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

The selection process resulted in three faith-based hospitals providing care under the scheme; oneeach for the north, central and south sections of the district. Contract details were agreed and amemorandum of understanding to inform the day-to-day operation of the scheme was signed bythe respective partners. The scope of the scheme was restricted to those requiring inpatient care upto and including a 14 day period beyond delivery. Given the limited budget available for what wasthought would be a high demand scheme, robust monitoring and control mechanisms were builtinto the pilot. The referrals were initially restricted to the PATHS supported clinics located in the ruralparts of the district, which were zoned with one of the faith-based providers. The clinics were asked toexercise discretion so that women who would not normally use private or faith-based hospitals, due tocost, were given priority for referral. However, the referring clinics were later expanded given the lownumber of referrals initially.The women referred were charged a maximum of N 10,000 (approx £40) for services, regardless of theactual cost. This constituted on average about 25% of the cost. A joint committee representing theDHB, providers and PATHS was established to monitor implementation of the pilot.The pilot started in November 2006. It ceased asa pilot in December 2007 when the governmenttook over the funding of the scheme. Whilst theuptake of the scheme was initially very muchslower than anticipated, the number of womenusing the scheme increased in 2007, and by early2008 80 women had benefited.“Mother of Christ has cared for 29 womenthrough the scheme. After 12 months Iwould suggest that 50% of the women caredfor would have died had the scheme notexisted.”Consultant Obstetrician,Mother of Christ HospitalImmunisationConsiderable thought was given to what action could be undertaken by the state in order to promotean increase in the uptake of routine immunisation (the idea was that this should complement theFMOH’s supplemental immunisation campaigns).A decision was made to commission an NGO,CREASUP, to use their highly successful peerto-peerchild support approach to encourageschool children to educate their peers, parentsand communities of the need for all childrento be routinely immunised. The campaign wascentred on schools, both primary and secondary,and in the communities surrounding theEarly Bird Clinics. These were the first PATHSsupportedclinics and were selected to maximiseimpact, given the training of the EBC staff. Overthe period October 2005 to September 2006,the NGO trained 1,350 peer educators andschool facilitators who reached some 40,000secondary school children, 43,000 primaryschool children and 50,000 people across thelinked communities.CREASUP is an NGO that works withchildren to effect behaviour change. Asmall core of children who are linkedto the NGO learn about the particularrequirements of the work from seniorCREASUP staff. They become the trainersand, using drama as a learning medium,they teach other children and adults inschools or at community level about issuesaround which changes in behaviourwill help save lives (or bring about otherpositive changes at individual, householdand community level). The children arenot only highly effective, but also in highdemand.54 PATHS Final Programme Report