My e-friend, Aishatu ( I hope to meet her in person this year, insha Allah), does some awesome work with an NGO and she gets to travel to cool places to monitor compliance to treatment and how Global funds are used to fight the scourge of TB. She shares some detail about her work which is quite interesting. This was originally featured on her Facebook page and will come as a series. Read and be informed...
So Community Health :
Let me start at the beginning :
A household survey was conducted among the poorest of the poor, and the major causes of death among the poorest of the poor via hospital records were discovered to be Malaria, complications from HIV infections and Tuberculosis. Childhood diseases that are mostly preventable through vaccination were leading causes of infant mortality in children, malnutrition among the most vulnerable population .
To this end Global Fund, Clinton Foundation, Bill and Melinda Gates Foundation, the United States Presidential Intervention Fund, and lately Dangote and TY Danjuma Foundation ( TY Danjuma Foundation also concentrates on Eradication of River Blindness as it is quite common in Taraba the state the Founder of the Foundation is from) decided to focus resources to fight these disease areas.
Funding and communication with Global Fund and other donors is coordinated through the country coordinating mechanism CCM, it is made up of members of Civil societies, government agencies and labor organization. It is headed by a Chairman and Secretary. There is a secretariat that sees to the day to day running. CCM meets regularly to ratify decisions like engagement of Principle Recipients and Sub Recipients. They also monitor and supervise activities by PRs and SRs
First step was to renovate and revive the Primary Health Care System because these are the centers closest to the people in the community. This was done in partnership with the world Bank, Federal Government of Nigeria at that time through the Millinuenm Development Goals Project Headed by the New Un Deputy Secretary Amina Mohammed, at that time she was the special Assistant to President Obasanjo on MDGs. We were lucky to have her as she ensured that these Primary Health Care Centres were indeed built or renovated as contracted no Magu Magu.
The terms of the partnership was Government provides 30 percent, renovating and building the centres, deploying staff to the hospital and paying Staff Salaries while the NGOs listed above do 70 percent ; Pay for the drugs, pay for the services which will be received free by the clients, pay for project vehicles, pay salaries of the NGO workers who will ensure compliance, pay for community mobilization and information dissemination to ensure behaviorial change among the population, pay for the feeding intervention to ensure the Orphaned and Vulnerable Children get the most support in intervention states, pay for support group meetings of infected clients, pay for after school club meetings for vulnerable kids, kids orphaned by HIV so they can meet play, support each other and learn skills.
At the beginning of the intervention there were many challenges which would be discussed later.
It initially kicked off in all 36 states including FCT making 37 but due to dwindling funds, failure of some state Governments to pay their own part of the counterpart funding intensive intervention has been reduced to 20 priority states including FCT. Services and drugs are provided in the remaining states but there is no community mobilization or behavioral communication change.
The Global Fund works through Principal, Sub Recipients and Sub Sub Recipients ; Meaning NGOs can apply to be Principal Recipients receive funding directly from Global Fund and Manage Sub Recipients, the Sub Recipients work with Community Based Organizations in the Grassroots to directly implement. This has created employment to thousands of people including me.
Kaduna and Lagos are the First states to become Principal Recipients, meaning they receive funds directly from Global Fund to Implement in their states. This is a pilot scheme
In summary these are some of the services received free at Primary Health Care Centers due to this intervention :
1. HIV TESTING AND SERVICES
2. MALARIA TESTING AND SERVICES
3. TB TESTING AND SERVICES ( IN DOTS SITES)
4. FAMILY PLANNING SERVICES
5. FREE VACCINATION AGAINST CHILDHOOD DISEASES
6. PRIORITY IS PREVENTION OF MOTHER TO CHILD TRANSMISSION BY TESTING PREGNANT WOMEN AND COMMENCING IMMEDIATE ENROLLMENT TREATMENT OF PREGNANT WOMEN WHO ARE POSITIVE TO PREVENT TRANSMISSION TO FOETUS.
By Aishatu Ene Ella-John
To be continued...
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