers, effective networking between hospitals and community health education through churches and mosques among others.
The communique noted the need to stem the tide of migration of Nigeria’s health workforce through adequate legislation and review of incentives for the health workforce, adding that the process for replacement/recruitment of health workforce through approval of waivers by the Head of Civil Service of the Federation (HCSF) should be smoothened to fill the gaps created by the migration of workforce.
Also advocated for in the communique, is the need to solicit funding from Government’s counterparts for partner-supported projects/programmes to ensure sustainability as well as a need for proper integration of the NSOANP into the National Health Act for better coverage and implementation.
“Need for improved collaboration of the FMoH with the Federal Ministry of Finance and other relevant MDAs in relation to obtaining import duty waivers for donated medical equipment/devices. FMoH and State Ministries of Health (SMoH) to improve infrastructure as well as recruit adequate workforce.”
The communique further stated the need for prompt actions to strengthen the workforce, improve training and service delivery: “Healthcare providers should be encouraged to support neighboring centres to treat more cases for value creation. Hospitals collaboration for the purpose of accreditations for training, incentives – rare allowance vs. pay according to caseloads and the development of the NSOANP training curriculum should be concluded in reasonable timeframe for prompt implementation.
“FMoH should intensify efforts to improve service delivery vis a vis work attitude of the workforce in Government Hospitals across boards.”
Additional recommendations in the communique hammered on infrastructure; the need to consult with end users for effective and efficient structural and architectural design, provision of regular power supply and alternatives such as solar panels, inverters and generators as backups in areas of critical care. Also the adoption of innovative methods of health financing – taxing products that can affect health: tobacco products, alcohol, petroleum products, coke.
More recommendations on information and research metrics according to the communique, read thus: “Expand the e-Registry to cover other areas of surgery, intensify collaboration between NSOANP and NHIMS with a view of synchronizing health data nationally, improve access to scientific journals through sponsorship to aid subscription like TETfund or FMoH, encouragement of diaspora engagement and partnership and also the need to invest in developing research capacity such as advocacy and collaboration between NSOANP, DHPRS, Management of FMoH, TETFUND and other potential sponsors.”