Healthcare Delivery System: Osun As A Case Study

Of recent, Osun Healthcare Delivery System has been in the limelight, particularly on issues bothering on salaries and allowances of its medical and health workers, a situation that has portrayed the state has been insensitive to the healthcare welfarism of the people. FRANCIS EZEDIUNO writes on the activities of the state government on healthcare delivery system.

In recent times, the healthcare delivery system in the State of Osun has been in the limelight, particularly on issues bothering on welfare of medical doctors; salaries and allowance, as well as ‘agitations’ by the medical workers for the provision of medical equipments and other consumables. The agitations, particularly, by medical doctors has recently resulted into industrial action.

Unfortunately, these agitations by the medical doctors on provision of consumables did not come, until the issues of Modulated Salaries Structure being paid to all categories of workers in the state, in line with the agreements reached by the government with the labour unions came to bear. Government of the state has said that the Modulated Salary structure was agreed on when it was clear that the revenue accruable to the state could not meet its obligations. In line with the agreement, the government has been paying 100 per cent of deserved salaries for workers in level 1-7 across board – including health workers; workers in level 8 to 10 receive 75 per cent; while workers in level 12 and above, the fat cats in the service receive 50 per cent of their pay, with a promise that the outstanding would be paid when the economic situation of the state improves. The other categories of workers have shown understanding on the adopted structure, but the medical doctors have insisted on taking their full pay, because they are “essential workers”.  Of course, findings have shown that the promise for the payment of the outstanding salaries are been fulfilled, as two months of the outstanding salaries and allowances were paid recently when the government received the second tranche of the Paris Club Refunds.

However, the agitation of the medical doctors in the state service, particularly on provision of consumables have continue to raise questions of sincerity on the part of the medical personnels, as the issues that resorted to industrial action has portrayed Osun as being insensitive, even without recourse to the investment of the government in the sector.

However, the records have shown that, the government has taken proactive measures towards ensuring that the people live a healthy life. One of such measures was the emergency declared by the Governor Rauf Aregbesola administration on environment which culminated into the introduction of bi-monthly general environmental sanitation, weekly market sanitations, and weekly sanitations in government establishments. These measures played a major role in the health-related issues in the state.

SANITATION MANAGEMENT

As it is with other areas of improving on public health, the state ministry of environment is seen to have been proactive in ensuring that citizens of the state have reason to enjoy the best which the environment has to offer. A central dumping ground has been provided where all the waste generated within Osogbo, the state capital and adjoining towns are disposed properly according to international standards. Also, massive awareness programmes have been ongoing to sensitise the public on the dangers of refuse and bush burning, indiscriminate dumping of refuse on drainage and the need to get water tested drinkable in laboratories before ingestion.

Besides, Osun is known to be one of the popular states in terms of dredging the waterways which have been blocked by the nonchalant attitudes of the people who have cultivated the habit of dumping refuse on waterways without recourse to health hazard attached to it. The Osun state government said it has completed the dredging of more than 150km of waterways and canals in the state to pave way for free flow of water in Osogbo, Edun Abon and other flood-prone areas across the state.

So far, all these efforts were seen to have yielded positive results and reduced the unnecessary traffic in the health facilities across the state, just as the level of public safety and health consciousness has risen.

Records available to this medium also show that during the first tenure of the administration, there was massive rehabilitation of health facilities across the state, supply of health equipment and provision of drugs, the gestures which received commendations from both local and foreign observers.

The state’s former Commissioner for Health, Dr Temitope Ilori has once said that the government has committed a huge sum of money to procure medical supplies, such as laboratory equipment, dental equipment, theatre equipment, many of which have been distributed to the various hospitals and being put to use.

She had also said that unlike what was obtained before the advent of the administration, the state government practice totally free healthcare delivery system, not only for the young and pregnant women, it cuts across all ages and sexes.

Part of the measures seen to have been taken by the government to strengthen its healthcare delivery system was the introduction of the Osun State Ambulance Services (O’Ambulance) which had contributed immensely to healthcare delivery system in the state. It is on record that in 2016, the service rescued more than 2000 people through its prompt rescue operations in to emergency cases across the state.

O-AMBULANCE

In an end-of-the-year review of its activities, the Director General of O’Ambulance, Mr. Akinloye, said the state ambulance service responded to more than 1,116 road traffic accident emergencies across the state last year, it responded to 178 cases of collapse, 348 hospital referrals and 132 labour emergency cases all of which lives involved were saved.

Akinloye said, of 1,829 casualties involved in all the emergency cases, the agency was able to save 1,774 lives and recorded only 55 deaths, saying, of the 1,774 casualties saved, 1,116 were males, while 658 were females. He added that of the 55 deaths recorded, 27 were males and 28 females.

The O’Ambulance boss said, “the agency was able to record such significant figure of lives saved due to the resources available to it, saying, the government made available ambulances with relevant equipment, which makes rescue operation and immediate first aid for victim quick an efficient one”.

He said, “We have two sets of ambulances. We have the small ones, which are 31 in numbers – one for each local government. They are stationed to serve the primary healthcare centres in the local governments. We have the big, high-tech ones. We have 17 of that and each is stationed along major routes especially where we do experience high rate of road traffic accident.

“We have our ambulances in strategic places and so it is easy for us to move swiftly. Our response to any scene of accident wherever it happens in the state is between 10 to 15 minutes. Sometimes, it is faster than that depending on the location of such incident.

He commended Governor Aregbesola for providing the logistics and other paramedical gadgets for the agency, saying the agency is more committed to saving lives of the people of Osun and those passing through the state.

“We have the logistics. And with the support of Mr. Governor, things are going on smoothly and we are working. We are in the business of ‘life-saving,’ so we cannot but double our efforts to ensure we prevent avoidable deaths”, he stressed

EYE-RELATED DISEASES

What about the eye treatment services in the state, which record showed that over 5,000 patients benefitted from eye treatment and about 1,854 of them were given eye glasses, while about 1,000 patients were operated for cataract extraction. The same goes for surgical mission, where over 1,000 patients were operated surgically, over 10,000 were screened for hypertension and diabetes, using the blood pressure check as well as urine test, while many of them were given drug freely. This was done during the first tenure of the administration and the intervention has not stopped.

MALARIA:

In 2009, records showed that Osun had over 500,000 reported cases of malaria, but by the end of 2011, about one and half years after the Aregbesola administration assumed office, the cases had dropped to less than 200,000 in the state. The tempo had since been dropping and the cases had further reduced due to the proactive measures taken by the government of the state.

Of recent, the Osun government, the National Malaria Eradication Programme (NMEP), Society for Family Health, Catholic Relief Services, Osun Ministry of Health commenced the flag-off of the replacement exercise for the Long Lasting Insecticidal Nets (LLIN). During the exercise, a total of 2.99 million LLINs would be distributed free to families and to achieve this, a sum of N2 billion was set aside.

This is only part of the many exercises embarked upon by the state government in an effort to rid the state of malaria.

While flagging off the replacement campaign of LLINs, the governor, represented by his deputy, Mrs Grace Laoye-Tomori said, no effort would be spared in kicking out malaria scourge in the state, saying dredging of drainages, streams and expansion of river channels were part of the measures deployed by his administration to enhance a healthy environment for all.

He contended that filthy environment, which serves as impetus for breeding mosquitoes and spreading malaria parasites would not be tolerated in the state to boost the health of the citizenry, saying the distribution of the net would complement the efforts being made by his administration in the fight against malaria in the state.

MATERNAL AND CHILD HEALTHCARE

Over the years, Osun has always been a force to reckon with when it comes to maternal and child healthcare. With this in mind, the state had always been a partaker in the national maternal and child healthcare week which is held twice in every year in March and November.

During these exercises, appreciable successes have always been recorded and it is on record that Osun has always come on top nationally, as the international agencies in partnership with the federal and state governments have always praised Osun for the inspiration towards addressing issues that have to do with maternal and child healthcare.

EBOLA, LASSA FEVER AND OTHERS: During the 2014 Ebola emergency and the Lassa fever emergencies that is still prevalent, the state of Osun government took and can still be seen taking adequate steps to keep its citizens protected. Some of these include, involving the media and soliciting their help in sensitising the populace about prevention and management of these diseases, establishing quarantine facilities in case of emergency, provision of protective kits for health workers who are the first in line to respond to emergencies, provision of ambulances for medical evacuations and also emergency telephone lines for effective communication.

HEALTH WORKERS WELFARE

It is a known fact that no state government has attained a 100 per cent level in the satisfaction of its workforce, same can be said of Osun. Notwithstanding the basic shortcomings, many yearnings of the health workers in the state have been met. Most of these health facilities have been staffed and equipped, many of the health centres: comprehensive health centres and primary Health Care centres are now operating a 24-hours shift.

The major challenge facing health workers in the state is that of salaries and allowances, of which the state government has promised to address as soon as the economy of the state bounce back to life.

PROVISION OF MEDICATION AND CONSUMABLES

It is no news that treatment in public hospitals in Osun is free, which means that dispensing of drugs is also free. From investigations, hospitals in the state still offer free treatment, especially to mothers and children, but medical consumables still have to be bought from major pharmacies outside the hospitals. However, a source has revealed that the government has already set machineries in motion and is in the process of taking delivery of some medical consumables.

ESTABLISHMENT OF STATE PRIMARY HEALTHCARE BOARD

In a bid to make healthcare affordable for all its citizens, the government of the state has established the State of Osun Primary health Care Development Board which had embarked on many laudable health initiatives and programmes, as well as gone into partnership with local and international development partners to improve on the state health system.

With the bill sent to the State House of Assembly for the creation of this agency assented to, the Aregbesola administration created the agency from the old State of Osun Ministry of Health. Since its creation in 2016, the state has further recorded astounding success in the areas of responsibility the agency has been saddled with.  More doctors have been employed, the primary health sector had been overhauled, and fence mending approaches have been implemented in order to broker peace between the state government and medical, health workers.

Unfortunately, one major critical challenge that the observers said has been hindering public health system is the lackadaisical attitude of some medical personnels to work. Findings showed that some of the doctors working in the government hospitals have their personal private hospitals, where they refer patients to for treatment and be charged, instead of treating such patient in government health centres. This attitude is seriously telling on the public health system and making the people to lose confidence in the system.

However, currently, doctors in the state service are on strike, a scenario that does not augur well for the healthcare delivery system of the state, especially the downtrodden and the fast-disappearing middle-class who cannot afford services rendered by private health facilities. The strike has grounded the health system in the state, hence, the need for the government and striking doctors to find a meeting point is vital.