2 May 2008 - What started as a Routine Immunization (RI) revival mission by the wife of the Governor of Adamawa State, Dr Halima Hammanyero Nyako, has led to the declaration of free medical service for children under five years of age and pregnant women in the state. At the State Specialist Hospital, Yola, and 26 other general and cottage hospitals in the state, the scheme has taken off, following the release of 60 million naira by the government for the purchase of vehicles, drugs, devices, and for monitoring and supervision. An Integrated Maternal and Child Health Needs Assessment Survey preceded the implementation of the scheme.

It all started when the State Social Mobilization Committee visited the governor’s wife to get support for a mop-up, following initial reports of a wild polio virus in Song LGA in May. At that time, notes Dr Dauda Madubu, WHO State Coordinator, the RI coverage for the state was the least in Nigeria at 34% for DPT3. The governor’s wife, a Senior Consultant Radiologist and mother of four, told them her preference for addressing low RI, although a mop-up was good as an interim measure. State Health Commissioner, Dr Zainab Kwonchi, says their calculation was that what was needed for two rounds of IPDs is equivalent to the amount required for RI for four years. Gaps were identified in training, data, cold chain and monitoring and supervision, but the starting point was the eventual release by each LGA of N100,000 imprest for RI activities, following Dr Nyako’s advocacy to her husband, and the governor’s directive to LGA chairmen. State Director, Primary Health Care, Dr Hammad Pariya, notes that already, the imprest has led to an increase in the number of clinic sessions and outreaches, although the use of funds needs be closely monitored.

Dr Nyako speaks fondly of the August 13 – September 1, 2007 21-LGA tour as opening her eyes to the magnitude of the problems with the health system and the difficult terrain. She now appreciates more the crucial role of men in health interventions, although the six-hour trip to and from Shelleng LGA – on her birthday - was her most difficult. During the tour, the State Chairman of the Cripples Association, Mallam Abubakar Hoseri - whose love for football was aborted by polio at age nine while in Primary Four, told his story. In Toungo LGA, a man who became blind from measles also testified. At Golantobal Model Primary Health Care Centre, the officer in charge, Mohammed Dahiru, recounts how he was applauded after the governor’s wife checked the RI monitoring chart, register, monthly summary and tally sheet booklets and found data properly recorded.

The scope of the scheme launched on November 26 is expected to widen in 2008 to include all primary health care facilities after an agreement with LGA chairmen, a development which Hajia Zainab Isa Falama, mother of the District Head of Mboi and one of those excited by that first ever such visit by a governor’s wife on RI, looks forward to.

Dr Nyako is hopeful that the state would achieve a 100% DPT3 coverage by the third quarter of 2008 when her husband would be one year in office. The prospects are good as free health care responds to queries by some critics, of “undue” focus on polio. By March 2008, the state had achieved a DPT3 coverage of 73%.

- By Nosa Owens-Ibie