USAID-IHP: Revitalizing health systems in Ebonyi through rewarding collaboration


The partnership between the United states Agency for International Development (USAID) and Ebonyi State Government, over the years, has produced desirable results, especially in the area of health, with particular focus on primary health.

Currently, there are six major health intervention projects under USAID funding in the State, all geared towards capacity building efficient and sustainable healthcare delivery. They include the Integrated Health program (IHP), the Break- through Action Nigeria (BA-N), Global Health Supply Chain program-Procurement and Supply Management (GHSC-PSM), Momentum Country Global leadership (MCGL), among others.

Among the various Health programs in the state, the Integrated Health program (USAID-IHP), being a current and updated project, has distinguished itself in the pursuit of its core mandate of strengthening healthcare facilities and services for durability and sustainability. 

Birthed in Ebonyi State in October, 2019, following a memorandum of understanding signed between the State Government and USAID for the revitalization of Primary HealthCare Services, the program has so far impacted much, especially in its focus areas: maternal and new born health, reproductive health and family planning; gender and child health which comprises integrated management of childhood illnesses, routine immunization and nutrition.

Moreover, the Program has broken limits, and still breaking, through its strategic involvement of the various major community stakeholders: traditional rulers, Town Union Executives, Development Committees and unions, as well as relevant Civil Society organizations in active ownership, management and revitalization of Primary health facilities in their domain. This particular partner innovation has introduced the “community watchdog” principle leading to better community monitoring, supervision and facility protection.

Recall that before now, most community stakeholders were passive over the happenings in the health facilities with health workers in these facilities showing acute recklessness in the discharge of their duties. IHP, in its learning agenda sessions have discovered that engineering community ownership of these health facilities would create an environment for sustainable positive outcome. 

Equipped with firsthand information on the deplorable condition of primary health facilities across the state from inception, the IHP in collaboration with the State Government was determined to leaving a legacy of unprecedented health facilities upgrade, health systems strengthening and manpower capacity improvement in Ebonyi State, capable of self sustaining.

It is in line with the commitment above that the USAID-IHP on Friday, August 27, 2021, donated health and training equipments to Ebonyi State Government for distribution to the 171 public primary health centres and 27 private facilities across the 171 political wards in the 13 local government areas of the State, currently in the IHP’s operational list.  These comprise of one major facility per ward.

The medical/training equipments comprising of training manuals, assorted job aides, anatomical models; kits, medical bowels, height measuring equipments and other supplies would be deployed to support roll out of Low Dose High Frequency Trainings in 3 key thematic areas: Maternal and Newborn Health, Child Health, Family Planning/Reproductive Health at health facility levels.  

The cumulative cost of the donated equipments and the upcoming training for health workers which was put at over one hundred million Naira, would further improve health care workers knowledge and skills in Maternal and Newborn Health; Child Health, Reproductive Health and Family planning.

Also, the emphasis on Low Dose High Frequency training whereby the training is taken to the workers at their various facilities further discourages truancy among health workers while enhancing on-the-spot practical experience.

The Ebonyi State Director, USAID-IHP, Gladys Olisaeke, speaking to our correspondent, gave a brief insight into the operations of the program in the State. 

She stated that part of the reasons USAID has concentrated its health projects in Ebonyi State were as a result of the State’s high statistics in maternal, child mortality and morbidity. She explained that apart from deploying its personnel to train health workers, IHP has engaged the partnership of three renowned local health-based organizations to lead the various trainings.
Olisaeke explained:  “The mortality and morbidity for mothers and children are higher in Ebonyi State compared to other Southeastern states. 

“When you compare the statistics for women, children, and adolescents, it is not as good as other States. So, this is why we are concentrating our work here.

“We are focusing on maternal and newborn health, reproductive health and family planning including gender and child health: and the child health comprises integrated management of childhood illnesses, routine immunization and nutrition.

“The cost of the training models which is those models we presented, the training manuals, other equipments and the training proper amount to over One hundred Million naira. 

“The models will be used to train health workers to provide health services. 

“We have the Manuals that will be used in the training, and they can also refer to those manuals after the training when they are doing their work and they somehow forget.

“We have engaged three local organizations to lead the rollout of these training in the health facilities. 

“We have the Women, Children’s Health and Community Development Initiative (WOCHAD) leading the low dose high frequency training for family health and reproductive health; we have Life Helpers Initiative, leading the training for child health, and Society for Obstetrics gynecologists in Nigeria (SOGON), Ebonyi State chapter. They are leading the maternal and new born low dose high frequency training in all those facilities we have mentioned.

“Now the total cost of engaging these organizations to get their trainers, go to each facility is over two Million Naira per facility, including the cost of the materials”

One of the main aspirations of the USAID-IHP is to ensure that its innovations towards revitalizing health facilities and services in the State are domiciled and sustained beyond the program at all levels. Therefore, to really ensure that these models, equipments and other of its intervention services are protected and effectively utilized to achieve their purposes, the IHP has always instituted an internal mechanism which hitherto was not in place: the integration of all tiers of government, community leaderships, and other stakeholders in its project executions.

This innovation has also enabled it engage effectively for proper need assessment of the health systems and facilities with the aim of providing lasting remedies.

Olisaeke further explained: “We are working very closely with the state, and in each of those trainings, they have not less than five officials that has been trained and are master trainers leading the training team in each of the thematic areas of maternal, new born health and family planning .

“Also, the Local government focal persons for each of these areas are part of the training, and they would have to be trained on these thematic areas.

“They will be working closely with the state and local government health officers to do the training, supervise them as well as in monitoring afterwards, to ensure that the equipments procured remains in the facilities and are put into use.”

In all these, it is noteworthy that the State government led by Governor David Umahi has done much for the thriving of these partnerships.  Apart from creating the enabling environment, he has been diligent in counterpart funding, as well as proactive in seeking remedies for health and other challenges facing the State. His infrastructural developments have created unprecedented investment attractions, creating easy access to facilities in all rural communities.

The State Commissioner for Health, Daniel Umezurike acknowledged the immense contributions of USAID and the ingenuity of the Governor while receiving the models and equipments in his office in Abakaliki.

Umezurike said: “This particular training: Low Dose High frequency training pilot study was conducted here in Ebonyi state.  This is part of the outcome of that partnership, that when you do a pilot study and you see it works, the precise place to implement it is still in Ebonyi state. So, that is what is playing out.

“I want to thank the USAID, and IHP in particular for this gesture. We thank them for their support, and I want to assure you that all these things provided will be judiciously used; they will be kept safe. 

“I always emphasize that cleaning is the most cost effective way of safeguarding our property and equipments.

”Each of these facilities will have their names engraved on it. 

“This training will in no small measure lower the mortality and improve child survival in Ebonyi state and that is the mission and vision statement of our dear Governor.

”Let me say that this journey started many years ago when we had MCSP and when they were closing out, His Excellency, led a team to USAID, precisely the US Ambassador's office, and made a request that Ebonyi state still needs partners support.

“The Governor understands that health is capital intensive which no person or government can undertake alone.

“It always requires partnership and collaboration, and the request was granted him.

‘For us in the ministry of health, we followed it up. 

“Each time I go to Abuja for any assignment, I go to the Ambassador's office begging that Ebonyi state needs support, and they granted our request and sent their support.

“Because they saw transparency in Ebonyi state, and also saw enabling environment for people to work, Ebonyi state today, is one of the most supported states in the federation. 

“But like Oliver Twist, we are still asking for more.

This is like a prayer answered and we cannot rest until everything about the State is transformed.

“Today, we are seeing huge investment and development in health sector in general, and primary health sector in particular, trying to improve on the maternal new born and child healthcare. 

“I am the highest advocate of Low Dose High frequency training, because the traditional training where you pull people from facilities to come and assemble in a place for days or weeks is not working very well…”

Indeed, the operations of the USAID-IHP in Ebonyi State, with other USAID-funded programs hold lots of promises of better days ahead in the health sector. It therefore behooves the Government, health workers and the entire people of the State to sincerely queue into the program irrespective of any immediate shortfall.

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