Overview Of The Oloibiri Health Programme
The Oloibiri Health Programme (OHP) is a three-year public health initiative, sponsored by Shell, to improve health and health care delivery for the communities of the Ogbia Local Government Authority area (LGA) in Oloibiri field, Nigeria. This Public Private People Partnership is championed by Shell as part of Nigeria's centenary celebrations and is named after Oloibiri community where oil was first discovered in commercial quantities in Nigeria.
Programme goals
The programme goals are to:
• Optimize health status indicators of communities within Ogbia LGA to levels comparable with those of developed economies
• Institutionalize best practices and experiences demonstrable from the project for possible replication and country-wide scale-up
Objectives and interventions
To achieve the goals of the programme, there are three main objectives which will each be addressed with specific interventions.
1. Promote universal health coverage and health system strengthening
This objective will be addressed through the following interventions.
• Upgrading of three primary health centres and one secondary health facility, focusing on infrastructure upgrade, utilities, equipment and supplies.
• Capacity building and training of local healthcare and community workers for the selected facilities.
• Establishment of a Drug Revolving Fund in project hospitals.
• Improving affordability of healthcare by creating a community-based health insurance scheme or other innovative financing model.
2. Enhance the social determinants of health
Holistic community health improvement will be promoted through investments in health determinants such as housing, education, renewable energy, education and sanitation.
3. Establish a learning and operations research centre
A Knowledge Management and Operations Research Institute will be established. This aims to directly address the second goal of the programme.
Timescales and Partners The Oloibiri Health Programme was initiated on 11 February 2015, when Shell Petroleum Development Company (SPDC) signed a Memorandum of Understanding with General Electric Nigeria to be the Implementing Partner for the Programme. Delivery of the programme is through collaboration with key stakeholders and partners. Partners include the Bayelsa State Government, Ogbia LGA, Federal University Otuoke, World Bank/IFC and GE Healthcare (providing the programme management office function).
How the Oloibiri Health Programme is different
The integrated and holistic approach to improving health and managing healthcare is what sets the Oloibiri Health Programme apart from others. Rather than just focusing on individual facilities or funding one-off projects it looks at all aspects of health and healthcare for a defined community. The guiding principles are sustainability, efficiency, safety and access. The OHP is not 'business as usual'.
Some of the ways in which the OHP differs from other health projects are listed here.
• Population-based rather than linked to a facility.
• Focused on improving and maintaining health, not just treating illness.
• A strong emphasis on improving the wider social determinants of health.
• Integration of the healthcare system rather than facilities working in silos.
• A focus on those in the lowest socio-economic groups to reduce inequalities in health outcome.
• Research, knowledge and learning built in to the programme, so that this can be shared and results replicated in other areas.
• Co-ordinated delivery of the interventions to better achieve the goals.
• Genuine ownership by key stakeholders.
A complementary programme
An important aspect of the Oloibiri Health Programme is that it complements other programmes such as the national 'Saving One Million Lives (SOME)' initiative launched in Nigeria in 2012. This addresses the leading causes of morbidity and mortality in the country through evidence-based interventions.
The Oloibiri Health Programme, and especially the investment in the wider social determinants of health, also advances the UN Sustainable Development Priorities and Goals by integrating impact and sustainability into its daily strategies and operations.
OBJECTIVE 1: UNIVERSAL HEALTH COVERAGE AND HEALTH SYSTEM STRENGTHENING
The Oloibiri Health Programme has, as a guiding principle, a commitment to universal coverage - healthcare for all members of the community regardless of their circumstances.
It also aims to promote health system strengthening. The World Health Organization (WHO) defines health system strengthening as: "..any array of initiatives and strategies that improves one or more of the functions of the health system and that leads to better health through improvements in access, coverage, quality, or efficiency."'
A health system is made of six building blocks which work together to produce the desired outcomes. One of the unique features of the Oloibiri Health Programme is that its scope deliberately targets all the health system building blocks. In this way the programme will strengthen the Ogbia LGA's health system in an integrated manner, increasing accessibility to healthcare, improving the quality of the health service provision and ensuring it is safe and efficient at all levels. The scope of the Oloibiri Health Programme includes four main types of-intervention through which it will address this objective. These are now discussed in turn.
'Health systems strengthening glossary. World Health Organisation. http://www.who.int/healthsystems/hss_glossary/en/index5.html, accessed 14 June 2017
Upgrading Healthcare Facilities
One of the six building blocks of a health system is service delivery. A vital part of service delivery is the quality of health service facilities. The Oloibiri Health Programme includes the upgrade of selected health facilities across Ogbia LGA, which will be integrated into a 'hub-and-spoke' service delivery model. One secondary health facility will be connected to five 'Health for Life' centres. The programme will also support 13 ward centres, one for each ward in the Ogbia LGA.
Upgrade of the identified health facilities will include improvement of the infrastructure so that buildings are safe and fit for purpose. Health delivery will be supported through provision of appropriate equipment and supplies. Utilities will be upgraded - ensuring constant water and power supplies and safe waste management systems.
Kolo General Hospital will undergo a transformation. Previously a dilapidated building with poor utilities, worn out furniture and inadequate equipment, it will become a fully upgraded modern facility. It will have reliable utilities, new equipment and furniture and a consistent supply of drugs and other essential supplies. There will be provision for maternal and infant care and new quality standards for patient care. Delivery of its services will be safe, timely, effective and patient centred. This will allow Kolo General Hospital to take on its central role as the referral hub for the Ogbia LGA.
The following health facilities will be upgraded.
• Kolo General Hospital - a secondary health facility
• Three 'Health for Life' centres: CHC Oloibiri, PHC Anyama, Cottage Hospital, Otuasega.
In addition, the programme will support 13 ward health centres:
• PHC Anyama
• BHC Emeyal
• CKC Imiringi
• CHC Kolo
• CHC Ogbia
• CHC Okodi
• PHC Ayakoro
• CHC Oloibiri
• Cottage Hospital, Akipelai
• Demonstration Clinic, Otuogidi
• Cottage Hospital, Otuasega
• PHC Otuokpoti
• Federal University Health Centre, Otuoke
Community Health Workers
Another of the six building blocks of a health system is the health workforce. As well as hospital staff, the health workforce in Ogbia LGA includes community health workers. The use of community health workers is a common strategy to address the need for health workers, especially in low income countries. If carefully selected, appropriately trained, and consistently supported these workers can improve coverage and access to basic healthcare.2 Community health workers are well placed to act as agents of change for promoting healthy behaviours and reducing health inequalities.
The Oloibiri Health Programme will conduct capacity building and training of facility-based and community health workers to help it achieve the objective of health service strengthening (hospital staff will be deployed by the Bayelsa State Ministry of Health and PHC staff by Ogbia LGA). The OHP will provide training, mentoring and supportive supervision of community health extension workers (CHEWs). These health workers are drawn from, and based in the Ogbia community. They therefore speak the local language and have a connection with the people they serve. Training for CHEWs will ensure they have the appropriate mix of skills and competencies for the roles they undertake. These facility-based and community health workers will receive education and training at an appropriate level for their role.
Drug Revolving Fund
Safe and effective delivery of preventative and therapeutic health services requires a reliable and sustainable supply of pharmaceuticals. High demand, limited funds and inefficient procurement and distribution processes can lead to frequent shortages in low income areas. There may also be the problem of the presence of fake, substandard or expired drugs. One method for financing drug supplies has been the establishment of Drug Revolving Funds (DRFs) in which, after an initial capital investment, supplies are replenished with monies collected from the sale of the drugs. An effective DRF ensures continuous availability, accessibility and affordability of quality drugs through a sustainable mechanism.
The Oloibiri Health Programme aims to set up a DRF in project hospitals to address the challenge of frequent stock outs of medicines and other supplies. The aim is to make essential drugs affordable to all who need them within the health facilities and community of Ogbia LGA. A detailed assessment of the current management and availability of pharmaceuticals within the health facilities of Ogbia LGA has been made. It has found that there are many challenges, including low levels of staffing, low staff morale, very poor quality drug storage and dispensing facilities, poor drug management protocols and a lack of essential drugs.
Various options for establishing a sustainable DRF will be considered by the stakeholders of the programme.
Financing
For a health system to improve access and coverage of healthcare, that care needs to be affordable. Universal healthcare coverage requires care to be affordable for all, irrespective of each person's circumstances. The Oloibiri Health Programme aims to improve the affordability of healthcare through provision of a health financing system. This is to ensure that the people of Ogbia LGA can use health services when they need to, regardless of their ability to pay for the services
The programme will include the establishment of a community-based health insurance (CBHI) scheme or other financing model. CBHI is a way of providing financial protection against the cost of illness and improving access to health services in low income areas. It pools risk and is usually voluntary, not for profit, and linked to a healthcare provider.
"The Oloibiri Health Programme aims to improve the affordability of healthcare through provision of a health financing system. This is to ensure that the people of Ogbia LGA can use health services when they need to, regardless of their ability to pay for the services"
OBJECTIVE 2: ENHANCE THE SOCIAL DETERMINANTS OF HEALTH
According to the WHO, the social determinants of health are: "the circumstances in which people grow, live, work, and age, and the systems put in place to deal with illness. Social Determinants of Health include income, education, employment etc. These social conditions are the single most important determinant of good health or ill health"'
These conditions are outside the health system but have the potential to strengthen or undermine the health of individuals, households and communities. Any health improvement programme would find it difficult to achieve meaningful and sustainable improvement of the health status of the population without improving the many key drivers of the health of individuals and communities which exist in people's everyday living and working conditions. In recognition of this, the Oloibiri Health Programme aims to achieve holistic community health improvement through specific investments in the social determinants of health.
Priority areas include:
• water - e.g. hand-pump community boreholes • sanitation programmes - e.g. latrine systems
• renewable energy systems - e.g. solar and wind technology
• safe and hygienic housing conditions, including reducing indoor pollution e.g. clean cook stove solutions and provision of affordable housing
• educational interventions - community health promotion
Priorities for each community/clan in Ogbia LGA will be determined in collaboration with the communities themselves. The interventions will be implemented in partnership with the communities to ensure ownership and sustainability.
OBJECTIVE 3: LEARNING AND OPERATIONS RESEARCH CENTRE
The success of a public health intervention is not just determined by the health changes it brings about in its population. It is also judged by the degree to which the findings and experience from that intervention contribute to the wider evidence base. Too often public health initiatives are carried out in isolation, with no record being left to guide others who wish to do something similar in future.
It is an important part of the Oloibiri Health programme, indeed one of its two goals, that what is learnt can be used in future by those wishing to replicate or scale up the model. For this to happen, programme data must be collected, analysed, evaluated and disseminated in an organized way.
To address this, the programme includes the establishment of a Knowledge Management and Operations Research Institute, to be situated within the Oloibiri community. This part of the project is to be led by Federal University Otuoke.
The Knowledge Management and Operations Research Institute will be responsible for monitoring and evaluating the programme. A data management application system will be developed and tested with potential users to ensure it is fit for purpose. A facility and population-based baseline survey will be undertaken to allow measurement of outputs against this baseline. Programme data will be routinely collected and reported. Findings from the programme will be documented, published and disseminated, thus making the learning available for future use.
OUTCOMES OF THE OLOIBIRI HEALTH PROGRAMME
It is hoped that the various interventions of the Oloibiri Health Programme will deliver results in the form of intermediate improvements in health indicators.
However, the ultimate success of the programme will be seen when the following expected outcomes are achieved in the Ogbia LGA.
• Increase in healthcare coverage for underserved communities
• Reduction in the number of mothers dying at childbirth
• Reduction in the number of children dying before the age of 5years
• Reduction in maternal and child morbidity
• Reduction in the prevalence of water and sanitation-related illness
• Improvement in quality of life and life expectancy of individuals within the community served
• Social development in the community
• Replication and scale-up of the programme model to other LGAs and states.
CONCLUSION
The Oloibiri Health Programme aims to improve the health of the communities of the Ogbia LGA with an innovative, holistic approach. It will strengthen the health system and promote healthcare coverage for all, while supporting the health of the population by investment in the wider determinants of health.
Beyond improving the health of one community, the knowledge and learning from the programme will be made available so that the model may be replicated in other areas and scaled up country-wide. An important aspect of the Oloibiri Health Programme is that it complements other state, national and international health programmes, and in particular the important Saving One Million Lives initiative in Nigeria.
Dr. Femi Oduneye, Regional Health Manager and Programme Sponsor:
In this country, good quality primary health care for all remains a challenge. The country needs to achieve a better balance between preventive and curative care. We need to ask ourselves - how can we maximise finite health resources to protect the population of and ensure that people remain healthy and productive? We need to explore a new model. The Oloibiri Health Programme (OHP) provides one such model. The programme aims to improve health and healthcare within the Ogbia Local Government area in an innovative, holistic way. It focuses on improving and maintaining health, not just treating illness. Through upgrading and integrating health facilities, training and supporting local healthcare & community workers and ensuring a reliable supply of medicines it will strengthen the local health system. Its laudable aim of universal health coverage will be addressed by creation of a financing scheme such as community-based health insurance. Perhaps most importantly, the programme recognizes that health is determined not just by healthcare, but by wider determinants such as access to clean water, sanitation, availability of energy, education and safe housing.
Learning from the programme will not be lost, as so often happens with public health initiatives. Through partnership with Federal University Otuoke, data will be collected, analysed and published so that others across the country can benefit. It's time to move health policies away from just treating the sick and towards keeping people healthy and preventing them from falling ill. The Oloibiri Health Programme will show what can be achieved in one local area. If successful, it may provide a model for scale-up countrywide, ensuring better health and a better quality of life for all.
ABUJA: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
PORTHARCOURT: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
LAGOS: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
You may also like
Philanthropy Points the Way: Kogi Nursing College Gets N30m Lifeline
At a time when Nigeria’s health and education sectors are crying out for me…
LAGOS: Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid CPR AED, CPD, ECG, Ambulance Drivers Training Schedule
Join our upcoming training sessions covering Basic Life Support, Pediatric …
ABIA APPROVES N500M FOR CIVIL SERVANT'S HEALTH INSURANCE SCHEME
Abia State government has approved N500 million as counterpart funding for …
FG BEGINS MALARIA VACCINATION FOR CHILDREN TODAY
The federal government will commence malaria vaccination in Kebbi and Bayel…
CENTRE PLANS $237M MEDICAL FACILITY FOR CANCER, SICKLE CELL TREATMENT
To provide world-class medical services and reverse medical tourism in the …
