FG, Sokoto govt’s collaboration as model in healthcare financing

Few days ago, the Federal Government, through the federal ministry of health, announced a collaborative effort with Sokoto government that will see to the deployment of overstaffed workers of Usmanu Danfodio University Teaching Hospital (UDUTH) to state-owned hospitals so as to expand access to quality healthcare delivery to generality of the citizenry.

UDUTH is a tertiary health facility owned by the Federal Government and located in Sokoto. Established in 1989, the hospital has more than 100 consultants, 400 resident doctors, 1000 nurses and other health professionals. The combined strength of workers at the teaching hospital is almost double the number obtained in primary and secondary health facilities owned by the state government.

So in order to fully utilise the expertise of the workers, the Sokoto state government proposed a working arrangement where the workers would be deployed to state hospitals and primary healthcare centres for a fee, while at the same time, they continue their primary assignment with the teaching hospital.

The arrangement is more like a fusion of the two health systems and has ten thematic areas which include medical services, seminar/ clinical presentations, ward rounds and theatre services. Others include residency training, employment of consultants, outreach services, accident and emergency response, centralised ambulance service and deployment of nurses. The rest are rural posting of resident doctors and consultants, integrated referral system and establishment of state-owned medical school and teaching hospital.

Speaking on the significance of the collaboration, UDUTH’s Chief Medical Director (CMD), Dr. Yakubu Ahmed, said the new agreement will see health workers at the Federal Teaching Hospital in Sokoto deployed to any other public hospital. He said the agreement comes amidst concern that health workers are over concentrated at the teaching hospital, the only one of its kind in Sokoto.

“If you compare us with the state, we have a large number concentrated staff in the hospital. So in this arrangement, involving six general hospitals- two from each senatorial district -are part of the deployment agreement. Resident doctors at the teaching hospital would be deployed to rural communities in the state, and they would be supervised by consultants from the hospital. At the moment, the teaching hospital sees many referrals because of its huge concentration of experts,” the CMD added.

Minister of Health, Professor Isaac Adewole called the agreement a “great feat” and one of the best things to happen to Nigeria’s health system. He said he had tried to achieve the feat when he was Provost, College of Medicine, University of Ibadan, but the effort was thwarted by “doctors on the state side.”

“It is not only peculiar to Sokoto State. I was in Zamfara. At the FMC in Zamfara, there are about 120 doctors, and the whole state has less than 40 doctors in the entire state, in fact 23 or so at the last count to manage 24 hospitals,” said Adewole.

“So, it is a matter of one doctor per hospital. And, yet, one hospital has about 120. To me, that is inequality, inequity and must not persist in our country. This is because those who are not benefiting are also Nigerians. It is our duty to address these things and also ensure we offer our people good care. What this agreement will do is to transfer quality services from the teaching hospital to the communities. Highly trained specialists will offer services that support the state and the local governments. And, it is something that other state governors should emulate,” Adewole said.

Sokoto Governor, Aminu Waziri Tambuwal and his health commissioner, Dr. Balarabe Shehu Kakale, said so far, there’s scarcity of professionals in the state health sector. They said by bringing the two systems together, the FG and SOSG will be overcoming a challenge bedeviling their two governments.

In Nigeria, we’ve lately heard much about intergovernmental cooperation. Cooperation between Federal and State Governments, and among 36 states of the federation, has now taken many forms, ranging from simply reviewing and understanding ordinances to formal arrangements creating new authorities to provide specific services. While many state governments would benefit from a more cooperative spirit, actual cooperative ventures require each unit to carefully weigh the needs of their citizens, the responsibilities they have for operating their territory, and the benefits of the cooperative effort.

The arrangement between Federal and Sokoto state governments has now created a new vista of opportunity whose ultimate beneficiaries would be members of the public. This effort is a great example of how governments can work together to achieve common goals. Apart from making it easy for people to enjoy quality service from the FG-trained professionals, it allows Sokoto government to enjoy the service at a minimal cost, thereby saving funds and channeling the saved funds to other useful ventures.

Abuja and Sokoto have now created a model whose benefit will be felt by millions of citizens. By agreeing to pool resources, the two sides are now set to provide better quality, more effective services than they could by themselves. Other states can cue in for the overall benefit of their citizens, and the nation as a whole.

Imam is the spokesman to Governor Aminu Waziri Tambuwal of Sokoto State.