Enugu and Ugwuanyi’s Giant Strides in Primary Healthcare

Samson Ezea

In his quest to ensure a healthy Enugu State, which is part of his government’s agenda, Enugu State Governor, Ifeanyi Ugwuanyi in pursuant to the Enugu State Healthcare Reform Law of 2017 established the Enugu State Primary Healthcare Development Agency (ESPHCDA), with the core mandate of ensuring adequate and assessable healthcare to Ndi Enugu, especially in the rural areas with emphasis on preventing illnesses and providing basic treatment of illnesses.

To ensure the effectiveness of the agency, the Governor appointed Dr. George Ugwu, who has Masters in Public Health, a renowned consultant obstetrician, gynecologist, an outstanding leader and Health Advocate as the Executive Secretary.

Dr. Ugwu, who was a former Chairman of Nigerian Medical Association (NMA) also served as Associate Dean and Consultant at the College of Medicine University of Nigeria Nsukka before his appointment by Gov. Ugwuanyi.

To ensure effective and healthy operation of the agency, Ugwuanyi relocated the agency to a befitting and well-furnished office complex with new generating sets and well-furnished conference room.

Upon assumption of office, Ugwu set the ball rolling by ensuring that the core mandate of the agency was duly followed to the letter.
The agency among other things embarked on several life changing programmes such as successful training of 1078 health workers and Ward Development Committee Chairmen for the implementation of the Basic Health Care Provision Fund and ensure
successful implementation of Maternal Newborn and Child Health week with free distribution of vitamin angel products donated by Ugo Touch of Life Foundation to vulnerable persons, courtesy of Her Excellency, Mrs Monica Ugwuanyi. The agency successfully conducted modified Integrated Medical Outreach Programme and Routine Immunization Intensification Programme in wards with relatively low coverage with support from UNICEF, Yellow Fever mass vaccination in 6 LGAs with overall 92% coverage. The agency introduced measles and men A second dose vaccines into the routine immunization schedule of Enugu State.

With the outbreak of COVID-19 in late 2019 and Enugu State taking its share of the scourge, the Enugu State Primary Healthcare Development Agency took delivery of the first batch of Oxford-AstraZeneca COVID-19 vaccines from the National Primary Health Care Development Agency (NPHCDA) at the Akanu Ibiam International Airport, Enugu.

The Executive Secretary of the agency, Ugwu, while receiving the dozes, reassured that the agency is ready and has the necessary cold-chain equipment to deliver the vaccines to the citizens of the state.

The agency subsequently flagged off the COVID-19 vaccination in the state by first vaccinating frontline healthcare workers, who in turn vaccinated members of the State Executive council, among whom were the Governor, Ifeanyi Ugwuanyi, his deputy, Lolo Cecilia Ezeilo, immediate past Chief Judge of the State, Hon. Justice Priscilla Emehelu, members of the state legislature and Judiciary, the traditional rulers, religious leaders and others.

In a bid to fight the COVID-19 scourge in Enugu State headlong, the agency embarked on various programmes like; distribution of COVID-19 prevention commodities in all Primary Health Centres and successfully supervised and handled the introduction of COVID-19 vaccines 1st Phase at 100% of the targeted population, which it is now aggressively pushing greater numbers for the ongoing second phase.
It would be recalled that as the State was grappling with the challenges associated with the first and second wave of the COVID-19 outbreak, Yellow Fever disease broke out in Enugu State in November 2020.

This was detected after tests and autopsies were conducted on the bodies of people that dies strangely in Ette Uno and Umuopu communities in Igbo-Eze North Local Government Areas of the State. The situation created panic, confusion and pandemonium in the affected communities and the entire state. The indigenes and residents of the communities were scared and upbeat.

While many claimed ignorance of the causes of the strange deaths, others attributed it to superstitions, some were of the view that it was the sudden surge in COVID-19 virus spread.

But in his usual prompt and swift response, just like he did during the outbreak of Covid-19 pandemic in the state, Governor Ugwuanyi dispatched Enugu State Ministry of Health Rapid Response Team and LGA Rapid Response Team to visit the affected communities in alongside the national and international health partners to unravel the immediate and remote causes of the sudden strange deaths in the communities.

Their findings revealed that the cause of the strange deaths was yellow fever. Further investigations as of the second week of November revealed that 222 suspected cases of Yellow Fever with 76 confirmed deaths have occurred in three states of Bauchi, Delta and Enugu.
Relying on heavily to ensure appropriate and adequate response to the outbreak by Enugu State Government is the Enugu State Primary Healthcare Development Agency (ESPHCDA), whose it is her constitutional responsibility to handle health scourge like the battle against the spread of the dreaded Yellow Fever disease.

The Agency, led by its Executive Secretary, Dr. George Ugwu, moved into action immediately in collaboration with its national and international health partners and massive support from the Enugu State Government liased with the leadership of the six local government areas in Enugu North Senatorial zone, where the disease has claimed lives to organise training for local government immunization teams and the Agency team members for reactive mass vaccination across the council areas to prevent further spread of the disease.

The Agency also mobilised resources and liased with Partners for financial, technical and human supports, which include mobilisation of stakeholders, prompt request and taking delivery of doses of Yellow Fever Vaccine from the National Cold Chain Store, engaging in high level Advocacy visits and sensitisation meetings with government for enabling environment and key stakeholders for specific roles and mobilisation of all and sundry for acceptance of vaccination, training of Town criers and House- to-House mobilizers to create awareness.

Others include production and distribution of news letters to community governance, churches, schools, media and markets for information and public enlightenment, radio spot announcements for public awareness, selection of teams for fixed and temporary fixed posts to ensure wider coverage, daily delivery of adequate vaccines to the LGAs and maintenance of cold chain equipment, monitoring and supervision of outbreak response activities by State Supervisors, State Technical Facilitators and Partners, conduct of daily evening review meetings at LGAs and Primary Healthcare Agency office to appraise daily activities, daily call in data by the M&E unit was regularly implemented through data generation and transmission, engagement of Media through Press briefing for media monitoring, reporting and wider audience reach out and enlightenment, mid-review/ debriefing of ES/CEO ENS-PHCDA and State Immunisation team by the implementing LGA teams, release of health workers stipends and logistic funds to boost their morale and attitude to work, weekly staff management meeting of the Executive Secretary ENS-PHCDA with Directors and programme officers for stock taking, appraisal and restrategizing, liaising and collaborating with other government agencies such as Fire Service and SEMA for general fumigation and other non-medical emergencies and requesting for State wide Yellow Fever Vaccination campaign from NPHCDA amongst other assistance and support.

It is these prompt response of the Enugu State Government, concerted efforts and commitment of the ESPHCDA, State Ministry of Health, national and international health partners, local government administration and stakeholders that has helped immensely to reduce drastically or eliminate completely the Yellow Fever-induced deaths in the state, especially in Enugu North Senatorial zone since the outbreak of the dreaded disease.
In July this year, there were reported cases of strange death at the New Artisan livestock market in Enugu. The Enugu State Primary Healthcare Development Agency, the Enugu State Ministry of Health and its health partners swung into action to remedy the situation.
After embraking on a visit to the scene of the incident to ascertain the cause of the deaths, state government launched an aggressive sensitisation campaign for residents to take precautionary steps towards preventing further spread.

The Executive Secretary of the ENSPHCDA, Dr. George Ugwu in a chat with journalists, affirmed that the disease, which was first detected at the New Artisan Cattle market Enugu, noted that timely intervention of the State Government made the spread of the disease to be curtailed. Dr. Ugwu also stated that the inhabitants of the market were sensitized on how to improve the sanitary condition of the market to avoid any future occurrence.

He called on residents of Enugu State to be health conscious by avoiding open defecation, take clean water, wash their hands and their vegetable and ensure they observe all health protocols so as to get Enugu rid of Cholera and other deadly diseases.

Following the approval of the governor, the agency, in collaboration with the Accountant-General of the State is facilitating the opening of Bank Accounts by public Primary Healthcare facilities in the State as part of the BHCPF requirements and to ensure proper accountability. Establishing, in collaboration with the Federal Ministry of Health (FMOH), National Primary Health Care Development Agency (NPHCDA) and UNICEF, are three Community Management of Acute Malnutrition (CMAM) sites in three. recently revitalized health centres at Abakpa-Nike, Obollo-Afor and Oji-River for the three senatorial zones of the State.This is to improve nutritional services to the children in Enugu state.

On the area of infrastructure, the agency has done appreciably well. They have
upgraded three primary health centres to Type 3 standard hospitals at Abakpa, Obollo Afor and Oji River.

They have constructed and equipped seven Primary Health Centres to Type 3 model hospital with state of the arts facilities. That is the first of its kind in the state. The agency has renovated thirty four Primary Health Centres, two per local government area in collaboration with the SOML Programme and has also provided 60KVA soundproof generator, inverter and over 200 solar refrigerators to ensure vaccines potency and their storage in appropriate conditions in all the local governments and wards.

All these giant strides in the state’s primary healthcare services are the outcome of grand design by a healthcare loving Governor, who makes health services of the ordinary citizens a compelling priority.

*Ezea writes from Independence Layout Enugu