6 <strong>PATHS</strong> <strong>F<strong>in</strong>al</strong> Programme Report
SUMMARYThe <strong>PATHS</strong> <strong>programme</strong> was operational <strong>in</strong> <strong>Enugu</strong> State from 2002 to 2008 and dur<strong>in</strong>gthat period worked with four Health Commissioners and six Permanent Secretaries. It washoused with<strong>in</strong> <strong>the</strong> State Health Board premises which did much to promote a harmoniousand cohesive work<strong>in</strong>g relationship with government structures. Whilst <strong>PATHS</strong> workedpredom<strong>in</strong>antly with <strong>the</strong> State M<strong>in</strong>istry of Health, it also worked <strong>in</strong> partnership with anumber of o<strong>the</strong>r government m<strong>in</strong>istries; <strong>in</strong>clud<strong>in</strong>g Local Government, Economic Plann<strong>in</strong>gand F<strong>in</strong>ance and <strong>the</strong> Local Government Services Commission. In addition, <strong>the</strong> <strong>programme</strong>worked with a number of faith-based hospitals; a large selection of NGOs and CBOs; and itspartner DFID <strong>programme</strong>s, particularly <strong>the</strong> State and Local Government Programme and<strong>the</strong> Health Commodities Procurement project.The <strong>in</strong>troduction of a District Health System (DHS) was at <strong>the</strong> heart of <strong>Enugu</strong> State’s health reformagenda. The vision was that a DHS would allow primary and secondary health services to be<strong>in</strong>tegrated, mark<strong>in</strong>g an end to fragmented and <strong>in</strong>efficient service delivery. The devolution ofmanagement under <strong>the</strong> DHS was also expected to create new opportunities to revitalise poorlyfunction<strong>in</strong>g primary health care facilities.<strong>PATHS</strong> support to <strong>the</strong> State M<strong>in</strong>istry of Health (SMOH) <strong>in</strong> <strong>Enugu</strong> focused on <strong>the</strong> development andstreng<strong>the</strong>n<strong>in</strong>g of <strong>the</strong> underp<strong>in</strong>n<strong>in</strong>g systems that would allow <strong>the</strong> DHS to function. Once <strong>the</strong> basicsystems were <strong>in</strong> place, efforts turned to improv<strong>in</strong>g service delivery. With <strong>the</strong> support of <strong>the</strong> DFIDHealth Commodities Project, much-needed drugs and equipment were supplied to <strong>the</strong> health facilitiesthat were supported by <strong>PATHS</strong> (approximately 100 at <strong>the</strong> conclusion of <strong>the</strong> <strong>programme</strong>). A M<strong>in</strong>imumService Package, standards of care, and a Drug Revolv<strong>in</strong>g Fund were <strong>in</strong>troduced, all of which helpedto improve service delivery and <strong>in</strong>crease access. Extensive staff tra<strong>in</strong><strong>in</strong>g, both cl<strong>in</strong>ical and non-cl<strong>in</strong>ical,was provided <strong>in</strong> 28 key areas. Approximately 2,500 staff benefited from tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Life Sav<strong>in</strong>g Skills(LSS), f<strong>in</strong>ancial management systems (FMS), bus<strong>in</strong>ess plann<strong>in</strong>g, health management <strong>in</strong>formationsystems (HMIS), and <strong>in</strong>ter-personnel communication skills (IPCC), among o<strong>the</strong>rs.Given that <strong>in</strong> 2002 <strong>the</strong> majority of patients <strong>in</strong> <strong>Enugu</strong> used private or faith-based facilities, <strong>PATHS</strong>supported <strong>the</strong> SMOH to develop public, private partnerships <strong>in</strong> health. The provision of EmergencyObstetric Care (EOC) services by three faith-based hospitals, with fund<strong>in</strong>g provided by <strong>the</strong> <strong>Enugu</strong>District Health Board, was pioneered under <strong>the</strong> <strong>Enugu</strong> EOC+ Pilot Scheme. Early results suggested that<strong>the</strong> scheme had resulted <strong>in</strong> a number of mo<strong>the</strong>rs’ lives be<strong>in</strong>g saved, and was a promis<strong>in</strong>g example of apublic-private partnership.<strong>PATHS</strong> also supported <strong>the</strong> SMOH and <strong>the</strong> constituent bodies of <strong>the</strong> DHS to develop partnerships withNGOs and community-based organisations, with <strong>the</strong> aim of utilis<strong>in</strong>g <strong>the</strong>ir skills, competencies andl<strong>in</strong>ks with communities to create demand for services. Efforts were also made to <strong>in</strong>crease communityparticipation and engagement <strong>in</strong> local service delivery. To this end, community representation on“<strong>Toge<strong>the</strong>rness</strong> <strong>in</strong> Health” <strong>the</strong> <strong>Enugu</strong> Experience <strong>in</strong> Health Sector Reform, 2002-2008 7
Change language