Kalejaiye Olasunkanmi

Paul

Welcome to our latest Open Forum meeting on the CFP chat. Our guest today is CFP for Nigeria, Kalejaiye Olasunkanmi. Thanks for offering to chat with us today Kalejaiye. Please introduce yourself and tell us what motivated you/your organisation to advocate for ‘Primary Health Care under One Roof’

Kalejaiye (CFP Nigeria)

Morning, Greeting from Nigeria.

(Welcomes from Melody, DCFP Zimbabwe, Duku, CFP Liberia, Dr-Soliman, CFP Egypt, Muh (DCFP Cameroon), Djallo (CFP Central African Republic), Mountassir (CFP Chad), Mahamat (DCFP Chad), Phatismo (DCFP Botswana), Hassan (CFP Somalia), Frederic (Steering Group)

Kalejaiye

I am the Executive Director Global Promoters for Community Initiative. What really motivated us is the decayed level of Primary Health Care (PHC) in Nigeria which has made us the fifth worst country in the world for the highest number of Mortality deaths. This tiggered us towards PHC advocacy. We want our mothers and children to be safe.

Paul

Thanks and of course. Can you tell us about the initiative please – the scope of the project. It can’t be easy in a country the size of Nigeria to know where to start?

Kalejaiye

The scope is to reduce mortality death rate through use of a national score card. We are working in nine states of Nigeria on PHC advocacy. The National Health Act of 2014 houses every health thematics in Nigeria and gave birth to the Primary Health Care under One Roof (PHCUOR) policy that we picked as a tool for our engagement with the Government. The project is solely on advocacy. The score card shows how each state is doing in each of the pillars of PHCUOR. We discovered some states scored very poor. The one we worked on  scored just 11% in Minimum Service Package (MSP). We choose to work on the MSP because that is where most of the dividend of democracy will reach the end users.  One thing about PHC advocacy, it that it houses every other component on Health issues. if we can get it right at the PHC level everything else will fall in place – nutrition, immunization, malaria, NTDs etc all falls under it

Paul

For clarification purposes, what does Primary Health Care Under One Roof mean?

Kalejaiye

In Nigeria, it was discovered that many government institutions are providing health service at the rural level without synergy. One Ministry will provide Human Resources for health, another for consumables etc. The Government saw the need to bring these under one management and co-ordination hence Primary Health Care Under One Roof – to have everything co-ordinated in one office. The score card is a state wise performance with 9 pillars that the PHCUOR needs to address. The state must fulfill all 9 pillars to get a good grade

Melody

Oh yes the picture becomes clear through partnership

Kalejaiye

You can say that but to a point as they see CSOs as obstacles – you need to prove that we are friends in progress before they will open the door of partnership. These are the nine state worked on  – Oyo, Lagos, Nasarawa, Bauchi, Gombe, Katsina, Cross River, Abia and Niger. We took Niger State

Mahamat

Can you tell us about your challenges?

Kalejaiye

The key challenge experienced during the project was the bureaucratic bottlenecks in accessing government functionaries and information. The team learnt that continuous visits and being patient with the authority paid in the end.

Duku

What are the less obvious challenges because it’s reported that Nigeria is one of the biggest contributors to Global Mortality Rate (GMR)?

Kalejaiye

Nigeria’s high GMR instigated our rigorous Advocacy efforts to get Nigeria out of that list and the idea came to revamp all our PHCs. The Government has now committed resources to ensuring each ward has one World Health Organisation (WHO) standard PHC center.

Muh

Do you work in consultation with homes or hospitals?

Kalejaiye

Advocacy has nothing to do with Homes and Hospitals because, if we can get the critical stakeholders involved including the service providers, every hospital will be functioning as it ought to and people will be able to access their health services

Mahamat

Any objectives please?

Kalejaiye

We have 2 main objectives – 1. To advocate to government and other critical stakeholders to develop the MSP. 2. To advocate to the wealthy citizens to use their resources to help the government. Government alone cannot do it.

Duku

As it stands, what is your success rate? Are the PHC centres and stakeholders compliant, in the way you want?

Kalejaiye

The major achievements of this project are visible and laudable. Some are mentioned below.

  • The project met its target and has produced a draft of casted MSPs.
  • A State Healthcare Delivery Plan was developed for the state.
  • The State Coordinator was appointed as a member of the costing committee for the plans.
  • All planned activities were conducted with results and some activity that was not contained in the workplan was also conducted within the limited resources
  • Niger State government through the office of the Hon. Commissioner for Health recognised our advocacy for the need for them to partner with local CSOs for effective implementation of government policy and programs.

The project was designed with sustainability by follow ups. On a monthly basis we contact the agency  – we hope they have recorded our names in their heart. We formed a coalition of CSOs that also includes journalists for the advocacy

Muh

To get something done in Africa you have to go in the field. How do you ensure follow up. I know my government is not that different from yours. They are very accurate on the paperwork but worse when it comes to practice.

Kalejaiye

That is where you need to involved media to record all your moves and observations. We shared our findings via social media and tagged them. Newspaper usually published our activities as well.

The nine pillars

This project has brought us to a table with the key stakeholders. We have met the Governor’s wife, house committee chairman on health. I took the matter also to traditional institution

My visit to Governor’s wife

Muh

How to you plan to extend your agency all over the country

Kalejaiye

We work base on the limited resources to hand. We have a mission to take it to the whole country with time

Duku

Are you working alongside other organizations or youth groups?

Kalejaiye

Yes, we formed a coalition that covers other CSOs

Paul

The 9 pillars which make the score card – are these graded or just yes/no? ie is it possible to track trends?

Kalejaiye

Yes, its graded by % so its possible to track trends – as I speak we are on phase 2 because we achieved the first pillars that we chose. We are now working on two additional pillars.

Paul

I think this information would be of great interest to SDSN’s manager Eve de la Mothe Karoubi. She was chatting here a month ago

Kalejaiye

The Government appreciates advocacy more than going to the media to report, but you need to be smart with them

Paul

Interesting – what key lessons have you learn’t

Kalejaiye

We have learn’t a lot. Working together as a coalition makes your work easier. Government knows what to do but will not do it if there is no external push. – just like Newton’s laws of motion. Consistent and unending advocacy is the way forward.

Check our twitter @glopromoters to see what we are uploading. You can also visit us on www.globalpromoters.org and on facebook – global promoters for community initiative. Global Promoters (GP) is a voluntary/non profit making organization with the aim of improving the quality of life through community based oriented projects in the  Health and Education areas. The organization was formed by a group of people with like minds and passion in 1999.

Paul

Thanks for the image of the pillars – what does MSP stand for please? I see it is the weak pillar for the example you gave us

Kalejaiye

Minimum Service Package  – its a UN standard for PHC

Paul

Why is it so poor for this state?

Kalejaiye

The former Executive Director only classified the Centres not knowing that a document must be costed and produced for services rendered at each PHC

My advocacy to the first lady of Niger State.

I will keep u posted as we continue the fight. Next two weeks is on GFF in Niger State. A day seminar. You are  invited (more info about GFF at https://www.globalfinancingfacility.org/government-nigeria-global-financing-facility-and-partners-co-finance-effort-improve-health-and

Paul

Thank you very much for your time today and for sharing the advocacy project with us..

Kalejaiye

You are welcome all. Am grateful. You can see the full project report on our website.