Policies, Partnerships and Projects: Lessons in Healthcare Reforms From Kaduna State by Ibrahim Jato

Our programs are structured to ensure that a pregnant woman does not die due to her inability to access quality services during pregnancy and childbirth, that a child is not lost from preventable diseases that communities are not overburdened with endemic diseases, and that community linkages are harnessed and promoted. – Nasir El-Rufai, Governor of Kaduna State.
With less than 100,000 qualified medical doctors to a population of about 180 million, oil-rich Nigeria has one of the worst doctor to patients ration in the world. This explains, in part, why Nigeria is among the seven countries with the lowest life expectancy in the world, averaging just 54 years. For perspective, countries like South Sudan and Afghanistan, ravaged by war in recent years, have higher life expectancy rates than Nigeria.
Nigeria also has the 7th largest infant mortality rate in the world, as well as one of the highest maternal mortality rates. If the statistics are disheartening, the reality is even more depressing. A typical 70 percent of health budget is spent in urban areas where about 30 percent of the population resides. Thus, there is a conspicuous absence of health facilities in many rural communities across the country. Where any exists, the absence of a qualified health professional or lack of drugs and other essential medical supplies hamper service delivery.
With a population of 6.4 million, Kaduna is the third most populous state in Nigeria and the situation of public health system there is hardly any deviation in from the trend observed in the country. As at 2013, only 40 percent of the over 1,000 primary health centres in Kaduna were functioning. A general lack of political commitment to health development coupled with poor funding, corruption has led gross inequity in the distribution of health facilities and personnel.
Today however, that trend has been completely reversed. A change in political leadership in the state eighteen months ago ushered in a new regime under renowned technocrat and Harvard alumni, Nasir El-Rufai. In a clear departure from the old, and rather retrogressive, style of administration, El-Rufai’s healthcare reforms in Kaduna is built on a foundation of solid policies. In an environment where the construction of a handful of hospitals counts as major achievements, El-Rufai has ditched mediocrity for excellence by instituting remarkable reforms with wide-reaching impact in Kaduna’s health sector.
Just three months into El-Rufai’s administration, the Primary Health Care Under One Roof Bill was signed into law. Essentially, the law permits the state to operate its primary healthcare activities on the same platform. The law also enables the transfer of workers in primary healthcare centres from local councils to the state civil service.
It is not uncommon for governments to bridge social welfare gaps by introducing subsidies. Unfortunately, however, subsidies schemes are often fraught with corruption and gross mismanagement. Kaduna State has managed to subsidize healthcare in such an efficient manner that other states in Nigeria should certainly learn from. For example, patients pay as little as N20,000 for dialysis treatments that cost as high as N200,000. This was achieved by supplying eight dialysis machines to four hospitals.
The sum of N180 million was committed to routine immunization through the State Primary Healthcare Development Agency to ensure no child eligible for immunization in Kaduna is missed. Also, the Joint United Nations Programme on HIV/AIDS selected Kaduna as the best performing state in Nigeria. Kaduna State won the prize because its hospitals counselled and tested 84,000 pregnant women for HIV during the period and referred everyone that tested positive to a treatment facility.
The decision in April to transfer all doctors, nurses, drugs and equipment at the Government House Clinic in Kaduna (used by the Governor and other top officials) to Dantsoho Hospital in Tudun Wada (used by the public), effectively eradicated the culture of privilege in Kaduna’s public health system. Policies like this make Kaduna the pacesetter in healthcare reforms in Nigeria and worthy example for not just other states but also the federal government to emulate. Kaduna’s people-centric and cost saving government house clinic policy contrasts sharply against the federal government’s decision to allocate 2 billion for capital projects as the State House Clinic in Abuja, an amount which far exceeds the combined allocations for capital projects in all teaching hospitals in the country.
To reduce maternal and infant mortality rate in Kaduna State, the El-Rufai administration re-engaged 800 retired nurses and midwives after a gap analysis revealed huge personnel shortage. This move has boost service delivery at primary health centres across the state and made quality and affordable healthcare accessible to people at the grassroots.
In Kaduna State, pregnant women, children under five years and the elderly have access to free health services at state-owned facilities. To widen the net of coverage and ensure all residents of the state have access to healthcare without incurring out-of-pocket expenditure, the El-Rufai administration approved the establishment of a Contributory Health Scheme. Under the scheme, a pool of funds contributed by residents will be supplemented with funds from the state coffers and the federal government through the National Health Insurance Scheme.
Thus, the financial barriers to healthcare that often exclude the poor and vulnerable will be removed. The corruption that often trails bills payment and out-of-pocket expenditure by patients at government hospitals will also be completely eradicated. This contributory model of universal healthcare coverage has proven to be successful in more advanced economies and is also being considered by Lagos State.
In what could be considered a leap towards stronger primary healthcare services in rural communities in Kaduna State, the government signed a strategic partnership with UK Department for International Development and the Bill & Melinda Gates Foundation. The four-year partnership will no doubt transform the primary healthcare system in Kaduna State and advance ongoing efforts in polio eradication, routine immunisation, family planning and maternal and child health services.
The biggest ever refit of public healthcare infrastructure in Kaduna State is the recent partnership agreement signed with global corporate giant, General Electric. Under the agreement, 278 healthcare facilities in Kaduna State will be equipped and units of relevant medical technology including ultrasound, heart monitors, neonatal incubators and anaesthesia machines will be made available to medical professionals. into the hands of our health workers.
The partnership, which includes a training package for the healthcare professionals and a three-year equipment maintenance agreement, is poised to deliver a comprehensive solution to the healthcare challenges in the state, including maternal and infant mortality, communicable illnesses and the problems caused by the growth of chronic conditions like diabetes, heart disease and cancer.
Governments at state and federal levels in Nigeria often focus on projects as a vehicle for healthcare delivery. As such, emphasis is placed solely on building hospitals, even when such are not properly equipped and capacity gaps are not bridged. This explains why major health indices in Nigeria remain poor despite billions budgeted annually for health, in addition to donations from international organisations.
The Kaduna State approach of blending sound policies with strategic partnerships to birth meaningful projects is on course to deliver at least one refitted hospital in each of the 255 wards in the state. This is in addition to 23 well equipped and staffed general hospitals. With all these in place, all residents of Kaduna are assured of comprehensive and affordable healthcare coverage for the years ahead.
This innovative approach should no doubt be a model for other states desirous of accelerated development in healthcare services.
Ibrahim Jato is a public finance expert based in Kaduna.

Nigerian Police response to Shiite procession disproportionate – US

The United States has expressed deep concerns over the latest clash between the Police and Shiite members in Kano, describing the security agency’s response to the procession as “disproportionate.”


It therefore called for calm and restraint on all sides, a reduction of tension and greater communication between Shiite members and government authorities.


A statement from the US embassy’s Information Office on Friday in Abuja said the Shi’ite group, like other religious communities, had the right to assemble, peacefully express their religious beliefs, and mark their celebrations.


The US admonished the Federal Government to protect and defend these rights


It said, “The US is deeply concerned by the deaths of dozens of Nigerians during clashes between individuals participating in a Shia procession and the Nigerian Police Force in Kano State on November 14.


“While the matter is still under investigation, we are troubled by the apparent disproportionate response by the police.”


The US also called on members of the IMN and all citizens to respect the rule of law and cooperate with the police in their attempt to maintain public order.


It urged the government to ensure accountability for the deaths of more than 300 IMN members during December 15, 2015 clashes between the group and security forces in Zaria, Kaduna State.


“We also call on the Nigerian government to conduct a transparent investigation of the latest incidents and bring to account anyone responsible for violating the law,” the statement added.

Kaduna State gets new Police Commissioner

Mr Agyole Abeh has been appointed as the new Kaduna State’s Commissioner of Police.


Abeh, who assumed office on Nov. 14, took over from Mr Sanusi Lemu.


The command’s Public Relations Officer, ASP Aliyu Usman, in a statement on Thursday said that the new CP hails from Ibi Local Government area of Taraba State.


The new commissioner was enlisted in the service on January 1, 1984 as pioneer cadet inspector and was trained at the Police College in kaduna.


Abeh holds a Bachelors Degree in Art (Philosophy) from University of Lagos and Advance Diploma in Law Enforcement Administration from same university.


He also attended Intermediate Management Course at Centre of Excellence, Police Stability Concentrate Vincentia, Italy.


Abeh attended Senior Leadership and Strategic Course, Police Staff College, Jos, and Senior Management Course in ASCON.

Bill Gates, Aliko Dangote In Kaduna State To Sign MoU With Northern Governors (PHOTOS)

Bill Gates, Aliko Dangote In Kaduna State To Sign MoU With Northern Governors Billionaire entrepreneurs, Bill Gates and Aliko Dangote are in Kaduna to sign the Memorandum of Understanding, MoU on routine immunization with the governors of six states.

The governors of Borno, Bauchi, Yobe, Sokoto and Kano are also in Kaduna, along with the Sultan of Sokoto and the Emir of Kano.


Credit: NationalMirror

Secondary School Teachers In Kaduna State Can Rise To Directorate Level – KDSG

Kaduna State Government has approved a career progression pattern that will enable teachers in the state’s secondary schools to rise to Grade Level 17 while still teaching in the classroom.



This is contained in a statement issued by Mr Samuel Aruwan, the Special Assistant to Governor Nasir el-Rufai on Media and Publicity on Sunday in Kaduna.



The statement said that professional teachers in the public service could progress to GL. 17 and enjoy all the allowances and privileges attached to the grade.



According to the statement, the Kaduna State Executive Council has approved the measure as part of efforts to strengthen teachers’ career development as well as boost their morale.



The statement said that the measure was aimed at revamping the standard of education in the state.



“Teachers who rise to level 17 will be addressed as Director-Tutors.


The gesture will allow teachers to bring their knowledge and experience to teaching specific subjects in secondary schools to bear on students.


Government hopes that the decision will halt the exodus of teachers from the classrooms and clamour to convert to other disciplines in search of greener posture.


The council’s approval for the teachers’ career progression is sequel to the promise of Gov. Nasir el-Rufai to ensure that teachers rise to the highest grade without having to stop teaching.


The retention of these experienced teachers will help in raising the standard of education in public secondary schools in the state,’’ the statement said.



The statement said that in order to strengthen education in Kaduna, the state executive council had also approved the establishment of six science secondary schools in different parts of the state.



The schools are expected to be financed by a USD17.3 million grant from the Islamic Development Bank (IsDB) with a USD3.8 million counterpart fund from the state government.



“The bank has approved the grant since 2009 and was meant for the establishment of four science secondary schools in the state.


The initiative was meant for the building and equipping of four science schools in different parts of the state to increase the number of science graduates from senior secondary schools in Kaduna State.


The project, which suffered delays over the years, is now to be fast-tracked and the state government has decided to increase to six, the number of science schools to be built.


The schools will be sited in Jere, Rigachikun, Manchok, Pambegua, Buruku, and Hunkuyi, while two of the sites previously identified were changed for several reasons.


A new school has already been constructed within the former project site at Koreye, while the site within the Millennium City is considered unsuitable for a boarding school, given that it is a business district,” the statement added.



Meanwhile, the state government has said that bidding for the contracts for the building of the six schools will begin afresh while the bank will be notified of the new development.





El-Rufai Warns MDAs Against Rejection Of Corps Members

Governor Nasir El-Rufai of Kaduna State has warned Ministries Departments and Agencies (MDAs) in the state against rejecting corps members posted to them.


El-Rufai gave the warning in Kaduna on Monday at the end of orientation course for the 2,450 National Youth Service Corps (NYSC) members deployed to the state under the first stream of 2015 batch ‘B’.


He said that the government would view with seriousness any case of rejection of corps members by any agency.
“I am fully aware that the major challenge of corps members after the orientation course is rejection by prospective employers.


“To this end, I wish to use this medium to remind MDAs in the state not to reject corps members posted to them because it is against the state government policy.”


Represented by the Commissioner of Sports, Youth and Culture, Mr Daniel Dan’auta, the governor promised the corps members, an enabling environment to discharge their responsibilities.


El-Rufai called on Nigerians to always promote national unity and integration in line with the objective of the scheme.
The governor also noted that a sustainable economic development would only be built on a sound educational foundation.


Earlier, the NYSC Coordinator in the state, Muhammed Momoh, advised the corps members to respect the custom and tradition of their host communities.


He thanked the government and people of the state for their support to the NYSC over the years.



Tribunal Upholds El-Rufai’s Victory As Kaduna State Governor

The Governorship Election Petition Tribunal sitting in Kaduna State has upheld the election of Nasir El-Rufai of the All Progressives Congress (APC) as the elected Governor of the state.

The All Progressive Grand Alliance (APGA) candidate in the April 11 Governorship election, Polycarp Gankon, had on May 28, 2015 approached the tribunal, asking it to set aside the election because of non-compliance of the Electoral Act, exclusion of his party from form EC8 in several polling units and wards in seven Local Government Councils of the state.

The petitioner also alleged that there was massive ballot box stuffing and exaggerated results by the APC during the election, thereby asking the three-man tribunal to nullify the election in the affected local councils.

But in an unanimous judgement that lasted for six hours, Chairman of the three-man panel, Justice Adebayo Adebara, held that the petitioner had not mustered enough evidence to prove his allegations of electoral malpractice and irregularity.

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Gov. El-Rufai Is Against Corruption In ‘Religious Feeding’ – Media Aide

The Kaduna State Government last week announced its decision to discontinue the practice of distributing food items and gifts during Ramadan.

While hosting religious leaders last week, the governor Mallam Nasir El Rufai, explained that Kaduna State is broke, and needs to tighten its finances to serve the people better, in a manner that befits their massive support for change. He made it clear that the state government will no longer tolerate the siphoning of government resources in the guise of gifts to prominent politicians, public servants and famous figures, or the feeding of indigent persons during religious occasions; neither will it be involved in sponsoring people 

The governor went further to explain that the government has stopped issuing contracts to so called ‘super’ politicians to supply foods, beverages and other essentials as Ramadan gifts across the state because the process is entirely fraudulent with nothing tangible to show for it, except playing to the gallery to score cheap political goals and fraudulently enrich few individuals. It is a known fact that the socalled feeding of the poor during Ramadan is a window created to loot the public treasury with impunity using religion as a cover

Findings have revealed how it is mainly prominent politicians and influential personalities that benefit from the Ramadan and Christmas gifts instead of the so called ‘poor’. Food stuffs, bought with public resources, are distributed to prominent government officials and other personalities, while the poor in whose name those foods are procured queue in droves for crumbs and are constantly subjected to several forms of hardships and degrading circumstances after such sham gestures. The hundreds of million of naira involved have not translated into visible feeding points in Kaduna.

The Governor is committed to always helping the needy in a transparent and sustainable manner.He is focused on providing sincere leadership, and that includes taking steps against the looting of the public treasury in the guise of feeding ordinary citizens who are deprived of social justice and basic amenities. 

The Governor’s position is simple. He will not dip his hands into the public treasury or aid the swindling of public funds using religion as a cover. Instead his generosity to the poor will continue  in his private status as a Muslim. His commitment to Zakat is constant and has been done for decades without any form of publicity. The Governor encourages people of means to do the same in their private capacities, and not abdicate their religious duty to care for the less well-off to the government. This year, Malam Nasir El Rufai and his friends are pooling resources to provide Ramadan feeding as private individuals to the vulnerable in our society. This is a healthy way of building a caring society, and if more widely adopted by people of means, will certainly provide for more persons than a fraudulent system of government provision that at best reaches only a few.

Samuel Aruwan 

Special Assistant, Media and Publicity 

23 June, 2015 

I Will Take Action Against Any Corrupt Official – El-Rufa’i

Kaduna State Governor-elect, Mallam Nasir Rufai yesterday vowed to deal with any individual that stole the State funds.

“I have said this and I will say it again, no one will take away the resources of this state without consequences,” he said.

According to him, the incoming administration will surely ask those who stole government money to politely return such fund but if they failed to do so the government will take “impolite action” against them.

The governor-elect also added that the outgoing Peoples Democratic Party (PDP) government in the state has failed to make the state great in the 16 years of governing the state.

el-Rufa’i, who disclosed this shortly after receiving a report from the All Progressives Congress (APC) Transition Committee, said it was time for his party to make the State great again.

“This report is the beginning we are trying to understand the government and see what has been left behind and we will see some more, I have said this and I will say it again, no one will take away the resources of this state without consequences,” he said.

“We are not going to let it happen there would he full accountability for every penny that accrue to this state and any one that has taken the money for this state will be asked politely to return it and if he dosn’t we will take actions that are not necessarily polite.

Zaria Stood Still For El-Rufai’s Campaign

The ancient town of Zaria in Kaduna state on Monday stood still for the All Progressives Congress, APC, governorship candidate, Nasir El-Rufai.

Mr. El-Rufai, who was conducting his gubernatorial campaign, was received by thousands of Zazzau Emirate residents at Eid Praying Ground in Zaria.

The candidate said the significance of the crowd that ushered him proved that change is inevitable and a new dawn beckons for development and purposeful leadership.

According to Mr. El-Rufai who was accompanied by thousands of APC leaders and members, the move for change is justified by the failed leadership and myriads of challenges in all parts of the state.

He said, “I am emotional and touched because of the way and manner we were received. We were received with total acceptance, trust and confidence that we have all it takes to rebuild our dear state.

“Our state is in need of direction, focus and practical leadership that will bring about justice, development and purposeful leadership to manage our complexities. Kaduna State is in search of a competent and capable sailor and crew to sail our state out of the storm.

“We are in the middle of this dangerous navigation, but we are confident that by the special grace of Almighty God we will sail to safety. It is not about us but what is best for tomorrow and the future.

“You should remember that we are standing before history and posterity, we must strive to stand for the best of the future that outlives our personal interests. We must be bold, courageous and firm to give the people of Kaduna our best .

“Think of our younger brothers and sisters, think of our children and grand-children, think of multiple generations ahead. Let us write our names in gold, and so stand up and save Kaduna State,” Mr. El-Rufai addressed the crowd.

Appealing for issue-based politics, Mr. El-Rufai condemned political violence saying, “It is Almighty God that gives power and we are seeking for this power from him and the people of Kaduna State.

“So don’t fight anyone, don’t abuse anyone, don’t blackmail or insult people because of political differences. Don’t abuse people’s parents, instead respect them because they are also our own parents and we hold them in high esteem. Don’t return violence for violence; don’t destroy people’s posters, billboards and properties because they did same.

“Be law abiding, respect law and order, leave them to God but use your votes wisely during elections. Violence is not the solution but good governance that will be provided by competent, sincere, honest and God-fearing leadership.”

Mr. El-Rufai kicked off the governorship campaign for Kaduna North Senatorial zone last week in Makarfi local government before touring Kudan, Ikara, Lere, Soba, Kubau and Sabon Gari local government areas before rounding off in Zaria local government on Sunday.

The campaign will on Tuesday commence in Kaduna Central Senatorial Zone before moving on to Kaduna South Senatorial Zone.

Source – Premium Times