The shortage of health workers in rural areas, especially in the Northern part of the country, has continued to take a toll on infant and maternal health. In this report, ANDY ASEMOTA writes on the efforts by some state governments and development partners to build capacity and reverse the trend.
Five northern states in collaboration with UK funded development agency, DFID, are currently focusing on empowering rural girls as
solution to shortage of health workers particularly in rural communities.
The states are Katsina, Kano, Jigawa, Zamfara and Yobe. They are being supported by DFID and some development partners to implement a five-year (2013 – 2017) programme tagged ‘Women For Health’ (W4H), which is designed to reduce the dearth of female health workers as well as infant and maternal mortalities.
To arrest the trend of the unfortunate situation where health workers deployed to rural communities move to urban centres thereby denying the rural populace their services, the programme therefore offers rural girls academic, social, financial and personal supports to study health related courses.
As part of the arrangements to assist rural girls to e eligible for admission into Health Training Institutions (HTIs), a Foundation
Year Programme (FYP) has been introduced to specifically enable the girls with academic deficiencies to eventually remediate the defects.
Chairman of the Foundation Year Working Group in Katsina State, Alhaji Suleiman Abdullahi Saulawa, who stated this during the presentation of the foundation year graduates of the W4H programme to its stakeholders penultimate Thursday, noted that the one-year programme domiciled at the School of Nursing, Katsina, has two components – the preparatory and bridging.
“The preparatory is one year intensive training designed to prepare rural females with five credits in sciences including English and Mathematics to sit for entrance examination into HTIs, while bridging is for rural females without admission requirement. In other words, they are to undergo one year training, sit for WAEC and NECO so as to obtain five credits in basic sciences and secure admission into HTIs,” Saulawa said.
According to him, a working group had been constituted to pilot the affairs of the Foundation Year Programme in the state following the signing of a Memorandum of Understanding (MoU) between the Katsina state government and the Women For Health Programme before its termination.
“The purpose of the MoU is to consolidate on the success recorded during the five years of W4H and ensure the sustainability of the programme beyond 2017,” he added.
Saulawa, who is also the Permanent Secretary of the Katsina State Local Government Service Commission, applauded W4H for providing technical support to the working group for another two years (2017 -2019), as part of the process of its gradual disengagemåent.
He also stated that in an effort to ensure the instutionalisation and sustainability of the FYP, the W4H programme is in support of the working group to amend the law establishing the College of Nursing and Midwifery Katsina (CONAMKAT) to provide for the establishment of a School of General Studies at the School of Nursing for FYP students.
The Bill, he said, has since been passed by the State House of Assembly and subsequently assented to by Governor Aminu Bello Masari of to fast track the healthcare service delivery in the rural communities, especially for women and children.
“From inception to date, a total of 502 students were admitted into FYP. Out of this number, 268 were admitted into various HTIs while 107 have so far graduated from the institutions. Of the 107 that graduated, 52 have so far been employed by the government while the
remaining 48 are awaiting employment,” he explained.
Also the National Programme Manager, Women For Health, Dr. Fatima Lamishi Adamu, stated that the presentation of the FYP graduates to stakeholders in the programme was aimed at celebrating the strength and capacity of the disadvantaged girls to withstand all pressures and become healthcare workers.
On the need for the programme, she said it is in recognition that doctors, nurses and midwives will not move to rural areas to work and the need to provide rural women with health workers they could trust and treat with respect and dignity.
Expatiating on the W4H programme, she said the journey funded by DFID started in November 2012 with a destination to support the state governments to increase their female health workers and deploy them to rural areas where they had the greatest need.
According to her, the desire to reduce unsatisfactory progress despite huge investment in the sector and inadequate skilled birth attendants were critical barriers that must be addressed to reduce maternal mortality as part of MDGs.
She added that when insecurity in the North drove away midwives engaged and deployed by federal government as a short term measure to shortage of health workers in the North, it became clear that northern states have to produce their own health workers.
“Unlike building hospitals, procuring hospital equipment, kits and drugs among others that can be done quickly within a year, producing qualified health worker will require a minimum of three years. It is a long-term investment. Privately, W4H team considered the journey a religious and personal one and a moral responsibility to protect our dignity for us as mothers and fathers,” said Adamu.
The programme, according to her, complemented the state governments’
efforts with infrastructure, procurement of teaching aids and equipment, monthly impress, building capacity of tutors to improve quality of teaching hence improve graduation rate through introduction of students centred learning and e-learning. This will be galvanized by the system strengthening of Health Training Institutions (HTIs) to respond to the needs of students irrespective of status.
Governor Masari was lauded for working with the programme to change the face of the health training institutes in the state for good, his doggedness in employing 52 of the qualified nurses and midwives and approving automatic employment for community midwives and taking over the implementation of the FYP including the funding of FYPWG.
Masari was however urged to grant automatic employment to the remaining 48 FYP graduates comprising 23 midwives, 9 nurses and 15 community health workers.
On his part, Gov. Masari pledged his administration’s unrelenting support of the programme but on the condition that the female health workers, their parents or husbands should be ready to make sacrifices for its success.
He said the graduates would be absorbed into the state health system on the condition that their appointments would be tied to specific health facilities or communities in their local government areas.
Masari, who frowned that most schools and clinics in urban centres were overpopulated with married women while those in rural areas where majority of the people of the state live were neglected, asked the husbands and parents of the female health workers: “if your daughters and wives cannot go to rural areas, whose wives and daughters do you want us to send there?”
He also assures that his administration had designed programmes to provide rural communities with basic amenities so that it would not be too difficult for the teeming population of the state to reside outside the state capital and local government headquarters.
According to him, the neglect suffered by rural communities could be surmounted by good leadership and the political will to do the needful even as he asserted that the problem was part of the issues aggravating insecurity in parts of the north.
His words: “All these security issues – Boko Haram and others – are tied down to failure in providing the basic needs of life in rural
communities. You would not believe that some communities are living in Katsina or Nigeria; they are so remote, I was in shock over some
villages and communities we have in Katsina State.”
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