PATHS Final programme report: "Togetherness in Health" the Enugu ...

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equired in order to ensure that more extensiverepairs could be carried out and a full servicedelivered. An allocation for both was included inthe 2008 SMoH budget.Monitoring of the PPM Officers progresssuggested that all new equipment was in useand some previously broken equipment hadbeen repaired and was back in use.“Professionally the course was an eye opener.I learnt more on plumbing job, how to handleplans and services, how to handle hospitalequipment and more about management.Personally it made me proud of myself, andproud of my job. When we went to UwaniClinic there were two baby weighing scaleswhich were dumped but I picked them up andrepaired them. They are using them now. AtAkpuoga Nike Clinic there were new tablesscattered, even drawers, which we picked upand repaired and they are making use of themnow.”Iziga Edwino, previously a carpenter who is nowPPM team leader for Enugu Metropolitan District44 PATHS Final Programme Report
Production of a Drug DirectoryNigeria is renowned for its preponderance of fake drugs, which are freely available across the country.PATHS supported the development of a Drug Directory of information on genuine medicines andconsumables. This involved identifying available generic and brand dosage forms, their compositionsand strengths, NAFDAC numbers, manufacturers, Nigerian representatives, agents, importers and theirdistributors and contact addresses.It was hoped that the Directory would help to:• Improve the quality of care provided by private or public medical practitioners, pharmacists etc;• Alert all stakeholders in health to their duties in checking fake, counterfeit, substandard orunwholesome drugs;• Improve the co-operation of pharmaceutical companies in making available all addresses of theircompanies, agents and distributors so that public sector drugs procurement could avoid the opendrug market;• Remove the doubt of some pharmaceutical manufacturers that the initiative intended to provethat they dumped their products in open markets and lacked distributors.Copies of the Drug Directory were widely circulated to pharmacists across the public and privatesectors, pharmacy outlets, and the National Council for Pharmacists for Nigeria. The Directory was wellreceived.Development of Laboratory ServicesThe laboratory strengthening initiative commenced early in the programme. The idea was to developlaboratory services linked to the private sector in Nsukka. For a number of reasons, however, theinitiative was not taken forward and the direction changed in 2006 when all the PATHS states cametogether to agree a way forward. The outcome of the discussions was implementation of a communitydiagnostic programme (CDP) to improve the testing of malaria, TB and Hb estimation. Much of thein-state TB work was managed in conjunction with German Leprosy Relief Association (GLRA) and theSMoH TB Supervisor, who provided the data and microscopes.A programme of work was agreed including:• Provision of equipment, reagents and Malaria Rapid Diagnostic Tests (RDTs)• Training of laboratory scientists/technicians/assistants from the public and private sectors• Community mobilisation to encourage utilisation of laboratory services• Provision of TB/DOTS (Directly Observed Treatment Shortcourse) signage and InformationEducation and Communication materials• Provision of motorcycles for TB & Leprosy supervisors• Development of standard operating procedures• Establishment of a quality assurance scheme• An independent review of all the SMOH-listed TB laboratories.A survey of TB/DOTS clinics/laboratories across the state found that of the 112 facilities that weresupposed to be providing these services, in practice only 25% were offering a genuine service. As aresult, a decision was made to focus the laboratory strengthening work on 20 laboratories (eight PHCand 12 SHC facilities: of which six were in the faith-based sector).“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 45
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 and 16: PHC centres and cottage hospitals i
Page 17 and 18: Section 2:Overview of the PATHSProg
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 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
Page 68 and 69: Intermediate Outputs1) The DHS stru
Page 70 and 71: 5) A culture of business planning a
Page 74 and 75: 4) The tendency for politicians to
Page 76 and 77: Abbreviations and AcronymsANCBCCBEO
Page 78 and 79: AcknowledgementsThe PATHS programme
Page 80 and 81: Master trainersSMoH/faith based sec
Page 82: 80 PATHS Final Programme Report

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