And also many working group meetings were held afterward to articulate the plan and came up with a refined document. It is now about one year since the March 2013 meeting and it will not be out of point to begin asking questions about what has being happening and if any concrete actions were taken to fully implement the ambitious plan.
It is good to go back to the initial concept which supported Nigeria to come up with its plans. I am referring to the United Nations (UN) Secretary-General’s Global Strategy for Women’s and Children’s Health that highlighted the inequitable access to life-saving drugs and health supplies suffered by women and children around the world. It called on the global community to work together to save 16 million lives by 2015. Three types of barriers that prevent women and children from receiving appropriate interventions have being identified;
1) The insufficient supply of high quality health commodities;
2) The inability to effectively regulate the quality of these commodities; and
3) The lack of awareness of how, why and when to use them.
The Nigeria’s country implementation plan builds on these challenges as well as the ten recommendations of the UN Commission. According to the plan the overall objective is to provide a roadmap for activities and targets that will ensure the availability and use of prioritized life-saving commodities for women and children. The commodities prioritised are;
1. Reproductive and maternal health: Oxytocin, Misoprostol, Magnesium sulphate, Female condoms, Emergency contraceptives, Implants, Intra-uterine contraceptive devices and Sulfadoxine-Pyrimethamine (SP).
2. Neonatal health: Chlorhexidine for cord care, Antenatal corticosteroids for prematurity, Injectable antibiotics and Neonatal resuscitation equipment.
3. Child health: ORS, Zinc and Amoxicillin.
Interestingly the plan had made reference to the secured additional annual US$8.35 million funding envelope under the Subsidy Reinvestment and Empowerment Programme (SURE-P) for Maternal and Child Health (MCH) to the existing US$3 million committed by the Government of Nigeria annually since 2011 to the procurement of contraceptive commodities. “This additional annual commitment of the Government of Nigeria is for the procurement of reproductive health commodities until 2015.”
This has been a big missing link as we are all aware that the existing US$3 million committed by the Government of Nigeria annually since 2011 to the procurement of contraceptive commodities wasn’t release for 2013 so also the additional annual US$8.35 million funding envelope under the Subsidy Reinvestment and Empowerment Programme (SURE-P) for Maternal and Child Health (MCH). Without this release, it means there were no procurement of some of these drugs in our health facilities earmarked from that funds.
The plans observed that it was the responsibility of the 3 subcommittees of the National MNCH Commodities Working Group inaugurated in March 2013 i.e. the Reproductive and Maternal Health subcommittee, as well as the Neonatal Health and Child Health subcommittees with oversight and coordination by the National Technical Reference Team to implement the plan. It also reported that Nigeria is committed to rapidly accelerating reductions in maternal, neonatal and child mortality and morbidity and improving health outcomes towards achieving MDGs 4 & 5 in line with the Transformation Agenda of the country to save one million lives and improve the quality of care for Nigerians by the end of 2015.
It is time to ask “how many lives have we saved so far and what interventions could be attributed to that?”
It was highlighted that the implementation plan has built on existing polices, strategies and initiatives such as National Strategic Health Development Plan (2010 – 2015), Integrated Maternal, Newborn and Child Health Strategy, Reproductive Health Commodities Security Strategy (2011 – 2015), National Essential Childhood Medicines Scale-up Plan 2011, National Child Health Policy, and the SOML Initiative to coordinate and maximize available resources towards improving and ensuring the sustainable supply of high quality life-saving commodities. Hmmm, it is time for more probing questions on the implementation of all these strategies mentioned and to what extend they all provide consistency in addressing a common goal?
Nigeria had requested US$10 million from the RMNCH Fund of the UN Commission on Life-Saving Commodities for Women and Children to accelerate its reproductive, maternal, and neonatal and child health efforts through 2015. The funding request was to kick-start the 1st year activity. I was reliably informed that some of the requested funds have being provided to Nigeria and so one must question and demand for accountability and transparency in the funds allocations, disbursements and expenditure and to also at a later date share information on its utilisation and how much of the funds were used for make the lifesaving drugs available in both the urban and rural health facilities?
The plan also observed that for each programme area, a set of activities is proposed to ensure the availability and appropriate use of priority life-saving commodities in relevant birth settings. For reproductive and maternal health, activities would centre on capacity building and strengthening of mentoring and supervision. For neonatal health, activities would centre on review of policies, guidelines and regulations, capacity building, demand and targeted advocacy. For child health, activities will centre on policy and regulatory improvements, demand generation for commodities, increasing availability and affordability of commodities through support of public sector procurement and distribution and private sector.
With all these beautiful plans and initiatives, the common man will just need one thing, “lifesaving drugs are available and accessible in health facilities all the time.”
All comments to Dr Aminu Magashi at email@example.com