‎Ondo Investing Billions To Strengthen Healthcare — Commissioner

‎The Ondo State Commissioner for Health, Dr. Banji Ajaka, speaks with DAMILOLA ORIGBEMISUYI, on how the state is responding to the “Japa” syndrome through continuous recruitment of health workers, improved welfare for medical personnel and massive investments in healthcare infrastructure. He also responds to concerns recently raised by the Nigerian Medical Association (NMA) on manpower and remuneration in the state.

‎The migration of healthcare professionals, popularly known as the “Japa” syndrome, has become a major challenge across the country. How has Ondo State been affected?

‎The Japa syndrome affects everybody and every state. Ondo State is not excluded. Before COVID-19, we had one of the best health systems in the country, both at the primary, secondary and tertiary levels. We had a good complement of personnel. But after COVID, which was the immediate cause of the Japa syndrome, the situation changed. Although there are remote causes too, when you compare salaries in dollars with earnings in naira, people are attracted to opportunities abroad.

‎What practical steps has the Ondo State Government taken to address the shortage of health workers?

‎The Japa syndrome affects all of us, and we have been responding to it by recruiting. It is mainly doctors that are seriously affected. Nurses are also affected, but we still have nurses available. Whenever we advertise vacancies, nurses apply and we recruit them. Doctors are the category most affected. Since the inception of this administration, we have been recruiting at the primary healthcare level. Recently, we concluded another recruitment of about 1,000 personnel, including doctors, nurses and other health workers. We also recruited last year. Many states are not recruiting doctors for primary healthcare, but Ondo State did so last year and has completed another recruitment this year. Those recruited have already been posted. At the secondary level, we recruited last year and are carrying out another exercise now for doctors, nurses, pharmacists, medical laboratory scientists and other cadres.

‎How would you assess the welfare package for doctors and other health workers in Ondo State?

‎In terms of salaries, Ondo State is one of the best. We are at par with the Federal Government. Since the inception of this administration, we adopted the federal salary structure. For doctors, we implemented what is called ‘skipping.’ Instead of starting at Grade Level 12, they now begin at Grade Level 13. Not many states are doing that. The Federal Government also introduced another salary adjustment for doctors. Ondo State was the first state to adopt and implement it. The doctors know this because they were part of the discussions.

‎The Nigerian Medical Association recently expressed concerns over manpower and implementation of improved remuneration. What is your response?

‎Those assertions are not correct. They are false. What the NMA chairman said does not represent the facts. We know we are not where we want to be, but for him to claim that we are not recruiting doctors or that we do not have doctors is simply not correct. At the primary level, we are recruiting doctors and other health workers. At the secondary level, we are recruiting. At the tertiary level, including the teaching hospital, recruitment is ongoing. It is also incorrect to say that we have not implemented the federal government’s circular on improved remuneration for medical and dental personnel. We were the first state in the federation to adopt it. You can investigate this.

‎The association also issued a number of strike notices this year. How did the government respond?

‎This year alone, the NMA issued strike notices several times, 21 days, 14 days and later three days. But did they eventually go on strike? No. When the Federal Government issues a circular, implementation is a process. We must study it, assess our finances, discuss it with stakeholders and negotiate how it can be implemented. It does not automatically become state policy. Issuing strike notices should not be the first option. Everything can be resolved through dialogue.

‎‎Looking ahead, are you optimistic that the state can overcome the manpower challenge?

‎We do not have a major problem with health personnel because we are producing them. We are producing about 200 doctors. Even if some leave, many will remain to work in the state. We are also producing nurses. Ondo State has about eight institutions producing nurses, including the newly established College of Nursing Sciences. The shortage is temporary. People are already coming back to the state. If you visit the University of Medical Sciences and the teaching hospital, you will see doctors returning for postgraduate training. We have doctors working at the grassroots in many local governments, with two, three or four doctors serving in some councils alongside other health personnel. We are paying among the best. Anyone can verify that.

‎Beyond recruitment, what investments has the government made in primary healthcare?

‎Regarding infrastructure, at the primary healthcare level, we have revitalised 105 Primary Healthcare Centres with an investment of about N10 billion across the state. This includes renovating existing facilities, constructing staff quarters, providing 24-hour solar electricity, water supply, basic medical equipment and tricycles for community transportation of patients. We have completed work on 105 centres and are beginning another phase. Our priority is to ensure there is at least one standard Primary Healthcare Centre in each of the state’s 203 wards. We have recruited and posted midwives, laboratory scientists and health information officers to these facilities. Electricity, water supply, solar power and medical equipment have all been provided. Journalists are free to visit the facilities and verify these claims. We can show you the locations, photographs and monitoring reports. Staff quarters have also been built. Each consists of one-bedroom apartments with kitchens and toilets, ensuring health workers remain available around the clock.

‎What is the government doing to improve secondary healthcare services?

‎At the secondary healthcare level, while carrying out renovations, we have also awarded contracts for six new 100-bed hospital complexes. These hospitals will function as one-stop centres where patients can access emergency care, delivery services, X-rays, laboratory services and other medical services within one complex. Contractors have already been mobilised to the sites. This represents a massive investment running into several billions of naira. Eventually, all 18 local government areas will benefit as we modernise secondary healthcare facilities across the state. Those facilities that have not yet been upgraded are receiving minor renovations while awaiting comprehensive redevelopment.

‎What progress has been made at the tertiary healthcare level?

‎At the tertiary level, we handed over the Akure Medical Complex, representing an investment of well over N100 billion. The entire facility was handed over without the state collecting any money. This is expected to attract further federal government investment while allowing the state to focus on other priorities. We have also invested over N7 billion in medical equipment, including MRI machines, CT scanners, digital X-ray machines, complete ophthalmology equipment, ultrasound machines and breast cancer screening equipment. Delivery and installation will begin soon.