The Honourable Minister of State for Health, Dr. Olorunnimbe Mamora has expressed concern over the continuing spread of COVID-19 infection among health workers in the country, despite all efforts being made to curtail it.

Dr. Mamora revealed his bewilderment at the Presidential Task Force (PTF) on COVID-19 Press Briefing in Abuja on Thursday, 13th August, 2020.

The Minister however reiterated Government's commitment to sustaining the gains so far made in reducing the ugly trend.  To this end, he disclosed that about 594 healthcare workers from various private and public facilities in Abia State have undergone training and retraining on infection prevention and control.  “We are concerned by the resurgence of infection in healthcare workers. In a bid to sustain the gains we have made in reducing the rate of infection among our health workers, we have made training and retraining of health workers on infection prevention and control our priority”, he said.

Dr. Mamora added that government is currently investigating healthcare-associated infection in a health facility in Kaduna State and that lessons learned from the investigation would be used to improve service delivery.

While urging the healthcare workers not to drop their guards, the Minister charged them to ensure appropriate usage of their Personal Protective Equipment (PPEs). “I encourage our health workers not to drop their guards as the pandemic is still with us.  Use your PPEs appropriately and judiciously.  We have ensured that PPEs are available in all our health facilities”, he said.

Updating on the Nation's COVID-19 cases, Dr. Mamora revealed that as at 13th August, 2020, Nigeria has tested 338,084 samples so far and has recorded 47,743 cases with 33,943 persons treated and discharged while 956 persons have been lost to the COVID-19 infection.  He added that more than 70% of all the tests conducted have been in 9 states including Lagos, Kano, FCT, Plateau, Oyo, Kaduna, Edo Ogun Rivers with 25% of the tests in Lagos alone. He assured of the Federal Government's continued collaboration with State Governments to ramp up case findings and sample collection activities saying, “Our target remains to test 1% of our population across the country.”

In another development, Dr. Mamora has commended the Nigerian youths for their efforts in national development, particularly in the area of community mobilization, risk communication through the social media and community engagement in the fight against the global pandemic.  He made this commendation while commenting on the United Nations’ International Youth Day which was commemorated on 12th August, 2020 across the world.

He also appealed to them to take responsibility and adhere to appropriate non-pharmaceutical measures, as the pandemic is already taking a toll on the youths in the country. “I wish to commend some of our youths who have supported community mobilization and risk communication through the social media and community engagement.  This pandemic has had its impact on our young people. “As at yesterday, 46% of positive cases in the country are young people between ages 21-40. I will therefore appeal to our youths to take responsibility. Let us ensure that we adhere to the advisories to wear face masks appropriately, regularly wash your hands and ensure respiratory hygiene”, he said.

Blessing Egbo
For: Olujimi Oyetomi, Director, Information, Media & Public Relations.

The Israeli Embassy in Nigeria led by H.E. Shimon Ben-Soshan which earlier planned a donation of 10, 000 face masks to “medical staff who are in the frontline in Nigeria” has made good its promise coming with the second donation of 2, 000 today, Wednesday, 12th August, 2020.  

The earlier donation of the first installment of 2, 000 was made earlier on Thursday, 7th May, 2020.  To this, the Honourable Minister of Health, Dr. Osagie Ehanire who in the company of the Permanent Secretary, Health, Mr. A.M. Abdullahi received the second installment of the promised face masks said he wish that Nigeria could reciprocate this kind gesture given the fact that Israel like every other country in the world is facing its own share of the COVID-19 pandemic.

The Israeli Ambassador to Nigeria H.E. Shimon Ben-Soshan had earlier pointed out that the face masks were designed in Israel but produced in Nigeria by a Nigerian-Israeli Company - Skill-G Nigeria.  The Israeli Ambassador proudly announced that “the production of the face masks were produced in Nigeria by Nigeria engineers”, but regretted that the State of Israel would have love to donate all the planned 10, 000 at once but that the production of technique is such that only 100 of such masks could be produced per day.  So, with the second batch of 2,000 brought in, an outstanding 6,000 of such masks are still being expected.

Display of the 2000 face shields.
Display of the 2000 face shields.

The Honourable Minister of Health gave two reasons why he is always feeling grateful whenever there is an extension of goodwill in forms of donations to Nigeria.  He said:  “First, we have a large population, and therefore, we need a lot of materials; Secondly, he said, “No one knows how long this will last and where we are heading as we are all looking forward to vaccine, then everybody has to be ready to defend its citizens; that’s where we are placing a lot of emphasis on stockpiling.”

Dr. Osagie Ehanire further said that “For the State of Israel, we know that you have your own problems and challenges of COVID-19 and as everyone is dealing with its own, it is very gratifying to note that you still have time to support your neighbour in need.  We too wish we could also send you something to you in Israel, because that would have been mutual.”  The Honourable Minister expressed sympathy with Israel over what he said are developments there:  “Our thoughts and prayers are with everybody there.”  He also asked for the opportunity for mutual studying of the situation and sharing of experience and knowledge between scientists in Israeli and Nigeria.

Dr. Ehanire also approached the visitors from the Israeli Embassy with two other requests:  (i) sharing knowledge with Israeli Researchers on Vaccine against COVID-19, so that “by the time we are able to get the vaccine, when you are the first to get, you will be able to support those countries that are in need for their citizens; and (ii) Nigeria working with Israeli consultancy to establish its Medical Ambulance Emergency Service disclosing that there has been zoom meetings in partnership with Israelis to learn how Israeli operates its emergency medical services which Nigeria is just trying to establish.  The Honourable Minister of Health mentioned the motorcycle medical response team in particular which Israel has been using.

Olujimi Oyetomi, Director, Information, Media & Public Relations.

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The Minister of Health, Dr. Osagie Ehanire, representing President Muhammadu Buhari GCFR today, Tuesday, 11th August, 2020 took delivery of 200 lifesaving ventilators from the people and Government  of the United States (US) to boost her response to COVID-19. The Minister of Health, Dr. Osagie Ehanire received the donation at Premier Medical Warehouse, Jabi, Abuja.

While conveying the appreciation of President Muhammadu Buhari, GCFR to President Donald Trump and the people of America, the Minister applauded the United States for the donation which he considers “generous and friendly” particularly at this time when the US is also being preoccupied by the global pandemic, the minister assured that the equipment will be judiciously used.

The President’s representative said: “This donation consists of 200 ventilators, which, as we all know by now, are a critical component of the response strategy to save the lives of persons who have been severely impacted by this viral infection.  “They will certainly be of great benefit to the people of Nigeria and I wish to convey the appreciation of His Excellency, Muhammadu Buhari, President of the Federal Republic of Nigeria and of the Government of Nigeria, to President Donald Trump and the United States Government for the generous consideration and friendly gesture.  We particularly appreciate that this gift comes against the backdrop that the United States is also fighting its own fierce battle against the COVID-19 plague. We wish them the very best in this challenge”, he said.

Dr. Ehanire also commended the United States Agency for International Development, the United States Centre for Disease Control (USCDC) and the US Ambassador to Nigeria, Her Excellency, Mary Beth Leonard, for their interests and engagement in Nigeria, even beyond the advent of COVID-19. “Her Excellency has demonstrated personal concern by paying a solidarity visit to the Federal Ministry of Health”, the Minister said.

The Minister also used the occasion to appeal to the United States Government to lend its full weight to the global efforts to find efficacious therapeutics and vaccines to neutralize the threat of COVID-19 to the global community and to guarantee fair allocation to all countries and people.  “The speed and ease with which COVID-19 has spread across the globe clearly shows that it is a threat to mankind.  Without the full collaboration of all nations, the threat of COVID-19 to any one part of the world is a threat to all”, he added.

The HMH, Dr. Osagie Ehanire and Ambassador Mary Beth Leonard cuting the ribbon to mark the  handing over ceremony.
The HMH, Dr. Osagie Ehanire and Ambassador Mary Beth Leonard cuting the ribbon to mark the handing over ceremony.

Earlier, the U.S. Ambassador to Nigeria, Mary Beth Leonard who made the donation on behalf of the United States’ Government said “The 200 ventilators being transferred today are compact and portable, and can be easily mobilized to reach those patients with the most severe symptoms of COVID-19.”

She added that the support includes training on the use and maintenance of this equipment and ensuring that the ventilators can address other respiratory illnesses in the years beyond the virus.

The Ambassador said the ventilators which she tagged “life-saving equipment” is a fulfillment of the commitment made by Presidents Donald Trump and Muhammadu Buhari earlier this year to assist in tackling the rampaging COVID-19 in Nigeria.

Blessing Egbo
For: The Director, Information Media & Public Relations.

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The Honourable Minister of Health, Dr. Osagie Ehanire has warned Nigerians on the looming danger ahead of the re-opening of the Nation’s economy if protocols meant to curb the spread of COVID-19 are not strictly adhered to.

Dr. Ehanire issued the warning during a press briefing of the Presidential Task Force (PTF) on COVID-19 in Abuja on Monday, 10th August, 2020.
The Honourable Minister admitted that although the reopening of the economy may come with many benefits, “more is to be lost if the right things are not done.”  He added that “there is need to prepare for societal changes that will arise as the economy reopens with increased transportation, trade and human interaction, including possible reopening of air travel. “We must make an effort to balance the benefits of a reactivated economy with the need to keep citizens safe, with no loss in gains so far made.”

Further, Dr. Ehanire disclosed that as of 10th August, 2020, Nigeria has tested 317,496 samples so far and has recorded 46,577 cases with 33,186 persons treated and discharged while 945 persons have been lost to the COVID-19 infection.  He further revealed that the COVID-19 infections have now been identified in 549 of the 774 local government areas in Nigeria, adding that half the number of cases is concentrated in 20 Local Government areas. “Half of all cases in Nigeria so far are concentrated in 20 Local Government Areas, which could offer the attractive option of targeted attention, to focus on case finding, isolation, and treatment”, he said.

The Minister therefore reminded Nigerians that until a vaccine is found for the virus, adherence to the guidelines is the surest way to stay safe as according to him, “Many more Nigerians today personally knew a person who succumbed to COVID-19, and so I ask that we remind ourselves today that COVID-19 is still with us and will be for a long time.  “Until there is a vaccine, the only options we have to protect ourselves, are still the non-pharmaceutical measures that are proven to be cheap and effective, such as the appropriate use of face masks, physical distancing, and avoiding crowds. If we do not adhere, there could be regrets”, Dr. Ehanire said.

While restating Government’s commitment to the fight against the pandemic, Dr. Ehanire listed some of the strategies being deployed to include: turning to gadgets that provide oxygen, like oxygen generators, which Government would like to have in many facilities, including General hospitals and larger Primary Health Centres.

Dr. Ehanire further mentioned that solar powered aggregates, where available, will be prioritized. The Honourable Minister also reported that he has directed that “Federal Health Institutions with oxygen plants should activate them as a matter of priority and ensure they can deliver to their Accident and Emergency Department.”  

He also listed activation of ambulance service to move patients to treatment centres under the guidance of Federal Ministry of Health as one of the strategies deployed to manage COVID-19 by the Health Team.   “Our focus is still to reduce fatality to less than 1%, not only with preventive measures, but also with a strategy that encourages citizens to report early for treatment and for hospitals to attend to all patients in distress; most importantly, to be able to provide oxygen treatment”, he said.

The Honourable Minister also said that the continuity of normal health services, capacity building of health workers and their protection with PPEs, are the most critical activities.  He urged State, LG authorities and healthcare workers to ensure that there is most rational and judicious use of such protective equipment is made.

Similarly, Dr. Ehanire informed that the National Council on Health (NCH) in its virtual  Emergency Meeting held on Thursday, 6th August, 2020 approved the revised Guidelines for the Administration, Disbursement and Monitoring of the Basic Healthcare Provision Fund (BHCPF), also called the BHCPF Guidelines 2020, which was suspended in January, to correct anomalies in the 2018 Operations Manual and the establishment of the National Emergency Medical Service and Ambulance System (NEMSAS), an innovative system to pool the assets of public and private sector ambulances and hospitals, to raise funds to augment government seed money, and to work with States to provide emergency medical care and patient transportation to all citizens whenever and wherever it is required and irrespective of immediate or potential ability to pay. These approvals, he said will no doubt give boost to the Nation’s fight against COVID-19.

Blessing Egbo
For: Olujimi Oyetomi, Director, Information, Media & Public Relations.

The Honourable Minister of Health Dr. Osagie Ehanire has restated the need for a modernized blood transfusion service in Nigeria stating that “the importance of blood transfusion service in the health system of a country is not something that we need to emphasize again”, in our country here, apart from a very high mortality rate, a large portion of which is very high, is ascribed to blood loss.”

The Minister of Health, made this statement when a visiting team from the National Blood Transfusion Service (NBTS) led by its National Coordinator, Dr. Joseph Amedu paid him a courtesy visit to update him on the progress and challenges faced by the NBTS.

The Minister said “with a high portion of mortality rate in Nigeria, ascribed to blood loss especially around delivery - postpartum haemorrhage with large amount of blood required for routine surgery, accidents, in trauma cases, chronic diseases like sickle cell anaemia which has a high prevalence in Nigeria, justify very well the need for the modernization and creation of a Blood Service Commission.”

He further highlighted the importance, potentials and benefits of the Blood Service Commission to include; fulfilling all the needs of the country in the areas mentioned, the idea of having One million strategic blood reserve for the country, sighting the explosion that rocked Lebanon with a large number of people requiring blood transfusion, in a case where one is faced with such, with a reserve you have somewhere you reach into to take care of mass catastrophe and disasters, he said is a “good idea.”

L-R The Honourable Minister of State for Health, Dr. Olorunnimbe Mamora, the HMH, Dr. Osagie Ehanire and the Permanent Secretary, Health, A. M Abdullahi at the(NBTS) meeting.
L-R The Honourable Minister of State for Health, Dr. Olorunnimbe Mamora, the HMH, Dr. Osagie Ehanire and the Permanent Secretary, Health, A. M Abdullahi at the(NBTS) meeting.

The Minister also spoke of commercializing the blood service industry, “with a huge population of 200 million with majority young people, which is a pool of donors more than Europe’s.  We have the materials right here, the masses. With a global high demand for blood products, parts and proper blood fractionation, the  Commission will not only be self sustaining but highly revenue generating, this is a goldmine if explored”,  he stated.

Dr. Ehanire said that the Ministry has noted the challenges faced by the NBTS, and will set up an appointment for the team to speak with the Joint Health Committees on Health of the National Assembly who are responsible for appropriation to have the opportunity to put forward the thoughts and vision of the NBTS Team to enable the NASS members join in appreciating the value of blood transfusion service and blood transfusion development in Nigeria which is also the vision of the President.  He advised the team to articulate its thoughts into a document to the Permanent Secretary of the Ministry of Health.

He noted the huge potential of blood transfusion service and is happy that the team has been able to articulate everything and put it on the table and let those who have the technology come up with suggestions and partnership, because “Government, the Minister said will not have all the money; the idea of private partnership is highly recommended and welcomed.  With South Africa being the most advanced country in Africa when it comes to transfusion science at the moment, a visit to learn from them will be worthwhile to know how it is organized and how to streamline blood testing and increase the parameters that are tested, to add more parameters.”

Earlier, National Coordinator informed the Minister of the NBTS proposal of a bill for a Commission which was approved by the Federal Executive Council in 2018.  He disclosed that this has just gone through public hearing on the 23rd of July, 2020 and awaiting passage by the 9th National Assembly.  He highlighted some of the progress made so far by the NBTS to include re-establishing relationships with partners and stakeholders for effectiveness and efficiency, with the NBTS prepared for active advocacy, enlightenment and sensitization to communities and Nigerians on the importance and need for voluntary non-remunerated blood donation, while working on different strategies to attract and convince donors even in the face of the COVID-19 pandemic.

Dr. Omale Joseph Amedu reading his speech at the (NBTS) meeting.
Dr. Omale Joseph Amedu reading his speech at the (NBTS) meeting.

He further said that the re-organization of the administrative and functional structures, to pave way for carrying out its mandate, concentrating energy and resources on having functional zonal centres, letting States take over their centres and those without, to establish one, while providing technical support to them.  He added that while awaiting the passage of the bill, they have started discussions with partners and the private sector for investors to indicate interest in the move to commence the commercialization through production of blood components and plasma derivative medicinal products.

Not leaving out some of the challenges faced to include; lack of enabling legislation required to carry out regulatory function on blood safety practices, though it is being addressed, he said, lack of adequate office accommodation, lack of sufficient funds for the NBTS’ operational activities, late release of budgetary appropriation for program implementation during the period under review resulting to low blood collection and late implementation and execution of scheduled activities; low public awareness and deep cultural myths and misconceptions on voluntary blood donation by the public were some of the challenges he listed.

The National Coordinator of NBTS also listed insufficient and outdated laboratory screening equipment which he said is hindering quality screening processes nationwide; continued insurgency and security challenges experienced across the country, which has greatly reduced blood collection activities in the affected zones, among others.

Dr. Joseph Amedu further appealed for financial intervention from the Ministry of Finance through the Office of the Honourable Minister of Health to enable the Service move forward “because the annual budget envelope may not be very reliable”.  He also requested that the Minister gives NBSC a special consideration during the bilateral budget discussion with the Budget Office for 2021 appropriation.

The NBTS is charged with the responsibility of providing safe, quality blood and blood products for transfusion in a cost-effective manner to all who may require it in Nigeria.

Blessing Efem
For: The Director, Information, Media & Public Relations,

The Honourable Minister of Health, Dr. Osagie Ehanire has expressed appreciation to the new executive of the Nigeria Medical Association (NMA) led by Prof. (Dr.) Innocent A.O. Ujah, FNMA, mni and has also welcome the offer of partnership and support from the medical association, a body to which he acknowledges that both the Honourable Minister of State for Health, Dr. Olorunnimbe Mamora and himself and other Doctors in Federal Ministry of Health (FMOH) belong.  

Dr. Osagie Ehanire stated that he was particularly happy to hear of the offer of support and partnership from the new executive of NMA:  “There is nothing we need more than the support of NMA.  All of us here are doctors and therefore and integral part of what you are doing and you are our key partner in whatever we are doing here at the Ministry.”

The Honourable Minister further said that he was also happy to hear of your support particularly about National Emergency Medical Services and Ambulance Support Scheme (NEMSAS).

The NMA had earlier proposed to partner with FMOH “with interest in not just as a stakeholder in Health in Nigeria but that of FMOH”; as well as support for the Ministry’s proposed project which it is now working to put in place – NEMSAS.  Dr. Ehanire revealed to his visitors that he was earlier in a meeting with the NEMSA’ Committee and has directed that NMA be a part of the Committee and promised to bring more of the NEMSAS project, which is “an innovative way to save lives”, to the attention of NMA very soon.

Dr. Osagie Ehanire further tasked the NMA Executive to find for FMOH “what percentage of maternal mortality arises from the fact of not being able to get to hospital or for getting to a hospital and finding it closed?”  He itemized the benefits of an emergency ambulance service that is readily available and assessable to serve the needy at emergency times and charged the NMA Executives to come on board the planning for this.

The Honourable Minister of Health also expressed his appreciation to the new NMA EXCO for its offer to work with FMOH Team on COVI-19 adding that the target of his team is to ensure that every local government area has a testing site, a general hospital, if not, a primary health care centre, so that samples can be collected and taken to test centers.  “We want every centre to have a holding room before and ambulance arrives to take a patient off; that means we attend to the vulnerable and we attend to people before they get clinically very unwell.”  He proceeded to show his visitors the table model of approved Primary Health Care for the country.  “We want to depress our case fatality rate to less than 1%.”
While responding further to some of the issues raised in the earlier address by the President of NMA, Dr. Ehanire said that the Health Insurance is under reform to make it mandatory in collaboration with States’ Government which has States’ Insurance Scheme with a target to achieving the universal health coverage.

Group photography to mark the visit.
Group photography to mark the visit.

On the request for the extension of the retirement age of Medical Doctors, Dr. Ehanire said he sympathized with the NMA:  “I think people can still give a lot after attaining 60 which was set I think when people’s life expectancy was low.” He also directed the NMA to give him “a rationale for the suggestion for a Surgeon General; what is the duty, terms of reference, so that we can understand directly what help it will bring.”

On NMA’s request for the Honourable Minister to assist its cause to have the Yayale Ahmed Committee’s report come to implementation, the Minister confessed that he does not know how far the Government has gone on it.  He said he is not acquainted with how far Government has gone with the Yayale Ahmed Report except that the report has been undergoing reviews.  “What will come out of it, I cannot tell you.  Government is naturally very careful about taking any step, without knowing the consequences.”

Earlier, the Honourable Minister of State for Health, Dr. Olorunnimbe Mamora commended the immediate past EXCO and congratulated the new team challenging the NMA to find a way to bring the President to attend some of their functions noting that the medical profession is a very dignified one and cautioned the Association to stand firm on principles and guide the young doctors – NARD before young doctors will seek to outpace the older and experienced ones in the leadership of the NMA.

The structure building of National Healthcare  Center being displayed during the visit by the Nigeria Medical Association  at the Ministry Conference room
The structure building of National Healthcare Center being displayed during the visit by the Nigeria Medical Association at the Ministry Conference room

The new NMA EXCO President, Prof. (Dr) Ujah requested to partner FMOH; the Ministers to facilitate payment of all outstanding allowances and entitlement of doctors and review same upwards.  He also request FMOH to fast track NMA’s proposal of a new scheme of service and retirement age of 70 years of special grade 1 consultant and 65 years for others; resolution of conflicting professional regulating bodies e.g. Medical and Dental Council of Nigeria (MDCN) vs Medical Laboratory Science Council of Nigeria (MLSCN); expand employment quota for doctors and central pooling and distribution of house officers and reviewing and implementing the Nation Health Act (NHAct).

Olujimi Oyetomi,
Director, Information, Media & Public Relations.

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In the Executive Summary to the BHCPF Document provided by the Executive Director/CEO of the NPHCDA, Dr. Faisal Shuaib, the enactment of the National Health Act 2014 and establishment of the Basic Health Care Provision Fund (BHCPF) in Section 11 represents a watershed moment in Nigeria’s path toward providing equitable access to care for Nigerians, and Universal Health Coverage. Its implementation is to be based on this Guideline document which stipulates the governance, administrative and funding and monitoring mechanism for the Fund.
He further said that in accordance with the National Health Act, the BHCPF is derived from (a) an annual grant from the Federal Government of Nigeria of not less than one per cent (1%) of its Consolidated Revenue Fund (CRF); (b) grants by international donor partners; (c) funds from any other sources, inclusive of the private sector. Its implementation is aimed at increasing the fiscal space for health, strengthening the national health system particularly at PHC level and ensuring access to care for Nigerians particularly the poor, contributing to overall national productivity.

Dr. Faisal further said in the executive summary that the BHCPF is to be managed by a robust governance framework led by the Honourable Minister at federal level and state Commissioners for Health at the state and approves all proposals and reports at the respective levels. The governance framework and operational protocols outlined in the Guideline does not create any additional layer of bureaucracy, but rather strengthens its implementation by leveraging the mandates and structural advantages of the main implementers i.e. the NPHCDA and NHIS and ensuring operational synergy. This is achieved through the support of the NASS Committees on Health, the Ministerial Oversight Committee, the State Oversight Committees and the Gateways’ Forum, LGHA Advisory Committee, the WDC and PHC management Committees; made of implementers and beneficiaries across the various tiers of government and health care delivery structure in Nigeria.

The executive summary gave the overall objective of the BHCPF being to ensure the provision of a Basic Minimum Package of Health Services (BMPHS) to all Nigerians and, strengthen the Primary Health Care (PHC) system. Based on the NHAct 2014, this is to be achieved by:

•    Disbursing 50% of the BHCPF through the National Health Insurance Scheme (NHIS) via a pathway to be called the NHIS Gateway, which would purchase health services based on the BMPHS from providers nationwide

•    Disbursement of 45% of BHCPF through the National Primary Health Care
Development Agency (NPHCDA Gateway) for the provision of essential drugs, vaccines and consumables for eligible primary health care facilities (20%), the provision and maintenance of facilities, laboratory, equipment and transport for eligible primary healthcare facilities (15%) and the development of Human Resources for Primary Health Care (10%); and

Utilization of 5% for the provision of Emergency Medical Treatment (EMT Gateway)

The Guideline outlines in details the governance structure and operations of each of the Gateways, governance structures and fiduciary measures and sanctions.

The sections relating to the NPHCDA Gateway outlines roles and responsibilities for the NPHCDA, the State PHC Boards and Agencies, the LGHAs, WDCs and PHC facilities. The Gateway actions would provide skill, capacity, technical support and fund the availability of essential medicines, health commodities, ensure facility availability of vaccines, human resources, maintain PHC facilities and sustain outreach services; all culminating in improvement in the quality of PHC services available to Nigerians.

Dr. Faisal’s summary went on to say that funding throughout the NPHCDA Gateway is based on annual improvement and quarterly business plans of the PHC facilities and annual proposals by the SPHCB/As. Investment by the SPHCB/As would be initially guided by the outcome of baseline assessments and prevailing health priorities in the state. Likewise, subsequent investments would be premised on the outcome of quality improvement assessment, monitoring and supervision and other surveys and financial audits. On a quarterly basis, PHC facility will receive a decentralized Facility Financing from the NPHCDA through the SPHCB/A, while SPHCB/A would receive and manage quarterly grants for human resources. Similarly, the SPHCB/A would be required to retire a statement of expenditure before receipt of funding for the subsequent quarter.

The summary went on to say that the sections on the NHIS Gateway, outlines how Nigerians and health care providers would enroll to become beneficiaries of the BHCPF, which would enable citizens access care based on the BMPHS at no cost to them in designated PHC and secondary health facilities. The Gateway would operate in a similar fashion to the NPHCDA, transmitting funds in the form of premium for lives covered from the NHIS through the SSHIA to the health care providers.

Payments for services rendered at the PHC level would be by capitation, while that for secondary care would be based on fee for service. Payments within the NHIS Gateway would be based on services provided in accordance with the BMPHS.  Bridging the gap between need and access to health care in emergency situations is the Emergency Medical Treatment (EMT) Gateway managed by the National EMT Committee as appointed by the National Council on Health.  

Related sections for the EMT Gateway expatiate on the administrative structures and processes for the establishment of an Emergency Ambulance Service in Nigeria, to bridge the gap between need and access to care in an emergency. The ambulance service would operate with extensive private sector participation and operate utilizing an emergency call-centre system to be co-located with the national emergency call-centre both at the federal level and in states.

The Guideline ensures transparency and accountability through the application of a robust M&E framework, an accountability framework, KPI for national and state levels and through its governance structure. As anticipated developmental partners and CSOs would also support the implementation of the funding and its monitoring in their various spheres and states of implementation as outlines in the sections on monitoring and evaluation.

The Executive Director/CEO of NPHCDA later expressed the confidence that judicious implementation of this Guideline would enable Nigeria effectively to fast-track the implementation of the BHCPF and yield impactful health benefits to its citizens.

Olujimi Oyetomi
Director, Information, Media & Public Relations.

Another Emergency National Council on Health virtual meeting is currently ongoing, 6th August, 2020 to consider Basic Health Care Provision Fund (BHCPF) Guideline developed by the National Primary Health Care Development Agency (NPHCDA) and others like the National Emergency Medical Service and Ambulance System (NEMSAS) presented by the Honourable Minister of Health through the Director, Trauma, Emergency and Disaster Response, Federal Ministry of Health (FMOH).

According to the draft agenda made available by the Planning, Research and Development Department of Federal Ministry of Health, the Emergency National Council on Health virtual meeting will consider the followings:
•    Memo on Approval of the Draft BHCPF Guideline presented by the Executive Director/CEO, NPHCDA.
•    The Basic Health Care Provision Fund (BHCPF) Guideline for the Administration, Disbursement and Monitoring of the BHCPF was developed by the NPHCDA in collaboration with National Health Insurance Scheme (NHIS) and National Emergency Medical Treatment Committee (NEMTC) in June, 2020.  
•    National Emergency Medical Service and Ambulance System (NEMSAS) presented by the HMH through the Director, Trauma, Emergency and Disaster Response, FMOH.
•    The DG, NCDC is expected to update the NCH on COVID-19 Response and Guideline for Setting up COVID-19 Sample Collection Sites in the States
•    The Executive Sectary of NHIS is also expected to brief the NCH on NHIS Financing for States.
•    The Director, Family Health in FMOH is expected to also brief SOML P4R Project.
The NCH is expected to come out with a Communiqué at the end of the Emergency National Council on Health.

It may be useful to recall that the National Council on Health (NCH) is the highest advisory body on health care and health issues in Nigeria.  Membership of NCH is composed of the Honourable Ministers of Health and the Commissioners of Health in the States of the Federation as well as the Secretary for Health and Human Services in Federal Capital Territory (FCT).

Of the BHCPF Guidelines which is at the heart of one of the memo to be considered by the Emergency NCH of 6th of August, 2020, the Foreword as given by Dr. Osagie Ehanire, the Honourable Minister of Health to the BHCPF document, describes the Basic Health Care Provision Fund (BHCPF) as enshrined in the National health Act 2014, as an irrevocable testament of Nigeria’s commitment to achieving Universal Health Coverage.

“It is a large-scale reform, aimed at expanding the fiscal space for health and shifting financial resource to the front lines of care. The BHCPF represents a sustainable model for ensuring equity and financial risk protection for the nation’s vulnerable populations, by guaranteeing effective access to a Basic Minimum Package of Health Services, funded from not less than one percent of the Consolidated Revenue Fund, financial grants from local and international donors, partners, the private sector and philanthropic individuals. It is envisaged that the prudent application of the fund would positively reverse our National health indices and place Nigeria firmly on the path to Universal Health Coverage.”

The HMH said, to achieve this given objective of the BHCPF “in an efficient accountable and transparent manner that also ensures value for money, this Guideline for Implementation of the BHCPF (year 2020), has been developed following a revision of the 2018 Operations Manual.”  He said: “This rapid transition was prompted by the need to address fundamental issues around the mechanisms for fund administration and some implementation processes in the preceding document that conflicted with the National Health Act amongst other concerns.”

This revised Guideline is the outcome of extensive conversations, consultation, and consensus between representative bodies of the Federal and State Governments, Legislators, Partners, CSOs and the Private sector. Its successful implementation would likewise be based on the unflinching commitment of all stakeholders, inclusive of the health providers and citizens themselves.

This Guideline will define and hold to account the actions of the core implementing entities i.e. the NPHCDA, the NHIS and the National Emergency Medical Treatment Committee. It would also guide the participation of all stakeholders contributing to or supporting the implementation of the BHCPF; and serve as a reference for health providers, training institutions, researchers, and the public.

Ultimately, the purpose of the Guideline is to afford health sector in Nigeria, an innovative and catalytic framework for assuring Nigerians of access to health services on demand that is of good quality and at no cost to citizens at the point of care. I enjoin all to support Nigeria in this quest based on the guide provided herein.

There are some illustrations in the BHCPF document which are meant to further enrich the understanding of the NCH members and other operators who may wish to appreciate the health funding arrangement more.  There is the ‘Framework for Funds disbursement under the NHIS Gateway’; ‘Monitoring and Evaluation Flow’; ‘Institutional Structure for NPHCDA Gateway’; ‘Schematic for Emergency Medical Response for National and States’; ‘Governing structure of the BHCPF’; ‘Framework for partnership engagement and contribution for the BHCPF’; and the ‘Fund Management Flow Chart’.

Olujimi Oyetomi
Director, Information, Media & Public Relations.

The Honourable Minister of State for Health, Senator Dr. Olorunnimbe Mamora has flagged off the Air Logistics Support from Federal Republic of Nigeria to Economic Community of West African States (ECOWAS)/West African Health Organization (WAHO), Tuesday, 4th July, 2020 at the Nigeria Air Force (NAF) Executive Airlift Base at the Nnamdi Azikwe International Airport, Abuja.

Dr. Olorunnimbe Mamora did the flag off, acting on behalf of the Chairman, Presidential Task Force on COVID-19 and the Secretary to the Government of the Federation, Mr. Boss Mustapha at about 18.25 p.m.

While flagging off the Air Logistics Support, the Honourable Minister of State for Health, who was initially at the flag off ceremony to represent the Honourable Minister of Health, Dr. Osagie Ehanire paid glowing homage to President Muhammadu Buhari who he said was appointed by his peers – Presidents of ECOWAS member Countries as ECOWAS Champion of COVID-19 fight for approving that the Nigeria Air Force should avail ECOWAS and the West African Health Organization (WAHO) the logistics support to airlift COVID-19 medical equipment procured on behalf of member States of ECOWAS by WAHO for distribution to the beneficiary ECOWAS Countries.  

Dr. Mamora declared that for President Muhammadu Buhari to have within so short a time, approve that NAF resources be deployed to assist in the airlift and distribution of the medical supplies of WAHO to the other West African Countries is the stuff of which a champion is made of and that “the role being played by Nigeria in the logistics support to distribute the medications and supplies is in the spirit of brotherhood.”  Dr. Mamora expressed optimism that it is the same spirit of brotherhood that will see the sub-region to overcome the COVID-19 pandemic in no distant time.

It may be recalled that WAHO on behalf of the ECOWAS member States procured some medical equipment to fight COVID-19 for the use of the member States.  The cost of airlifting was jointly borne by member States and delivered to Abuja where it was stored up.  The stock for Nigeria was recently taken delivery of whilst the rest was initially stored up at the Premier Medical Warehouse in Jabi, Abuja to be airlifted for distribution to the other Countries.

The Director General of WAHO, Prof. Stanley Okolo in a communication released on the subject said the flag off event became necessary because NAF plans to airlift the first batch of the consignments to countries starting by Wednesday, 5th August, 2020 and going in the following order:

Wednesday, 5th August: routing through Abuja – Abidjan – Bissau – Banjul – Dakar – Abuja;
Friday, 7th August: routing through Abuja - Lome – Monrovia Freetown – Conakry – Praia – Abuja;
Monday, 10th August: routing through Abuja – Niamey – Ouagadougou – Bamako – Cotonou – Lagos.

Olujimi Oyetomi, Director, Information, Media & Public Relations, FMOH.

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The Honourable Minister of Health, Dr. Osagie Ehanire has restated that an estimated 20,000 maternal deaths could be prevented annually if optimal breastfeeding were practiced.

The Minister made this revelation during a press briefing to commemorate the 2020 World Breastfeeding Week; a weeklong long series of activities held from the 1st to 7th of August every year to create awareness and generate support for improved breastfeeding practices for good health and wellbeing outcomes for infants and young children.

The theme of this year’s celebration which is “Support Breastfeeding for a Healthier Planet” focuses on the impact of proper infant feeding on the environment, by garnering support for breastfeeding for the health of people and planet.

Dr. Ehanire who highlighted the benefits of breastfeeding to both mother and child to include stronger immunity for babies, reduced risk of suffering many childhood illnesses and infections, naturally environmentally friendly, since it does not draw on any resources or create environmental pollution, longer-term health benefits including reduced risk of overweight and obesity in childhood and adolescence, with studies showing that obesity rates are 15-30% lower in breastfed babies compared to formula-fed babies.

Breastfeeding, the Minister added, provides health benefits to mothers, by helping to prevent postpartum bleeding, support child spacing, lower the risk of breast and ovarian cancers and earlier return to pre-pregnancy body weight.

He however expressed the note that despite these benefits, the breastfeeding indices in Nigeria are below optimal. “According to the National Demographic and Health Survey 2018, 97% of children are breastfed at one point or the other; but only 42% are put to breast within 1 hour of birth and the proportion of children 0 to 6 months who are exclusively breastfed is a mere 29%. The World Health Organization (WHO), in a series of Lancet publications on breastfeeding, reports that scaling up breastfeeding practices to almost universal level could prevent an estimated 823 000 annual deaths, or 13•8% of all deaths of children younger than 24 months.”

Speaking further, the Minister of Health said the Federal Ministry of Health recommends early initiation of breastfeeding within an hour of birth, exclusive breastfeeding for the first 6 months of life, continued breastfeeding up to 2 years of age or beyond and introduction of appropriate complementary food as from 6 months. And as part of measures to increase optimal breastfeeding practice the Ministry developed the National Social and Behavioral Change Strategy for Infant and Young Child Feeding, but a major barrier to its proper implementation is the practice by mothers and care givers, on giving water to babies from birth to the age of 6 months.  In addressing this problem, Dr. Ehanire said, “The National Zero Water Campaign was launched during the 2019 World Breastfeeding Week celebration, aimed to educate Nigerians on the need to give babies only breast milk, and no other liquids in the first six months of life. The Campaign is ongoing in several States.”

The Honourable Minister further disclosed that the National Guidelines on the Baby Friendly Initiative (BFI) is currently being reviewed. He said it encompasses baby friendly services in the hospital, community and workplace; the goal of which is to incorporate programming breastfeeding as an integrated delivery in routine services pertaining to breastfeeding at health facility, community and workplace, and incorporating the revised 10 steps to successful breastfeeding.

Whilst reiterating that the Ministry’s commitment to promoting and supporting breastfeeding is resolute and is to address threats which unwholesome marketing of breastmilk substitutes (BMS) poses to optimal breastfeeding practice. He enjoined all to make a renewed commitment to do more to help the Nigerian child experience the lifesaving benefits of optimal breastfeeding. “An investment in breastfeeding is a cost-effective investment in our nation’s health, economy and future workforce the Minister stated.”

Earlier, the Minister of State for Health, Dr. Olorunnimbe Mamora in his welcome remarks, said that the theme of this year’s celebration highlights the links between breastfeeding and planetary health, aimed at informing people about the links between breastfeeding and the environment; it anchors breastfeeding as a climate-smart decision, engages individuals and organizations for greater impact.

Dr. Olorunnimbe Mamora said the theme galvanizes action for improved breastfeeding practices. His words: “Recalling that Nigeria is committed to the 1990 Innocenti Declaration which enjoins all Nations to protect, promote and support mothers to optimally breastfeed our infants and young children.”

The Honourable Minister of Women Affairs Dame Pauline Tallen who was present to express goodwill during the press briefing to mark the 2020 Breastfeeding Week, stated that commemorating the week, which dates back to 1992 coincides with the peak of advocacy around women issues and concerns during the Better Life for Rural Women Programme, is a reinforcement of the need for proper bonding for the mother and child, from birth to 6 months exclusively before the gradual introduction of water and other forms of complimentary feeding. She called on organizations at all levels to key into this initiative and set up support facilities for working mothers.

Similarly, the Country Representative of UNICEF, Peter Hawkins in his goodwill message said that almost 97% of children in Nigeria were breastfed at some point, but more needs to be done when it comes to early initiation and exclusive breastfeeding to meet global targets. “The rate of exclusive breastfeeding in Nigeria has recorded a minimal improvement over the years; 25% in 2014, down to 23.7% in 2016/17, and up again to 29% in 2018.” He went further to say that “The global target is to increase exclusive breastfeeding rate in the first 6 months of life to at least 50 percent by 2025.”  He further stated that the COVID-19 Pandemic has however impacted optimal breastfeeding practices through its effects on household incomes and perception about the safety of breastfeeding for both mothers and children.  He added that given the lack of evidence that transmission of the virus can occur through breast milk, the WHO recommends that all mothers - including those with suspected and confirmed COVID-19 be encouraged to initiate and continue breastfeeding their babies, while observing all necessary safety and hygiene precautions.
Also present at the event were representatives from CS-SUNN, Donors amongst others.

Blessing Efem
For:  The Director, Information, Media & Public Relations.

FMOH Agencies

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