PATHS Final programme report: "Togetherness in Health" the Enugu ...
PATHS Final programme report: "Togetherness in Health" the Enugu ... PATHS Final programme report: "Togetherness in Health" the Enugu ...
KEY FACTSPublic sector health facilities (436)2 Tertiary hospitals, UNTH (Federal) and ESUTSpecialist Teaching hospital, Park Lane (State)6 District hospitals2 Sub district hospitals8 Specialist clinics3 Dental clinics56 Cottage hospitals189 Health centres39 Health clinics131 Health postsPrivate/faith based facilities (488)84 Clinics28 Clinics and maternity homes10 Dental centres/clinics20 Eye clinics5 Health centres2 Homeopathic hospitals119 Hospitals with maternity services69 Maternity homes128 Hospitals23 Medical centresFor a variety of reasons including irregularpayment of salaries, non payment of allowances,poor working conditions and lack of staffaccommodation, many individuals employedin the public sector ran their own private clinicsand some were known to actively divert patientsaway from the public sector to their own facilities.The level of commitment to the delivery ofgood public sector services by those employedwithin the sector was low, resulting in frequentabsenteeism. Since absenteeism was also an issuewithin the management cadres, this reduced theincentives to use sanctions to deal with this andthe other human resource related problems thatbeset the sector.Substantial state Government health funds wereprovided for the upgrading of the State’s mainsecondary hospital to a tertiary teaching facility.This left the remaining facilities short of funds.ChallengesThe under-utilization of public healthfacilities in Enugu State is frequentlyattributed to:••••••••high informal chargespoor staff attitude to work and patientsdeplorable state of infrastructureinadequate drug supplypoor work environmentinadequate incentivesinaccessibility of facilitiespoor quality of care• inadequate staffing, particularly medicalstaffing and pharmacists14 PATHS Final Programme Report
Section 2:Overview of the PATHSProgrammeThe PATHS programme commenced nationally in June 2002 and was introduced into Enugu state inJuly 2002 with the recruitment of the State Team Leader. The programme started with a core staff ofseven people; a State Team Leader, a State Programme Officer, an Administrator, an Accountant, anOffice Assistant and two drivers. In 2005 the establishment was expanded to include a Logistician, anAccounts Supervisor and a further driver.Inevitably over the six year timeframe of the programme there were a number of staff changesincluding the State Team Leader in 2004, State Programme Officer in 2005, three changes ofAdministrator in 2006 and five drivers. The longest serving member of staff was Ugochi Egbujor, theAccountant, who was with the programme from inception onwards.PATHS Enugu StaffDr Andrew McKenzie State Team Leader July 02 - February 04Angie Roques State Team leader July 04 - June 08Gloria Onyeabo State Programme Officer October 02 - September 04Dr Chibuzo Oguoma State Programme Officer January 05 - June 08Klara Aqua Administrator September 02 - December 05Ifeanyi Echefu Administrator March 06 - September 06Amaka Umeigbo Administrator October 06 - June 08Ugochi Egbujor Accountant October 02 - June 08Mohammed Salihu Accountants Supervisor September 05 - June 08Amaka Umeigbo Logistician April 05 - September 06Rita Nkwam Office Assistant May 03 - July 07Ikechukwu Alioke Office Assistant November 06 - June 08Mba Kalu Driver July 02 - March 05Eze Livinus Driver May 03 - April 05Uchenna Ezeala Driver April 05 - June 08Gabriel Ogbu Driver April 05 - November 05Hyginus Chinze Driver April 05 - November 05Vincent Uzochukwu Driver December 05 - June 08Raymond Browne Driver January 06 - June 07Ignatius Ndubuisi Driver July 06 - June 07“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 15
- Page 3 and 4: "Togetherness in Health"the Enugu E
- Page 5 and 6: FORWARDI am very pleased on behalf
- Page 8 and 9: 6 PATHS Final Programme Report
- Page 11 and 12: Section 1:Setting the Enugu Context
- Page 13 and 14: KEY FACTSHealth Indices: Comparison
- Page 15: PHC centres and cottage hospitals i
- Page 19: Stakeholder initiatives supported b
- Page 22 and 23: PATHS ApproachEngagement Process wi
- Page 24 and 25: Pro-poor FocusPATHS pro-poor focus
- Page 26 and 27: “PATHS has indeed impacted very p
- Page 28 and 29: the 56 Executive Secretaries of Loc
- Page 30 and 31: Health Board and the Districts. The
- Page 32 and 33: it was agreed that the original ide
- Page 34 and 35: •••Working to an agreed timef
- Page 36 and 37: PATHS provided much of the infrastr
- Page 38 and 39: to access for the Ministry of Healt
- Page 40 and 41: and the core DRF models used in oth
- Page 42 and 43: Enabling Service DeliveryDeveloping
- Page 44 and 45: Procurement of Drugs and EquipmentT
- Page 46 and 47: equired in order to ensure that mor
- Page 48 and 49: Training in the laboratory of Annun
- Page 50 and 51: The services to be delivered were a
- Page 52 and 53: Where care is givenEnugu’s health
- Page 54 and 55: Enugu State Total Deliveries in Pub
- Page 56 and 57: The selection process resulted in t
- Page 58 and 59: Reduced maternal andinfant mortalit
- Page 60 and 61: By the conclusion of the second ser
- Page 62 and 63: With the advent of the DHS it was a
- Page 64 and 65: Inter-Personal Communication and Co
KEY FACTSPublic sector health facilities (436)2 Tertiary hospitals, UNTH (Federal) and ESUTSpecialist Teach<strong>in</strong>g hospital, Park Lane (State)6 District hospitals2 Sub district hospitals8 Specialist cl<strong>in</strong>ics3 Dental cl<strong>in</strong>ics56 Cottage hospitals189 Health centres39 Health cl<strong>in</strong>ics131 Health postsPrivate/faith based facilities (488)84 Cl<strong>in</strong>ics28 Cl<strong>in</strong>ics and maternity homes10 Dental centres/cl<strong>in</strong>ics20 Eye cl<strong>in</strong>ics5 Health centres2 Homeopathic hospitals119 Hospitals with maternity services69 Maternity homes128 Hospitals23 Medical centresFor a variety of reasons <strong>in</strong>clud<strong>in</strong>g irregularpayment of salaries, non payment of allowances,poor work<strong>in</strong>g conditions and lack of staffaccommodation, many <strong>in</strong>dividuals employed<strong>in</strong> <strong>the</strong> public sector ran <strong>the</strong>ir own private cl<strong>in</strong>icsand some were known to actively divert patientsaway from <strong>the</strong> public sector to <strong>the</strong>ir own facilities.The level of commitment to <strong>the</strong> delivery ofgood public sector services by those employedwith<strong>in</strong> <strong>the</strong> sector was low, result<strong>in</strong>g <strong>in</strong> frequentabsenteeism. S<strong>in</strong>ce absenteeism was also an issuewith<strong>in</strong> <strong>the</strong> management cadres, this reduced <strong>the</strong><strong>in</strong>centives to use sanctions to deal with this and<strong>the</strong> o<strong>the</strong>r human resource related problems thatbeset <strong>the</strong> sector.Substantial state Government health funds wereprovided for <strong>the</strong> upgrad<strong>in</strong>g of <strong>the</strong> State’s ma<strong>in</strong>secondary hospital to a tertiary teach<strong>in</strong>g facility.This left <strong>the</strong> rema<strong>in</strong><strong>in</strong>g facilities short of funds.ChallengesThe under-utilization of public healthfacilities <strong>in</strong> <strong>Enugu</strong> State is frequentlyattributed to:••••••••high <strong>in</strong>formal chargespoor staff attitude to work and patientsdeplorable state of <strong>in</strong>frastructure<strong>in</strong>adequate drug supplypoor work environment<strong>in</strong>adequate <strong>in</strong>centives<strong>in</strong>accessibility of facilitiespoor quality of care• <strong>in</strong>adequate staff<strong>in</strong>g, particularly medicalstaff<strong>in</strong>g and pharmacists14 <strong>PATHS</strong> <strong>F<strong>in</strong>al</strong> Programme Report
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