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FEDERAL MINISTRY OF HEALTH
MID-TERM REPORT OF ACHIEVEMENTS OF THE
DR. GOODLUCK EBELE JONATHAN’S ADMINISTRATION
PRESENTED BY
Prof. C. O. Onyebuchi Chukwu
Honourable Minister of Health
AT THE
MINISTERIAL PLATFORM
THURSDAY, JUNE,13,
2013
+
+
His Excellency,
Arc. Mohammed Namadi Sambo, GCON
Vice President, Federal Republic of Nigeria
+
Prof. C. O. Onyebuchi Chukwu
Minister of Health
Federal Republic of Nigeria
+
Dr. Muhammad Ali Pate
Minister of State for Health
Federal Republic of Nigeria
+
Mrs. F. B. A. Bamidele
Permanent Secretary, Health
Federal Republic of Nigeria
+
Presentation Outline
• Mandate of the Ministry
– Vision
– Mission
• Mr. President’s Transformation Agenda in the
Health Sector
• Achievements
• Our Performance Contract
• Conclusion
+
Mandate of the Ministry
 To
formulate, disseminate, promote, implement,
monitor and evaluate health policies of the
Federal Government of Nigeria.
 Using the National Council on Health (NCH), the
Ministry leads States and Local Governments, the
Private Sector and Civil Society Organisations in
formulating health policies. It is the coordinating
body of the Federal Government on issues of
health.
 The Honourable Minister of Health is the Chairman
of NCH
+
Vision and Mission Statement
To develop and implement policies that
strengthen the national health system for
effective, efficient, accessible and affordable delivery of
health services in partnership with other stakeholders.
A world-class government institution that
ensures a healthy Nigeria
VISION
MISSION
+
Core Values of Federal Ministry of
Health
 Excellence
 Competence
 Integrity
 Diligence
 Innovation
 Accountability
 Equity
 Teamwork
+The Transformation Agenda in the Health Sector.
 Improved health outcomes in the country are critical to
the achievement of our national vision of being one of
the twenty foremost industrialised nations by the year
2020 and the Transformation Agenda of Mr. President
 Mr. President, Dr. Goodluck Ebele Jonathan GCFR, has
made health one of his priorities: the Minster of Health
and the Minister of State for Health are members of the
National Economic Management Team (NEMT).
 The National Strategic Health Development Plan (2010-
2015) approved by the FEC in December 2010 is
aligned with National Vision 20:2020 and is the
roadmap for Mr. President’s Transformation Agenda in
the Health Sector.
+
STRUCTURE OF THE MINISTRY
 The Ministry provides oversight for the three tiers
of national health delivery system in general but
has specific control over departments and
agencies under it.
 There are eight (8) Departments, five (5)
Agencies/Research Institutes, twenty (20)
Teaching Hospitals, twenty three (23) Federal
Medical Centres, fourteen (14) Specialist
Hospitals/Centres, fourteen (14) Health
Professional Regulatory Bodies, and seventeen
(17) Health Professional Training Institutions.
+
Our Activities
 The activities of Federal Ministry of Health and its
agencies from 29th May, 2011 to date are guided
by a number of instruments which include the
constitution of the Federal Republic of
Nigeria, 1999, the National Health
Policy, Nigerian Vision 20:2020, the 1st National
Implementation Plan of Vision 20:2020, the
National Strategic Health Development Plan
(NSHDP), annual budgetary
appropriations, international declarations and
commitments and the Action Push Agenda.
+ NSHDP and ACTION PUSH Agenda
Eight NSHDP Priority
Areas
Six Pillars of the
Action Push Agenda
Six core Values of the
Action Push Agenda
Leadership and
Governance for Health
Action Accountability
Health Service Delivery Continuity Consistency
Human Resources for
Health
Teamwork Transparency
Financing for Health Innovation Integrity
National Health
Management Information
System
Outreach Order
Partnerships for Health Networking Nigeria
Community Participation
and Ownership
Research for Health
+ RECENT INITIATIVES FOR TRANSFORMING
THE HEALTH SECTOR
• Millennium Development
Goals
• Refurbishing /modernization of
federal tertiary hospitals
Project
• The National Strategic Health
Development Plan
• The Action Push Agenda
• Midwives Service Scheme
• Introduction of new vaccines
• SURE-P Health Programme
• Saving One Million Lives
Initiative
• Community Based Social
Health Insurance
 Reintroduction of overseas
component of the Residency
training abroad
 New technologies for fighting
counterfeit medical products
 Nigeria Centre for Disease
Control
 National Oral Health Policy
 National Drug distribution
Policy and Guidelines
 National Pharmaco-Vigillance
Policy
 Performance Contracts
+ACHIEVEMENTS/SUCCESS STORIES
These are categorized based on the eight priority
areas of the National Strategic Health Development
Plan:
• Leadership and Governance
• Health Service Delivery
• Human Resources for Health
• Financing for Health
• Health Management Information System
• Partnership for Health
• Community Participation and Ownership
• Research for Health
+ LEADERSHIP AND GOVERNANCE
 Mr. President is Co-Chairing the UN Commission on Life
Saving Commodities for Women and Children’s Health
 The federal health budget is based on NSHDP;
 The 2012 Appropriation is based on the NSHDP;
 Completion of the 2010 and 2011 Joint Annual Review
(JAR) respectively;
 Stoppage of use of conventional syringes and change to
auto-disable syringes by all Federal Tertiary Institutions,
 The Federal Executive Council (FEC) approved the
National Policy on Oral Health; and
 Membership of WHO, PMNCH
+
 International Positions in Health
 First VP 64th WHA
 Chairman 60th WHO RCA
 Chairman ECOWAS Ministers of Health,2011
 Chairman Conference of AU Ministers of Health
2013-2015.
Board Positions Occupied by Nigeria
 WHO Executive Board
 Partnership for Maternal and Child Health
 The Global Fund to fight HIV/AIDS,
Tuberculosis and Malaria
LEADERSHIP AND GOVERNANCE
+
The Federal government has put in place Policies and
Guidelines for improved health care delivery:
 National Oral Health Policy and Appointment of
Senate President as National Champion and
eminent personalities as State Ambassadors on Oral
Health
 National Pharmacovigilance Policy
 National Drug Distribution Policy and Guidelines
 Neglected Tropical Diseases Master Plan
LEADERSHIP AND GOVERNANCE
+
The Ministry is also working with the relevant agencies to enact
/review the following legislations:
 National Health Bill
 Anti-Tobacco Bill
 NAFDAC Act
 National Health Insurance Scheme Act
 Nigeria championed the 65th WHA resolution on
Substandard/Spurious/Falsely Labelled/Falsified/ Counterfeit
Medical Products
LEADERSHIP AND GOVERNANCE
+ Other notable achievements include
 Nigeria sponsored WHO resolution on counterfeit
drugs which was adopted at the 65th WHA
 Completion of the work of the Presidential
Committee on a harmonious working relationship in
the Health Sector and presentation of its Report to
FEC
+
 Re-introduction of the Overseas component of the
Residency Training Programme and Overseas
refresher courses for our young consultants and other
health professionals in different specialties. Sixty (60)
resident doctors and young consultants benefitted
from this programme in 2012
 Conducted 2 National Council on Health Meetings and
2 pre-NCH meetings
Other notable achievements include:
+  Clinical Governance: institutionalized the clinical
governance system within the Federal Tertiary Health
Facilities so that patients receive qualitative health
care services
 Revitalistion of SERVICOM at the FMOH and all our
Parastatals to improve quality of service
 Signing of Performance Contract with FMOH Heads
of Departments and Agencies as a follow up to the
Performance Contract we signed with Mr. President.
This occasion took place on 9th October, 2012.
+2. HEALTH SERVICE DELIVERY
 Infrastructural Development;
 Medical Services
 Disease Control;
 Maternal, Newborn and Child Health
 Elimination of Sub Standard, Fake and Counterfeit
Drugs;
 Strategies to reduce outward medical tourism
+ INFRASTRUCTURAL DEVELOPMENT
 Rehabilitation and equipping of Obafemi Awolowo
University Teaching Hospital, Ile-Ife and the University
of Benin Teaching Hospital are completed, and
awaiting Presidential commissioning, while Nnamdi
Azikwe University Teaching Hospital and the
University of Calabar Teaching Hospital have reached
significant stages of completion (80%).
 Establishment of National Trauma Centres in the
University of Abuja Teaching Hospital and the National
Hospital Abuja. Both are nearing completion
+ INFRASTRUCTURAL DEVELOPMENT
• Federal Staff Hospital, Jabi, Abuja - The Ministry in collaboration
with the Chinese Government completed and equipped the
permanent site for the Federal Staff Hospital in Abuja. The hospital
was commissioned by the President on 28th January, 2013.
• NIPRD main administrative and laboratory building completed
• Acquired property t o house the administrative headquarters of the
Medical Laboratory Science Council of Nigeria and the Nigeria
Centre for Disease Control respectively
 Commissioned various projects in Federal Tertiary Hospitals across
the country and other completed projects awaiting commissioning.
 Completion of the Public Health Quality Assurance/Reagent Control
Laboratory of the Medical Laboratory Science Council of Nigeria
(located in Yaba Lagos and awaiting commissioning)
+ Pre-commissioning visit to
Federal Staff Hospital
The VP who represented Mr. President
commissioning the Permanent Site,
Federal Staff Hospital, Abuja
+
Other Commissioned Projects
 Federal Neuro Psychiatric Hospital, Kaduna
(Commissioned a new Male Medical Ward,
New Female Medical Ward, Laboratory Block,
Child and Adolescent building, reconstructed
Female Ward, Medical Library and
Occupational Therapy Complex).
 Federal Neuro Psychiatric Hospital, Calabar
(Commissioned the new Medical Block and
the rehabilitated Occupational Therapy Unit).
 Federal Medical Centre, Makurdi ( Projects
completed and awaiting commissioning (
Intensive Care Centre, Laboratory Block, Male
& Female Surgical Wards, Laboratory Block at
Outreach Centre, Male and Female Wards at
Outreach Centre and Assorted Medical
Theatre Equipment).
 Federal Medical Centre, Gombe
(Expanded and equipped Accident and
Emergency unit, completed the
construction of Sickel Cell Centre and the
Male Oncology Ward.
 The opening of a dedicated ward for
haematology and haemato-oncology and
the introduction of CCTV assisted
monitoring in the burns and plastic
surgery intensive care unit at the
University of Benin Teaching Hospital.
 New Respiratory Intensive Care Unit
(Avian Flu and other viral diseases) at
University of Abuja Teaching Hospital,
Gwagwalada.
+ Abubakar Tafawa Balewa
University Teaching Hospital
Commissioned Admin.
Block, ATBUTH, Bauchi
Special Baby Intensive Care
Unit, ATBUTH, Bauchi.
+
University College Hospital, Ibadan
(Commissioned New Cardiac Unit)
HMH inspecting newly installed equipment at
the CAT-Lab, UCH, Ibadan.
Newly installed equipment at the CAT-
Lab, UCH, Ibadan.
+
Federal Medical Centre, Azare
(Commissioned Oxygen plant, Dialysis Unit and the Medical Record Block).
Dialysis Unit at FMC Azare.
Medical Records Block at FMC
Azare.
Oxygen Plant at FMC
Azare.
+
INTENSIVE CARE UNIT (ICU) WITH MONITORING STATION AT
UNIVERSITY OF ILORIN TEACHING HOSPITAL
+ Commissioned Projects in Federal Tertiary Hospitals in 2012
UUTH Intensive Care Unit UUTH Orthopaedic Ward
+Ongoing projects
 NCDC reference
laboratory, Gaduwa (nearing
completion)
 National Diagnostic Centre –
land acquired and design
commissioned
 Ongoing FGN Hospitals
Modernization Programme
 UCTH, Calabar
 NAUTH, Nnewi
 Trauma Centres
 National Hospital, Abuja
 UATH, Gwagwalada, Abuja
These ongoing projects are at
different stages of completion
+
NIGERIA CENTRE FOR DISEASE CONTROL (NCDC) IN GADUA, ABUJA
+
NATIONAL TRAUMA CENTRE, NATIONAL HOSPITAL ABUJA
+
NATIONAL TRAUMA CENTRE, GWAGWALADA ABUJA
+ New admin and lab complex at NIPRD
+
OTHER NOTABLE MILESTONES
• All equipment for some
Hospitals that were at
the Port have all been
released for installation
and improvement of
service delivery in the
Hospitals.
• The Federal Medical
Centre, Abakaliki was
upgraded to the status
of a Teaching Hospital.
• Inauguration of a
Ministerial Committee for
unlocking of the private
sector potentials for the
establishment of world
class specialist hospitals and
high-end diagnostic centres
in each of the six geo-
political zones of the
country.
+
 Stem Cell Transplant for
Sickle Cell Disease– In
January, 2012, the University
of Benin Teaching Hospital
recorded a break-through in
the infusion of stem cells
into sickle cell anaemia
patient
 Establishment of Geriatric
Units in Federal Tertiary
Hospitals- NCH has directed
all Tertiary and Secondary
Health Facilities to establish
a Geriatric unit. The Geriatric
Centre of the University
College Hospital, Ibadan has
been commissioned.
Milestones from May 29th , 2011-date
MEDICAL SERVICES
+
The following centres have the capability to
do renal transplantation
◦ Obafemi Awolowo University Teaching
Hospital
◦ Ife, Aminu Kano University Teaching
Hospital Kano
◦ University College Hospital, Ibadan,
◦ University of Maiduguri Teaching
Hospital Maiduguri,
◦ Lagos University Teaching Hospital,
◦ University of Ilorin Teaching Hospital
and
◦ St Nicholas Hospital, Lagos (Private)
These centres
carried out
kidney
transplant in
2012
MEDICAL SERVICES
+
Open Heart Surgery: the Centre of Excellence for Heart
Disease at the University of Enugu Teaching hospital has been
refurbished.
 The centre has now resumed open heart surgery after 8 years.
Microsurgery of the brain is also now being conducted at FMC
Umuahia.
Commenced laparoscopic surgery at the Federal
Medical Centre, Gombe.
 Full laparoscopic services at the Obafemi Awolowo University Teaching
Hospital Ile Ife.
Total knee and hip replacement at National
Orthopaedic Hospitals in Enugu and Igbobi, Lagos as well as FMC
Yenagoa and the University of Benin Teaching Hospital.
MEDICAL SERVICES
+
Brain Tumor Excision at FMC Umuahia
+
MEDICAL SERVICES
Cancer Control
In 2012, the Ministry continued to ensure that Nigerians got
screened for the common cancers such as cancer of the breast,
cervix, and prostrate by establishing the following new centres for
mass cancer screening:
 Federal Medical Centre, Gusau.
 University of Port-Harcourt Teaching Hospital, Port-Harcourt.
 National Obstetric Fistula Centre, Abakaliki.
 Federal Medical Centre, Keffi
 Federal Medical Centre, EbutaMetta
 Abubakar Tafawa Balewa Teaching Hospital Bauchi
+
 Take over of regional/state VVF centres at Abakaliki, Ebonyi
State (2011), Katsina, Katsina State (later 2013) and Ningi,
Bauchi State (2014)
 At the National Obstetric Fistula Centre Abakaliki we have:
 Carried out 1,722 VVF repairs
 screened 3,800 people for cervical cancer within one year;
 Treated those with pre-malignant lesions by cryosurgery and
followed up; and
 screened 280 men for prostate cancer
 Those suspected to have malignancy are referred
 Supplied Orthopanthomogram to six (6) dental centres
 Supplied dental equipment to Primary Health Care Centres
attached to tertiary hospitals
Other Medical Services
+
 Entered into bulk purchase agreement with PAHF on
Auto-disable syringes.
 Procured and distributed 12 nos. ambulances to our
Federal Tertiary Hospitals
 Procured and distributed 80 blood banks to both
private and public health facilities in the country.
 Procured chelating agents for the treatment of 400
victims of lead poisoning in Zamfara
 Six (6) special sickle cell treatment cetnres
established at FMC Gombe, FMC Keffi, Federal
teaching Hospital Abakaliki, FMC Ebute-Metta, FMC
Birnin Kebbi and FMC Yenagoa
Other Medical Services
+
Polio Eradication
Mr. President doubled the funding of
Polio Eradication activities to 4.7
billion Naira.
• The Presidential Taskforce on Polio
Eradication was constituted and
inaugurated under the
Chairmanship of the Honourable
Minister of State for Health.
• A new robust Polio Eradication
emergency plan was developed with
an accountability framework.
• All State Governors and the Minister
of FCT have re-committed to the
Abuja commitment and in the last
one year have actively and
personally led the quarterly
Supplementary Immunization Days
(SIDs) in their respective states.
The Vice President witnessing the
decoration of the HMH by the Rotary
International President, Sakuji Tanaka
as second level major donor.
DISEASE CONTROL
+
POLIO-FREE TORCH CAMPAIGN
+
+
 Control of Cerebro Spinal Meningitis (CSM):
The country introduced the new CSM vaccine, MenAfric
which confers protection for at least 10 years as against 3
years with the previous vaccines.
 Control of Yellow Fever- New Security-featured
International Certificate of Vaccination and Prophylaxis
(ICVP, popularly known as Yellow Card) has been
introduced.
 Mass Yellow Fever campaign scheduled for 2013
 Introduction of Pentavalent vaccines (DPT, HB, Hib). This
will help protect against Childhood Pneumonia &
Hepatitis B.
DISEASE CONTROL
+
Current Routine Immunisation performance
 16 States: (Kogi, Kwara, Nasarawa, Kaduna, Sokoto, Zamfara,
Anambra, Enugu, Imo, Akwa Ibom, Cross Rivers, Delta, Ekiti, Ondo,
Osun & Oyo States) achieved the Target of 78% DPT3 coverage in
April 2013 compared to NO State for the same month in 2012.
 33 States performed better in April 2013 compared to same period
2012.
 7 States (17%)States conducted > 80% of their planned Fixed
Sessions and only 3 States (8%) conducted > 80% of planned
Outreach Sessions in April 2013.
 Nationally the number of Un-immunized children has reduced by
49% in April 2013 as compared to April 2012.
 30 (81% of) States achieved > 20% reduction in the number of
un-immunized children in April 2013.
DISEASE CONTROL
+
Coverage for all antigens are calculated using birth cohort & women of child bearing age group
Penta3 Coverage in Phase 1 &2 States=76%
Routine Immunization Performance
Apr 2013 ....7
Above 80 %
< 50 %
50 -79.99%
Non-Penta States
Key: Coverage
Hib3 Coverage in Phase 1&2 States=76%
+
HIV/AIDS , TB and Malaria Control
• Signed the
Implementation Plan for
the Framework
Partnership with the
United States
Government.
Commenced the
decentralization of ART
services to the primary
health care level
.
• Commissioned of the new
Testing and Treatment
Centre for Multi-Drug
Resistant Tuberculosis (MDR-
TB) in Lagos.
• Roll Back Malaria –
Additional 28,826,786
million LLINs distributed
bringing the total to 58
million nets.
• 2010 Malaria Indicator
Survey Report Launched and
disseminated
DISEASE CONTROL
+
HIV/AIDS , TB and Malaria Control
• An MoU was also entered into
with local manufacturers of
autodisable syringes for the
bulk purchase of the syringes.
• The Ministry in October, 2012
directed all Federal tertiary
hospitals to discontinue the
use of conventional syringes
and commence the use of
autodisable syringes
• Work in progress on the draft
President’s Emergency
Response Plan (PERP) for
AIDS.
• Preparation for Abuja +12
Summit on
HIV/AIDS, TB, Malaria and
other related infections.
• Memorandum on the
Integrated Test Treat , Cure
and Larviciding Project
presented to FEC.
DISEASE CONTROL
+
 Successful conduct of a mid-term evaluation of
the 2010-2015 National Strategic plan for TB and
Leprosy Control in April 2013.
Procurement of second line anti-TB drugs
 The WHO elimination target of less than 1case
per 10,000 population has been achieved at the
national level and in all Zones.
DISEASE CONTROL
+
Guinea worm Eradication – For more than 4
years , there has been no case of Guinea worm
infestation. The International Certification
Team that will evaluate Nigeria before being
certified GWD-free country will visit us from
June, 24th to 13th July, 2013.
DISEASE CONTROL
+
Establishment of the Nigeria Centre for Disease
Control (NCDC).
Commissioning of the new Respiratory Intensive
Care Unit (Avian Flu and other viral diseases) at
University of Abuja Teaching Hospital,
Gwagwalada.
DISEASE CONTROL
+
Respiratory Intensive Care Unit, Gwagwalada
+
 Improvement in some of the health indices [Under
5 mortality for 2011 is 141/1000 (Lancet 2011) as
against 157/1000 in 2008 , Maternal Mortality ratio
has reduced from 545/100,000 live births in 2008
to 487/100,000 in 2011 (Lancet 2011)]
 Membership of Scale Up Nutrition (SUN)
 National Nutrition Summit (Feb. 25, 2012)
 Procurement and free distribution of Family
Planning Commodities.
MATERNAL NEWBORN AND CHILD
HEALTH
+
• The development and
implementation of the
Integrated Maternal New born
and child health Strategy with
the following interventions
implemented:
– ensuring Skilled Birth Attendant
at health facilities through the
Midwives Service Scheme
– inclusion of emergency obstetric
drugs namely Magnesium
sulphate and Misoprostol in the
essential drug list, and
– the procurement and distribution
of the drugs.
Improvement in access to Family
Planning Commodities:
◦ Signed a MOU with UNFPA for 3
years, 2012-2014 on Govt
counterpart contribution of $3m
per annum
◦ Additional commitment of $8.3m
for Reproductive and MNCH
commodities under the SURE-P/
MCH.
◦ Task shifting for Community Health
Extension workers to provide
injectable contraceptive
commodity.
◦ Distribution of free contraceptive
commodities at Public sector
health facilities. This has led to
increased uptake.
MATERNAL NEWBORN AND CHILD
HEALTH
+SURE-P and the Saving One Million Lives
Initiative
 Under the Subsidy Reinvestment
Programme , Human resource for
Health has been increased and
jobs created by recruiting 3,960
health care workers to provide
MNCH services in 500 SURE-P
supported primary health care
(PHC) centres spread across the 36
states and FCT.
These health care workers comprise:
 929 midwives;
 1,783 community health
extension workers (CHEWs); and
 1,248 female village health
workers
 Completed a Conditional Cash
Transfer (CCT) Proof of Concept
Phase and State of Readiness
Assessment for the follow-up Pilot
Programme
 Commenced communication and
advocacy activities towards ensuring
a Sustainability Plan to preserve the
gains of the SURE-P MCH
Programme.
 Initiated the supply of essential
drugs, health commodities and
medical equipments to all 625
SURE-P supported primary and
secondary health facilities.
+The conditional cash transfer pilot has kicked off in 5 PHC facilities
in FCT and will expand to 8 other States in June.
▪ Inauguration of State CCT
Steering Committees in all other
8 pilot States
▪ Enrolment of Programme
beneficiaries in the other 8 pilot
states-
Anabmbra, Bauchi, Bayelsa, Ebo
nyi, Kaduna, Niger, Ogun, Zamfa
ra
▪ Monthly cash transfer days in each
CCT Pilot State
▪ The CCT pilot programme was launched at Deidei
Comprehensive Health Centre, Bwari Area
Council, Abuja on 13th May, 2013.
▪ An inaugural cash transfer day was conducted for
the women who had been registered since enrolment
began on 15th of April 2013.
▪ Of a total of 261 eligible beneficiaries, 172 (66%)
attended and received their cash transfers (total
₦206,900 disbursed)
▪ The CCT pilot programme is now operational in all
5 FCT facilities and the PIU will conduct the next cash
transfer days in each facility in June 2013.
▪ Data from the first month’s enrolment in Deidei CHC
suggest very high uptake (an increase of 37.4% in
ANC attendance and 15.3% in facility deliveries),
compared to baseline data.
CCT pilot launch overview 3 months from now…
+ SURE-P MCH OUTCOMES AS AT FEBRUARY 2013
Total ANC
Visits
New ANC
Visits
Deliveries by
SBAs
FP New
Acceptors
No attending
FP Clinics
No of
Postnatal
Checks
April to Sept 2012 140503 51807 16695 11176 26292 25870
Oct to feb 2013 154133 61623 18285 14987 29190 26338
Core MNCH Indicators - Comparison with Baseline in SURE
P MCH Facilities
Maternal mortality has dropped by more than 50 percent in MSS
Facilities from 2009 to 2012.
Trends in Facility Based Maternal Mortality Rates per 100,000 Live Births
789
586
457
369
July -Dec 2009 July-Dec 2010 July-Dec 2011 July-Dec 2012
LAUNCH OF THE SAVING ONE MILLION LIVES INITIATIVE BY MR. PRESIDENT
+ Elimination of Substandard, Fake and
Counterfeit Drugs
 Deployment of ICT for detection of fake and
Counterfeit drugs (TRUSCAN and text messaging
technique).
 WHO accreditation of local pharmaceutical industries
for drug production
 Introduction of the text messaging technique for the
authentication of drugs.
 The upgrading of the standards and capacities of
local drug manufacturing facilities like “Juhel” in
Anambra State and “May & Baker” in Ogun State is also
a major achievement. This has resulted in a decrease
from 16.5% to 7.5% of the incidence of fake drugs in
Nigeria
 NAFDAC has put in place an e-registration process
that has hastened applications for registration.
+ LAUNCH OF TRUSCAN FOR DETECTING FAKE DRUGS BY
Mr. PRESIDENT, REPRESENTED BY THE HONOURABLE
MINISTER OF HEALTH
+
Presentation of Report of WHO Pre-qualification Assessment of Six
Local Pharmaceutical Companies
+ Strategies to Reduce Outward
Medical Tourism
 Ministerial Committee on unlocking the Private Sector Potential for
th establishment of World Class Hospitals and high-end diagnostic
centres in each of the six geo-political zones.
 Improved specialist training
 Budgeting for Overseas Residency Programme
 Modernisation/Refurbishment of Federal Tertiary Hospitals
 Acknowledgement and deliberate encouragement of private health
sector leading to the upsurge in the number of private health
facilities providing wolrd-class services in the areas of cancer
screening, general medical check-up and diagnostics, endoscopic
services, laser surgery, etc
+3. HUMAN RESOURCES FOR HEALTH
 The Midwives Services Scheme (MSS) has continued to grow
with 3305 midwives and 946 CHEWS being deployed to 1000
health facilities. This project has received recognition
internationally
 The total numner of health workers trained/recruited in both
the MSS and SURE-P now stand at 10,103 comprising of 4200
midwives, 2903 CHEWS and 3000 Village Health Workers
 Reintroduction of the overseas component of the Residency
Training Programme;
 Capacity Building in Emergency Preparedness ( e.g Training in
Israel, Training in Abuja by the International Committee of the
Red Cross, Training organised by AFRICOM in Lagos, 2nd ATLS
course organised by Emergency Response Limited, Principles of
Operative Orthopaedics organised by AO).e
+
First Lady Dame Patience Jonathan Unveiling MSS Bill Board
Communication
+
 National Stakeholders Conference on Trauma and
Emergency Response
 Committee on training of Paramedics in Nigeria
established
 First National Conference on Human Resources for
Health.
 Registration and training of Medical Physicists in
Nigeria for the first time ever
 Revised Curriculum for Undergraduate Medical and
Dental Education.
 Committee on the training of Herbal Practitioners
in Medical Schools inaugurated.
+
 Committee on training of Complimentary and
Alternative Medicine Practitioners constituted
 Accreditation of new Faculties of Pharmacy.
 CDC-Mentoring Laboratory towards National
Accreditation ( MELTNA)
 Task-shifting: trained CHEWs may now administer
injectable contraceptives
 New curriculum for the training of Community
Midwives
 Development of Global Health Players Programme
+
Other notable Milestones
• The Medical Laboratory
Science Council of Nigeria
got a grant from CDC for
the training of Medical
Laboratory Assessors and
Mentors to strengthen
Nigeria’s Laboratory
Quality Management
Systems using the
WHO/CDC/ASLM/SPLITA
tools, ISO 15189 Standards
and CLSI Guidelines.
FMoH in
collaboration with
IAEA commenced
the residency training
of Medical Physicists
at Usmanu Dan Fodio
University Teaching
Hospital Sokoto in
2012.
+ 4. FINANCING FOR HEALTH
 Community Based Social Health Insurance Programme as
well as Voluntary Contributor Social Health Insurance
Programme.
 Revision of capitation, service fees and benefits
 ICT platform for NHIS initiated. Design is 85% completed
 National Conference on Health Financing.
 Preparation for the Presidential Summit on Universal
health Coverage
 Up scaling of the NHIS-MDG/MCH Project.
 Work in progress on Social Health Insurance for the
Handicapped and Prisoners respectively
+
Flag-off of the Community Based Social Health
Insurance Programme
HEALTH INSURANCEHEALTH INSURANCE
+
Flag-off of the Community Based Social Health Insurance
Programme and also evidence of Community Participation and
Ownership
+ 5. HEALTH MANAGEMENT INFORMATION SYSTEM
• The National Health Management Information System was
strengthened through the migration of the DHIS 1.4 unto
the DHIS 2.0 which is web based which allows for real time
data entry and access from any part of the world.
• The Federal Ministry of Health in 2012 distributed complete
computer system to 173 local governments to ensure real
time data reporting. More Local governments will benefit
from this programme in 2013
• The National HIV/AIDS Call Centre was commissioned in
April, 2012 by the First Lady to provide HIV/AIDS
information, guidance and counselling to callers.
+ 6. PARTNERSHIP FOR HEALTH
 Signing of MoUs
 With Austrian Government on Partnership in Public Health
 With Remi Babalola Foundation Centre on Human Resources for Health
 With UNFPA on Procurement, Supply and Distribution of Contraceptives
under Mr. President’s initiative for free contraceptives in Nigeria
 With General Electric (GE) for the establishment of private world class
specialist hospitals and diagnostic centres under PPP arrangement.
 Signing MOU with Health Professionals in Diaspora
 With Federal Ministries of Women Affairs and Social Development and
Finance
 Approval of NIPRD as Regional Hub of the African Network for Diagnostics
and Innovations (ANDI)
 Regular meetings of Health partners Coordination Committee and
development of template for mutual accountability
 Regular meetings of the Inter-agency Coordinating Committee
+
 Resuscitation of Biovaccines limited , a joint venture between
FGN and Mayer and Baker on Yellow fever vaccines
 Admission of NCDC into the International Association of
National Public Health Institutions (IANPHI)
 Adoption of PHCs by Federal Tertiary Hospitals
 Partnership with Office of the First Lady on various health
issues
 Partnership with Bank Of Industry (BOI)- offers credit facilities
to local pharmaceutical industry
 Partnership with ECOWAS Bank for International Development
to support our local pharmaceutical industry
+
 Town Hall meeting by the Minister of Health in 2011 in Gedi
LGA in Adamawa State.
 Town Hall meeting by the Minister of Health in 2012 at
Ebonyi LGA in Ebonyi State where over 4000 women
participated. The 2013 will be in Benue.
 Town Hall Meeting on HIV/AIDS by the First Lady in
Nyanya, FCT.
 Resuscitation of the Ward Development Committees.
 Recruitment of Village Health Workers
7. Community Participation and Ownership
+
Town Hall Meeting during the MNCH week in Gedi LGA, Adamawa State
+
COMMISSIONING OF THE DOTT HEALTH CLINIC, BAUCHI
+
8. RESEARCH FOR HEALTH
 Health research in Nigeria is being
championed by the Nigeria Institute of
Medical Research (NIMR), National
Institute for Pharmaceutical Research
and Development (NIPRD), as well as
Federal Tertiary Health Institutions and
other non-government hospitals and
organisations
 Social production of NIPRISAN by
NIPRD.
 Support for research on Violence and
Injury Prevention and Surveillance
Programme in Nigeria
 Support for research on the Hidden
Epidemic of Death and Disease caused
by Smokeless Tobacco and Cigarette
Use in Nigeria.
 Inauguration of Committee of
Chairmen of Ethics Committee
covering all federal tertiary health
institutions.
 In 2012 alone, National Health
Research Ethics Committee
reviewed nearly 100 research
protocols including those for two
clinical trial studies.
 Development of Clinical Trials
Registry – started in 2012 and is
being finalised for registration as a
WHO affiliated registry
 Provision of diagnostic and health
research services to about 3000
members of the public by NIPRD.
 Determination of prevalence of
hepatitis and its clinical impact on
persons on HAART in NIPRD GOPD
 Development of monographs on 30
Nigerian medicinal plants
+
Surveys
NIMR has also conducted the following
surveys:
Malaria vector study on insecticide
resistance
Cholera epidemic study;
Non communicable diseases study in
Lagos
Neglected tropical diseases study; and
HIV/AIDS study
+ Surveys
 Global Adult Tobacco Survey (GATS) completed and awaiting
Presidential approval. This is part of our commitment to Zero Tolerance
for Tobacco
 Nationwide prevalence survey of TB - in the 36 states and FCT is
currently ongoing. This is the first attempt at documenting the actual
burden of TB.
 National HIV/AIDS & Reproductive Health Survey – This is conducted
every five years to provide data on behavioural aspects of HIV/AIDS as
well as general information on reproductive health.
 National Antenatal Sero-Prevalence Survey – This is an important
survey that provides us with progress data on our efforts to reduce and
halt the spread of HIV/AIDS.
 2013 National Demographic and Health Survey being conducted in
collaboration with the National Population Commission
 Household and Health Facility Surveys across the country being
conducted in collaboration with National Bureau of Statistics
+OUR PERFORMANCE CONTRACT
Key Deliverable
Baseline
Planned
Target
Actual
Achieveme
nt
Remarks
2011
(December)
2012
(December)
2012
(December)
1Improved Quality Health Care
Prevalence of Counterfeit and fake drugs in
circulation (%)
19.6% 17% 18.2%
% reduction in post-operative infection rates 43 45 -
Administrative
data
Waiting time for patients (From registration to first
contact with a Doctor) (mins)
30 25 25
Administrative
data from Keffi
FMC
Increase Access to Healthcare
Health Insurance Coverage 6% 8% 7.5%
Administrative
data from
NHIS
Percentage of LGAs having at least one FG
supported ART refill site (%)
36 40 48
Key Deliverable
Baseline
Planned
Target
Actual
Achieveme
nt
Remarks
2011
(December)
2012
(December)
2012
(December)
Provision of Policy, Regulatory and
Administrative Services
Maximum time required for MTB threshold from
contract approval to signing at FMOH
10 working
days
8 working
days
8 working
days
Administrative
data
Number of interventions to enforce regulations 20 25 25
Increased Access to Basic Services
Polio eradication: Increase population immunity
against Wild Polio Virus (WPV1 and 3) measured
by non polio AFP zero dose (%)
Estimated
20% in HRS
less than
10% zero
dose
-
Polio eradication: at least 80% of wards reach 90
percent coverage during IPDs
less than 50
80% or more
reach 90%
coverage
86
Administrative
data from
NPHCDA
Key Deliverable
Baseline
Target Achievement
2011
(December)
2012
(December)
2012
(December)
Routine immunization: Percentage coverage for
measles vaccine
67 75 78.2
Maternal and Child Health: Increase in total
focused ANC attendance in MSS sites
828,922
at least 10
percent
increase
over 2011
1,044,863
(26%
increase)
Maternal and Child Health: Increase in pregnant
women with births attended by skilled health
worker in MSS sites
110,028
at least 10
percent
increase
over 2011
141,929
(29%
increase)
Life Saving Commodities: Percentage of
supported PHC facilities that report more than 1
month stock out of essential life-saving
commodities
Assessment
ongoing
10%
reduction
from
baseline
-
Key Deliverable
Baseline
Planned
Target
Actual
Achievement
Remarks
2011
(December)
2012
(December)
2012
(December)
Improved Quality of Health Care
PHC Quality: Percentage of
MSS/SURE-P supported PHCs that
have initiated at least one quality
improvement programme e.g use of
check lists
Assessment
on-going
40% 100%
Application of
integrated supportive
supervision in all the
sites applied as total
quality assurance
strategy
FTHI Clinical Governance: Percentage
of FTHIs with quality improvement/
clinical governance programmes in
place
None 25% 25%
Unlocking the Private Sector ’ s
Market Potential
Revive Private Sector Health Alliance Inactive
Functional
PSHA
-
+ CONCLUSION
In conclusion, I wish to state that Mr. President’s
Transformation Agenda in the Health Sector is effectively
being implemented and on course.
Two cardinal enablers that will make a quantum difference are:
 i). A National Health Act which will define the Health System
and provide governance structures for accountability, and
 2). Universal Health Coverage entailing compulsory health
insurance and improving geographical access to health.
These will anchor the total transformation of the health
sector.
I thank all our development partners and other stakeholders
in health for their collaboration and support in our strive to
provide quality and affordable health care to all Nigerians.
+
I thank you for
your attention.

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FEDERAL MINISTRY OF HEALTH MID-TERM REPORT

  • 1. + FEDERAL MINISTRY OF HEALTH MID-TERM REPORT OF ACHIEVEMENTS OF THE DR. GOODLUCK EBELE JONATHAN’S ADMINISTRATION PRESENTED BY Prof. C. O. Onyebuchi Chukwu Honourable Minister of Health AT THE MINISTERIAL PLATFORM THURSDAY, JUNE,13, 2013
  • 2. +
  • 3. + His Excellency, Arc. Mohammed Namadi Sambo, GCON Vice President, Federal Republic of Nigeria
  • 4. + Prof. C. O. Onyebuchi Chukwu Minister of Health Federal Republic of Nigeria
  • 5. + Dr. Muhammad Ali Pate Minister of State for Health Federal Republic of Nigeria
  • 6. + Mrs. F. B. A. Bamidele Permanent Secretary, Health Federal Republic of Nigeria
  • 7. + Presentation Outline • Mandate of the Ministry – Vision – Mission • Mr. President’s Transformation Agenda in the Health Sector • Achievements • Our Performance Contract • Conclusion
  • 8. + Mandate of the Ministry  To formulate, disseminate, promote, implement, monitor and evaluate health policies of the Federal Government of Nigeria.  Using the National Council on Health (NCH), the Ministry leads States and Local Governments, the Private Sector and Civil Society Organisations in formulating health policies. It is the coordinating body of the Federal Government on issues of health.  The Honourable Minister of Health is the Chairman of NCH
  • 9. + Vision and Mission Statement To develop and implement policies that strengthen the national health system for effective, efficient, accessible and affordable delivery of health services in partnership with other stakeholders. A world-class government institution that ensures a healthy Nigeria VISION MISSION
  • 10. + Core Values of Federal Ministry of Health  Excellence  Competence  Integrity  Diligence  Innovation  Accountability  Equity  Teamwork
  • 11. +The Transformation Agenda in the Health Sector.  Improved health outcomes in the country are critical to the achievement of our national vision of being one of the twenty foremost industrialised nations by the year 2020 and the Transformation Agenda of Mr. President  Mr. President, Dr. Goodluck Ebele Jonathan GCFR, has made health one of his priorities: the Minster of Health and the Minister of State for Health are members of the National Economic Management Team (NEMT).  The National Strategic Health Development Plan (2010- 2015) approved by the FEC in December 2010 is aligned with National Vision 20:2020 and is the roadmap for Mr. President’s Transformation Agenda in the Health Sector.
  • 12. + STRUCTURE OF THE MINISTRY  The Ministry provides oversight for the three tiers of national health delivery system in general but has specific control over departments and agencies under it.  There are eight (8) Departments, five (5) Agencies/Research Institutes, twenty (20) Teaching Hospitals, twenty three (23) Federal Medical Centres, fourteen (14) Specialist Hospitals/Centres, fourteen (14) Health Professional Regulatory Bodies, and seventeen (17) Health Professional Training Institutions.
  • 13. + Our Activities  The activities of Federal Ministry of Health and its agencies from 29th May, 2011 to date are guided by a number of instruments which include the constitution of the Federal Republic of Nigeria, 1999, the National Health Policy, Nigerian Vision 20:2020, the 1st National Implementation Plan of Vision 20:2020, the National Strategic Health Development Plan (NSHDP), annual budgetary appropriations, international declarations and commitments and the Action Push Agenda.
  • 14. + NSHDP and ACTION PUSH Agenda Eight NSHDP Priority Areas Six Pillars of the Action Push Agenda Six core Values of the Action Push Agenda Leadership and Governance for Health Action Accountability Health Service Delivery Continuity Consistency Human Resources for Health Teamwork Transparency Financing for Health Innovation Integrity National Health Management Information System Outreach Order Partnerships for Health Networking Nigeria Community Participation and Ownership Research for Health
  • 15. + RECENT INITIATIVES FOR TRANSFORMING THE HEALTH SECTOR • Millennium Development Goals • Refurbishing /modernization of federal tertiary hospitals Project • The National Strategic Health Development Plan • The Action Push Agenda • Midwives Service Scheme • Introduction of new vaccines • SURE-P Health Programme • Saving One Million Lives Initiative • Community Based Social Health Insurance  Reintroduction of overseas component of the Residency training abroad  New technologies for fighting counterfeit medical products  Nigeria Centre for Disease Control  National Oral Health Policy  National Drug distribution Policy and Guidelines  National Pharmaco-Vigillance Policy  Performance Contracts
  • 16. +ACHIEVEMENTS/SUCCESS STORIES These are categorized based on the eight priority areas of the National Strategic Health Development Plan: • Leadership and Governance • Health Service Delivery • Human Resources for Health • Financing for Health • Health Management Information System • Partnership for Health • Community Participation and Ownership • Research for Health
  • 17. + LEADERSHIP AND GOVERNANCE  Mr. President is Co-Chairing the UN Commission on Life Saving Commodities for Women and Children’s Health  The federal health budget is based on NSHDP;  The 2012 Appropriation is based on the NSHDP;  Completion of the 2010 and 2011 Joint Annual Review (JAR) respectively;  Stoppage of use of conventional syringes and change to auto-disable syringes by all Federal Tertiary Institutions,  The Federal Executive Council (FEC) approved the National Policy on Oral Health; and  Membership of WHO, PMNCH
  • 18. +  International Positions in Health  First VP 64th WHA  Chairman 60th WHO RCA  Chairman ECOWAS Ministers of Health,2011  Chairman Conference of AU Ministers of Health 2013-2015. Board Positions Occupied by Nigeria  WHO Executive Board  Partnership for Maternal and Child Health  The Global Fund to fight HIV/AIDS, Tuberculosis and Malaria LEADERSHIP AND GOVERNANCE
  • 19. + The Federal government has put in place Policies and Guidelines for improved health care delivery:  National Oral Health Policy and Appointment of Senate President as National Champion and eminent personalities as State Ambassadors on Oral Health  National Pharmacovigilance Policy  National Drug Distribution Policy and Guidelines  Neglected Tropical Diseases Master Plan LEADERSHIP AND GOVERNANCE
  • 20. + The Ministry is also working with the relevant agencies to enact /review the following legislations:  National Health Bill  Anti-Tobacco Bill  NAFDAC Act  National Health Insurance Scheme Act  Nigeria championed the 65th WHA resolution on Substandard/Spurious/Falsely Labelled/Falsified/ Counterfeit Medical Products LEADERSHIP AND GOVERNANCE
  • 21. + Other notable achievements include  Nigeria sponsored WHO resolution on counterfeit drugs which was adopted at the 65th WHA  Completion of the work of the Presidential Committee on a harmonious working relationship in the Health Sector and presentation of its Report to FEC
  • 22. +  Re-introduction of the Overseas component of the Residency Training Programme and Overseas refresher courses for our young consultants and other health professionals in different specialties. Sixty (60) resident doctors and young consultants benefitted from this programme in 2012  Conducted 2 National Council on Health Meetings and 2 pre-NCH meetings Other notable achievements include:
  • 23. +  Clinical Governance: institutionalized the clinical governance system within the Federal Tertiary Health Facilities so that patients receive qualitative health care services  Revitalistion of SERVICOM at the FMOH and all our Parastatals to improve quality of service  Signing of Performance Contract with FMOH Heads of Departments and Agencies as a follow up to the Performance Contract we signed with Mr. President. This occasion took place on 9th October, 2012.
  • 24. +2. HEALTH SERVICE DELIVERY  Infrastructural Development;  Medical Services  Disease Control;  Maternal, Newborn and Child Health  Elimination of Sub Standard, Fake and Counterfeit Drugs;  Strategies to reduce outward medical tourism
  • 25. + INFRASTRUCTURAL DEVELOPMENT  Rehabilitation and equipping of Obafemi Awolowo University Teaching Hospital, Ile-Ife and the University of Benin Teaching Hospital are completed, and awaiting Presidential commissioning, while Nnamdi Azikwe University Teaching Hospital and the University of Calabar Teaching Hospital have reached significant stages of completion (80%).  Establishment of National Trauma Centres in the University of Abuja Teaching Hospital and the National Hospital Abuja. Both are nearing completion
  • 26. + INFRASTRUCTURAL DEVELOPMENT • Federal Staff Hospital, Jabi, Abuja - The Ministry in collaboration with the Chinese Government completed and equipped the permanent site for the Federal Staff Hospital in Abuja. The hospital was commissioned by the President on 28th January, 2013. • NIPRD main administrative and laboratory building completed • Acquired property t o house the administrative headquarters of the Medical Laboratory Science Council of Nigeria and the Nigeria Centre for Disease Control respectively  Commissioned various projects in Federal Tertiary Hospitals across the country and other completed projects awaiting commissioning.  Completion of the Public Health Quality Assurance/Reagent Control Laboratory of the Medical Laboratory Science Council of Nigeria (located in Yaba Lagos and awaiting commissioning)
  • 27. + Pre-commissioning visit to Federal Staff Hospital The VP who represented Mr. President commissioning the Permanent Site, Federal Staff Hospital, Abuja
  • 28. + Other Commissioned Projects  Federal Neuro Psychiatric Hospital, Kaduna (Commissioned a new Male Medical Ward, New Female Medical Ward, Laboratory Block, Child and Adolescent building, reconstructed Female Ward, Medical Library and Occupational Therapy Complex).  Federal Neuro Psychiatric Hospital, Calabar (Commissioned the new Medical Block and the rehabilitated Occupational Therapy Unit).  Federal Medical Centre, Makurdi ( Projects completed and awaiting commissioning ( Intensive Care Centre, Laboratory Block, Male & Female Surgical Wards, Laboratory Block at Outreach Centre, Male and Female Wards at Outreach Centre and Assorted Medical Theatre Equipment).  Federal Medical Centre, Gombe (Expanded and equipped Accident and Emergency unit, completed the construction of Sickel Cell Centre and the Male Oncology Ward.  The opening of a dedicated ward for haematology and haemato-oncology and the introduction of CCTV assisted monitoring in the burns and plastic surgery intensive care unit at the University of Benin Teaching Hospital.  New Respiratory Intensive Care Unit (Avian Flu and other viral diseases) at University of Abuja Teaching Hospital, Gwagwalada.
  • 29. + Abubakar Tafawa Balewa University Teaching Hospital Commissioned Admin. Block, ATBUTH, Bauchi Special Baby Intensive Care Unit, ATBUTH, Bauchi.
  • 30. + University College Hospital, Ibadan (Commissioned New Cardiac Unit) HMH inspecting newly installed equipment at the CAT-Lab, UCH, Ibadan. Newly installed equipment at the CAT- Lab, UCH, Ibadan.
  • 31. + Federal Medical Centre, Azare (Commissioned Oxygen plant, Dialysis Unit and the Medical Record Block). Dialysis Unit at FMC Azare. Medical Records Block at FMC Azare. Oxygen Plant at FMC Azare.
  • 32. + INTENSIVE CARE UNIT (ICU) WITH MONITORING STATION AT UNIVERSITY OF ILORIN TEACHING HOSPITAL
  • 33. + Commissioned Projects in Federal Tertiary Hospitals in 2012 UUTH Intensive Care Unit UUTH Orthopaedic Ward
  • 34. +Ongoing projects  NCDC reference laboratory, Gaduwa (nearing completion)  National Diagnostic Centre – land acquired and design commissioned  Ongoing FGN Hospitals Modernization Programme  UCTH, Calabar  NAUTH, Nnewi  Trauma Centres  National Hospital, Abuja  UATH, Gwagwalada, Abuja These ongoing projects are at different stages of completion
  • 35. + NIGERIA CENTRE FOR DISEASE CONTROL (NCDC) IN GADUA, ABUJA
  • 36. + NATIONAL TRAUMA CENTRE, NATIONAL HOSPITAL ABUJA
  • 37. + NATIONAL TRAUMA CENTRE, GWAGWALADA ABUJA
  • 38. + New admin and lab complex at NIPRD
  • 39. + OTHER NOTABLE MILESTONES • All equipment for some Hospitals that were at the Port have all been released for installation and improvement of service delivery in the Hospitals. • The Federal Medical Centre, Abakaliki was upgraded to the status of a Teaching Hospital. • Inauguration of a Ministerial Committee for unlocking of the private sector potentials for the establishment of world class specialist hospitals and high-end diagnostic centres in each of the six geo- political zones of the country.
  • 40. +  Stem Cell Transplant for Sickle Cell Disease– In January, 2012, the University of Benin Teaching Hospital recorded a break-through in the infusion of stem cells into sickle cell anaemia patient  Establishment of Geriatric Units in Federal Tertiary Hospitals- NCH has directed all Tertiary and Secondary Health Facilities to establish a Geriatric unit. The Geriatric Centre of the University College Hospital, Ibadan has been commissioned. Milestones from May 29th , 2011-date MEDICAL SERVICES
  • 41. + The following centres have the capability to do renal transplantation ◦ Obafemi Awolowo University Teaching Hospital ◦ Ife, Aminu Kano University Teaching Hospital Kano ◦ University College Hospital, Ibadan, ◦ University of Maiduguri Teaching Hospital Maiduguri, ◦ Lagos University Teaching Hospital, ◦ University of Ilorin Teaching Hospital and ◦ St Nicholas Hospital, Lagos (Private) These centres carried out kidney transplant in 2012 MEDICAL SERVICES
  • 42. + Open Heart Surgery: the Centre of Excellence for Heart Disease at the University of Enugu Teaching hospital has been refurbished.  The centre has now resumed open heart surgery after 8 years. Microsurgery of the brain is also now being conducted at FMC Umuahia. Commenced laparoscopic surgery at the Federal Medical Centre, Gombe.  Full laparoscopic services at the Obafemi Awolowo University Teaching Hospital Ile Ife. Total knee and hip replacement at National Orthopaedic Hospitals in Enugu and Igbobi, Lagos as well as FMC Yenagoa and the University of Benin Teaching Hospital. MEDICAL SERVICES
  • 43. + Brain Tumor Excision at FMC Umuahia
  • 44. + MEDICAL SERVICES Cancer Control In 2012, the Ministry continued to ensure that Nigerians got screened for the common cancers such as cancer of the breast, cervix, and prostrate by establishing the following new centres for mass cancer screening:  Federal Medical Centre, Gusau.  University of Port-Harcourt Teaching Hospital, Port-Harcourt.  National Obstetric Fistula Centre, Abakaliki.  Federal Medical Centre, Keffi  Federal Medical Centre, EbutaMetta  Abubakar Tafawa Balewa Teaching Hospital Bauchi
  • 45. +  Take over of regional/state VVF centres at Abakaliki, Ebonyi State (2011), Katsina, Katsina State (later 2013) and Ningi, Bauchi State (2014)  At the National Obstetric Fistula Centre Abakaliki we have:  Carried out 1,722 VVF repairs  screened 3,800 people for cervical cancer within one year;  Treated those with pre-malignant lesions by cryosurgery and followed up; and  screened 280 men for prostate cancer  Those suspected to have malignancy are referred  Supplied Orthopanthomogram to six (6) dental centres  Supplied dental equipment to Primary Health Care Centres attached to tertiary hospitals Other Medical Services
  • 46. +  Entered into bulk purchase agreement with PAHF on Auto-disable syringes.  Procured and distributed 12 nos. ambulances to our Federal Tertiary Hospitals  Procured and distributed 80 blood banks to both private and public health facilities in the country.  Procured chelating agents for the treatment of 400 victims of lead poisoning in Zamfara  Six (6) special sickle cell treatment cetnres established at FMC Gombe, FMC Keffi, Federal teaching Hospital Abakaliki, FMC Ebute-Metta, FMC Birnin Kebbi and FMC Yenagoa Other Medical Services
  • 47. + Polio Eradication Mr. President doubled the funding of Polio Eradication activities to 4.7 billion Naira. • The Presidential Taskforce on Polio Eradication was constituted and inaugurated under the Chairmanship of the Honourable Minister of State for Health. • A new robust Polio Eradication emergency plan was developed with an accountability framework. • All State Governors and the Minister of FCT have re-committed to the Abuja commitment and in the last one year have actively and personally led the quarterly Supplementary Immunization Days (SIDs) in their respective states. The Vice President witnessing the decoration of the HMH by the Rotary International President, Sakuji Tanaka as second level major donor. DISEASE CONTROL
  • 49. +
  • 50. +  Control of Cerebro Spinal Meningitis (CSM): The country introduced the new CSM vaccine, MenAfric which confers protection for at least 10 years as against 3 years with the previous vaccines.  Control of Yellow Fever- New Security-featured International Certificate of Vaccination and Prophylaxis (ICVP, popularly known as Yellow Card) has been introduced.  Mass Yellow Fever campaign scheduled for 2013  Introduction of Pentavalent vaccines (DPT, HB, Hib). This will help protect against Childhood Pneumonia & Hepatitis B. DISEASE CONTROL
  • 51. + Current Routine Immunisation performance  16 States: (Kogi, Kwara, Nasarawa, Kaduna, Sokoto, Zamfara, Anambra, Enugu, Imo, Akwa Ibom, Cross Rivers, Delta, Ekiti, Ondo, Osun & Oyo States) achieved the Target of 78% DPT3 coverage in April 2013 compared to NO State for the same month in 2012.  33 States performed better in April 2013 compared to same period 2012.  7 States (17%)States conducted > 80% of their planned Fixed Sessions and only 3 States (8%) conducted > 80% of planned Outreach Sessions in April 2013.  Nationally the number of Un-immunized children has reduced by 49% in April 2013 as compared to April 2012.  30 (81% of) States achieved > 20% reduction in the number of un-immunized children in April 2013. DISEASE CONTROL
  • 52. + Coverage for all antigens are calculated using birth cohort & women of child bearing age group Penta3 Coverage in Phase 1 &2 States=76% Routine Immunization Performance Apr 2013 ....7 Above 80 % < 50 % 50 -79.99% Non-Penta States Key: Coverage Hib3 Coverage in Phase 1&2 States=76%
  • 53. + HIV/AIDS , TB and Malaria Control • Signed the Implementation Plan for the Framework Partnership with the United States Government. Commenced the decentralization of ART services to the primary health care level . • Commissioned of the new Testing and Treatment Centre for Multi-Drug Resistant Tuberculosis (MDR- TB) in Lagos. • Roll Back Malaria – Additional 28,826,786 million LLINs distributed bringing the total to 58 million nets. • 2010 Malaria Indicator Survey Report Launched and disseminated DISEASE CONTROL
  • 54. + HIV/AIDS , TB and Malaria Control • An MoU was also entered into with local manufacturers of autodisable syringes for the bulk purchase of the syringes. • The Ministry in October, 2012 directed all Federal tertiary hospitals to discontinue the use of conventional syringes and commence the use of autodisable syringes • Work in progress on the draft President’s Emergency Response Plan (PERP) for AIDS. • Preparation for Abuja +12 Summit on HIV/AIDS, TB, Malaria and other related infections. • Memorandum on the Integrated Test Treat , Cure and Larviciding Project presented to FEC. DISEASE CONTROL
  • 55. +  Successful conduct of a mid-term evaluation of the 2010-2015 National Strategic plan for TB and Leprosy Control in April 2013. Procurement of second line anti-TB drugs  The WHO elimination target of less than 1case per 10,000 population has been achieved at the national level and in all Zones. DISEASE CONTROL
  • 56. + Guinea worm Eradication – For more than 4 years , there has been no case of Guinea worm infestation. The International Certification Team that will evaluate Nigeria before being certified GWD-free country will visit us from June, 24th to 13th July, 2013. DISEASE CONTROL
  • 57. + Establishment of the Nigeria Centre for Disease Control (NCDC). Commissioning of the new Respiratory Intensive Care Unit (Avian Flu and other viral diseases) at University of Abuja Teaching Hospital, Gwagwalada. DISEASE CONTROL
  • 58. + Respiratory Intensive Care Unit, Gwagwalada
  • 59. +  Improvement in some of the health indices [Under 5 mortality for 2011 is 141/1000 (Lancet 2011) as against 157/1000 in 2008 , Maternal Mortality ratio has reduced from 545/100,000 live births in 2008 to 487/100,000 in 2011 (Lancet 2011)]  Membership of Scale Up Nutrition (SUN)  National Nutrition Summit (Feb. 25, 2012)  Procurement and free distribution of Family Planning Commodities. MATERNAL NEWBORN AND CHILD HEALTH
  • 60. + • The development and implementation of the Integrated Maternal New born and child health Strategy with the following interventions implemented: – ensuring Skilled Birth Attendant at health facilities through the Midwives Service Scheme – inclusion of emergency obstetric drugs namely Magnesium sulphate and Misoprostol in the essential drug list, and – the procurement and distribution of the drugs. Improvement in access to Family Planning Commodities: ◦ Signed a MOU with UNFPA for 3 years, 2012-2014 on Govt counterpart contribution of $3m per annum ◦ Additional commitment of $8.3m for Reproductive and MNCH commodities under the SURE-P/ MCH. ◦ Task shifting for Community Health Extension workers to provide injectable contraceptive commodity. ◦ Distribution of free contraceptive commodities at Public sector health facilities. This has led to increased uptake. MATERNAL NEWBORN AND CHILD HEALTH
  • 61. +SURE-P and the Saving One Million Lives Initiative  Under the Subsidy Reinvestment Programme , Human resource for Health has been increased and jobs created by recruiting 3,960 health care workers to provide MNCH services in 500 SURE-P supported primary health care (PHC) centres spread across the 36 states and FCT. These health care workers comprise:  929 midwives;  1,783 community health extension workers (CHEWs); and  1,248 female village health workers  Completed a Conditional Cash Transfer (CCT) Proof of Concept Phase and State of Readiness Assessment for the follow-up Pilot Programme  Commenced communication and advocacy activities towards ensuring a Sustainability Plan to preserve the gains of the SURE-P MCH Programme.  Initiated the supply of essential drugs, health commodities and medical equipments to all 625 SURE-P supported primary and secondary health facilities.
  • 62. +The conditional cash transfer pilot has kicked off in 5 PHC facilities in FCT and will expand to 8 other States in June. ▪ Inauguration of State CCT Steering Committees in all other 8 pilot States ▪ Enrolment of Programme beneficiaries in the other 8 pilot states- Anabmbra, Bauchi, Bayelsa, Ebo nyi, Kaduna, Niger, Ogun, Zamfa ra ▪ Monthly cash transfer days in each CCT Pilot State ▪ The CCT pilot programme was launched at Deidei Comprehensive Health Centre, Bwari Area Council, Abuja on 13th May, 2013. ▪ An inaugural cash transfer day was conducted for the women who had been registered since enrolment began on 15th of April 2013. ▪ Of a total of 261 eligible beneficiaries, 172 (66%) attended and received their cash transfers (total ₦206,900 disbursed) ▪ The CCT pilot programme is now operational in all 5 FCT facilities and the PIU will conduct the next cash transfer days in each facility in June 2013. ▪ Data from the first month’s enrolment in Deidei CHC suggest very high uptake (an increase of 37.4% in ANC attendance and 15.3% in facility deliveries), compared to baseline data. CCT pilot launch overview 3 months from now…
  • 63. + SURE-P MCH OUTCOMES AS AT FEBRUARY 2013 Total ANC Visits New ANC Visits Deliveries by SBAs FP New Acceptors No attending FP Clinics No of Postnatal Checks April to Sept 2012 140503 51807 16695 11176 26292 25870 Oct to feb 2013 154133 61623 18285 14987 29190 26338 Core MNCH Indicators - Comparison with Baseline in SURE P MCH Facilities
  • 64. Maternal mortality has dropped by more than 50 percent in MSS Facilities from 2009 to 2012. Trends in Facility Based Maternal Mortality Rates per 100,000 Live Births 789 586 457 369 July -Dec 2009 July-Dec 2010 July-Dec 2011 July-Dec 2012
  • 65. LAUNCH OF THE SAVING ONE MILLION LIVES INITIATIVE BY MR. PRESIDENT
  • 66. + Elimination of Substandard, Fake and Counterfeit Drugs  Deployment of ICT for detection of fake and Counterfeit drugs (TRUSCAN and text messaging technique).  WHO accreditation of local pharmaceutical industries for drug production  Introduction of the text messaging technique for the authentication of drugs.  The upgrading of the standards and capacities of local drug manufacturing facilities like “Juhel” in Anambra State and “May & Baker” in Ogun State is also a major achievement. This has resulted in a decrease from 16.5% to 7.5% of the incidence of fake drugs in Nigeria  NAFDAC has put in place an e-registration process that has hastened applications for registration.
  • 67. + LAUNCH OF TRUSCAN FOR DETECTING FAKE DRUGS BY Mr. PRESIDENT, REPRESENTED BY THE HONOURABLE MINISTER OF HEALTH
  • 68. + Presentation of Report of WHO Pre-qualification Assessment of Six Local Pharmaceutical Companies
  • 69. + Strategies to Reduce Outward Medical Tourism  Ministerial Committee on unlocking the Private Sector Potential for th establishment of World Class Hospitals and high-end diagnostic centres in each of the six geo-political zones.  Improved specialist training  Budgeting for Overseas Residency Programme  Modernisation/Refurbishment of Federal Tertiary Hospitals  Acknowledgement and deliberate encouragement of private health sector leading to the upsurge in the number of private health facilities providing wolrd-class services in the areas of cancer screening, general medical check-up and diagnostics, endoscopic services, laser surgery, etc
  • 70. +3. HUMAN RESOURCES FOR HEALTH  The Midwives Services Scheme (MSS) has continued to grow with 3305 midwives and 946 CHEWS being deployed to 1000 health facilities. This project has received recognition internationally  The total numner of health workers trained/recruited in both the MSS and SURE-P now stand at 10,103 comprising of 4200 midwives, 2903 CHEWS and 3000 Village Health Workers  Reintroduction of the overseas component of the Residency Training Programme;  Capacity Building in Emergency Preparedness ( e.g Training in Israel, Training in Abuja by the International Committee of the Red Cross, Training organised by AFRICOM in Lagos, 2nd ATLS course organised by Emergency Response Limited, Principles of Operative Orthopaedics organised by AO).e
  • 71. + First Lady Dame Patience Jonathan Unveiling MSS Bill Board Communication
  • 72. +  National Stakeholders Conference on Trauma and Emergency Response  Committee on training of Paramedics in Nigeria established  First National Conference on Human Resources for Health.  Registration and training of Medical Physicists in Nigeria for the first time ever  Revised Curriculum for Undergraduate Medical and Dental Education.  Committee on the training of Herbal Practitioners in Medical Schools inaugurated.
  • 73. +  Committee on training of Complimentary and Alternative Medicine Practitioners constituted  Accreditation of new Faculties of Pharmacy.  CDC-Mentoring Laboratory towards National Accreditation ( MELTNA)  Task-shifting: trained CHEWs may now administer injectable contraceptives  New curriculum for the training of Community Midwives  Development of Global Health Players Programme
  • 74. + Other notable Milestones • The Medical Laboratory Science Council of Nigeria got a grant from CDC for the training of Medical Laboratory Assessors and Mentors to strengthen Nigeria’s Laboratory Quality Management Systems using the WHO/CDC/ASLM/SPLITA tools, ISO 15189 Standards and CLSI Guidelines. FMoH in collaboration with IAEA commenced the residency training of Medical Physicists at Usmanu Dan Fodio University Teaching Hospital Sokoto in 2012.
  • 75. + 4. FINANCING FOR HEALTH  Community Based Social Health Insurance Programme as well as Voluntary Contributor Social Health Insurance Programme.  Revision of capitation, service fees and benefits  ICT platform for NHIS initiated. Design is 85% completed  National Conference on Health Financing.  Preparation for the Presidential Summit on Universal health Coverage  Up scaling of the NHIS-MDG/MCH Project.  Work in progress on Social Health Insurance for the Handicapped and Prisoners respectively
  • 76. + Flag-off of the Community Based Social Health Insurance Programme HEALTH INSURANCEHEALTH INSURANCE
  • 77. + Flag-off of the Community Based Social Health Insurance Programme and also evidence of Community Participation and Ownership
  • 78. + 5. HEALTH MANAGEMENT INFORMATION SYSTEM • The National Health Management Information System was strengthened through the migration of the DHIS 1.4 unto the DHIS 2.0 which is web based which allows for real time data entry and access from any part of the world. • The Federal Ministry of Health in 2012 distributed complete computer system to 173 local governments to ensure real time data reporting. More Local governments will benefit from this programme in 2013 • The National HIV/AIDS Call Centre was commissioned in April, 2012 by the First Lady to provide HIV/AIDS information, guidance and counselling to callers.
  • 79. + 6. PARTNERSHIP FOR HEALTH  Signing of MoUs  With Austrian Government on Partnership in Public Health  With Remi Babalola Foundation Centre on Human Resources for Health  With UNFPA on Procurement, Supply and Distribution of Contraceptives under Mr. President’s initiative for free contraceptives in Nigeria  With General Electric (GE) for the establishment of private world class specialist hospitals and diagnostic centres under PPP arrangement.  Signing MOU with Health Professionals in Diaspora  With Federal Ministries of Women Affairs and Social Development and Finance  Approval of NIPRD as Regional Hub of the African Network for Diagnostics and Innovations (ANDI)  Regular meetings of Health partners Coordination Committee and development of template for mutual accountability  Regular meetings of the Inter-agency Coordinating Committee
  • 80. +  Resuscitation of Biovaccines limited , a joint venture between FGN and Mayer and Baker on Yellow fever vaccines  Admission of NCDC into the International Association of National Public Health Institutions (IANPHI)  Adoption of PHCs by Federal Tertiary Hospitals  Partnership with Office of the First Lady on various health issues  Partnership with Bank Of Industry (BOI)- offers credit facilities to local pharmaceutical industry  Partnership with ECOWAS Bank for International Development to support our local pharmaceutical industry
  • 81. +  Town Hall meeting by the Minister of Health in 2011 in Gedi LGA in Adamawa State.  Town Hall meeting by the Minister of Health in 2012 at Ebonyi LGA in Ebonyi State where over 4000 women participated. The 2013 will be in Benue.  Town Hall Meeting on HIV/AIDS by the First Lady in Nyanya, FCT.  Resuscitation of the Ward Development Committees.  Recruitment of Village Health Workers 7. Community Participation and Ownership
  • 82. + Town Hall Meeting during the MNCH week in Gedi LGA, Adamawa State
  • 83. + COMMISSIONING OF THE DOTT HEALTH CLINIC, BAUCHI
  • 84. + 8. RESEARCH FOR HEALTH  Health research in Nigeria is being championed by the Nigeria Institute of Medical Research (NIMR), National Institute for Pharmaceutical Research and Development (NIPRD), as well as Federal Tertiary Health Institutions and other non-government hospitals and organisations  Social production of NIPRISAN by NIPRD.  Support for research on Violence and Injury Prevention and Surveillance Programme in Nigeria  Support for research on the Hidden Epidemic of Death and Disease caused by Smokeless Tobacco and Cigarette Use in Nigeria.  Inauguration of Committee of Chairmen of Ethics Committee covering all federal tertiary health institutions.  In 2012 alone, National Health Research Ethics Committee reviewed nearly 100 research protocols including those for two clinical trial studies.  Development of Clinical Trials Registry – started in 2012 and is being finalised for registration as a WHO affiliated registry  Provision of diagnostic and health research services to about 3000 members of the public by NIPRD.  Determination of prevalence of hepatitis and its clinical impact on persons on HAART in NIPRD GOPD  Development of monographs on 30 Nigerian medicinal plants
  • 85. + Surveys NIMR has also conducted the following surveys: Malaria vector study on insecticide resistance Cholera epidemic study; Non communicable diseases study in Lagos Neglected tropical diseases study; and HIV/AIDS study
  • 86. + Surveys  Global Adult Tobacco Survey (GATS) completed and awaiting Presidential approval. This is part of our commitment to Zero Tolerance for Tobacco  Nationwide prevalence survey of TB - in the 36 states and FCT is currently ongoing. This is the first attempt at documenting the actual burden of TB.  National HIV/AIDS & Reproductive Health Survey – This is conducted every five years to provide data on behavioural aspects of HIV/AIDS as well as general information on reproductive health.  National Antenatal Sero-Prevalence Survey – This is an important survey that provides us with progress data on our efforts to reduce and halt the spread of HIV/AIDS.  2013 National Demographic and Health Survey being conducted in collaboration with the National Population Commission  Household and Health Facility Surveys across the country being conducted in collaboration with National Bureau of Statistics
  • 88. Key Deliverable Baseline Planned Target Actual Achieveme nt Remarks 2011 (December) 2012 (December) 2012 (December) 1Improved Quality Health Care Prevalence of Counterfeit and fake drugs in circulation (%) 19.6% 17% 18.2% % reduction in post-operative infection rates 43 45 - Administrative data Waiting time for patients (From registration to first contact with a Doctor) (mins) 30 25 25 Administrative data from Keffi FMC Increase Access to Healthcare Health Insurance Coverage 6% 8% 7.5% Administrative data from NHIS Percentage of LGAs having at least one FG supported ART refill site (%) 36 40 48
  • 89. Key Deliverable Baseline Planned Target Actual Achieveme nt Remarks 2011 (December) 2012 (December) 2012 (December) Provision of Policy, Regulatory and Administrative Services Maximum time required for MTB threshold from contract approval to signing at FMOH 10 working days 8 working days 8 working days Administrative data Number of interventions to enforce regulations 20 25 25 Increased Access to Basic Services Polio eradication: Increase population immunity against Wild Polio Virus (WPV1 and 3) measured by non polio AFP zero dose (%) Estimated 20% in HRS less than 10% zero dose - Polio eradication: at least 80% of wards reach 90 percent coverage during IPDs less than 50 80% or more reach 90% coverage 86 Administrative data from NPHCDA
  • 90. Key Deliverable Baseline Target Achievement 2011 (December) 2012 (December) 2012 (December) Routine immunization: Percentage coverage for measles vaccine 67 75 78.2 Maternal and Child Health: Increase in total focused ANC attendance in MSS sites 828,922 at least 10 percent increase over 2011 1,044,863 (26% increase) Maternal and Child Health: Increase in pregnant women with births attended by skilled health worker in MSS sites 110,028 at least 10 percent increase over 2011 141,929 (29% increase) Life Saving Commodities: Percentage of supported PHC facilities that report more than 1 month stock out of essential life-saving commodities Assessment ongoing 10% reduction from baseline -
  • 91. Key Deliverable Baseline Planned Target Actual Achievement Remarks 2011 (December) 2012 (December) 2012 (December) Improved Quality of Health Care PHC Quality: Percentage of MSS/SURE-P supported PHCs that have initiated at least one quality improvement programme e.g use of check lists Assessment on-going 40% 100% Application of integrated supportive supervision in all the sites applied as total quality assurance strategy FTHI Clinical Governance: Percentage of FTHIs with quality improvement/ clinical governance programmes in place None 25% 25% Unlocking the Private Sector ’ s Market Potential Revive Private Sector Health Alliance Inactive Functional PSHA -
  • 92. + CONCLUSION In conclusion, I wish to state that Mr. President’s Transformation Agenda in the Health Sector is effectively being implemented and on course. Two cardinal enablers that will make a quantum difference are:  i). A National Health Act which will define the Health System and provide governance structures for accountability, and  2). Universal Health Coverage entailing compulsory health insurance and improving geographical access to health. These will anchor the total transformation of the health sector. I thank all our development partners and other stakeholders in health for their collaboration and support in our strive to provide quality and affordable health care to all Nigerians.
  • 93. + I thank you for your attention.