Saving One Million Lives Program for Results (SOML PforR) is a joint healthcare initiative by the federal and state governments which is aimed at substantially reducing the high rate of death as a result of preventable causes. It provides an easy access to less-privileged Nigerians, mostly in the rural areas who cannot get adequate quality healthcare services particularly in the areas of maternity, child health, and nutrition.
The initiative is funded by the healthcare loan collected by the federal government in 2016 from the World Bank which was distributed to state governments as healthcare intervention. Each state received a grant of 1.5 million USD through a rigorous process. Given the result-oriented nature of the program, the grant is renewable annually, but strictly on the basis of recorded tangible achievements.
The program is based on the following focal points:
- Improving maternal, newborn and child health;
- Improving routine immunization coverage and achieving polio eradication;
- Elimination of mother to child transmission of HIV;
- Scaling up access to essential medicines and commodities;
- Malaria control; and
- Improving child nutrition.
The SOML Program at Katsina State.
Because the process of receiving the intervention funds is strenuous, the program did not take off in Katsina until February, 2017, which delayed its impact. However, the effective and efficient manner in which the initiative has been domesticated in the state, which is geared to address the peculiar problems that have ravaged its healthcare and impeded any access thereto, for the target population, who mostly live predominantly in the rural and suburban parts of the state. This target population, sadly, together with those of other states, make up the poorest 40 percent of the population among whom it is estimated that almost 1 million women and children die yearly, largely from preventable causes.
Basically, the program is structured on a phased implementation strategy. Among other less obvious problems, the Katsina State SOML project has been able to address the infrastructural challenges in those remote areas in terms of hospital facilities and service equipment by building primary health centers across the 34 local government areas of the state.
But even where there are primary health centers, they are usually devoid of doctors, nurses and other auxiliary healthcare providers capable of rendering the required services. As a result, women in labor were forced to give birth at home and therefore are exposed to different life-threatening conditions. The Katsina SOML project has deployed one skilled locum doctor to every primary health center in the state, to be on call once a week, and three locum nurses on shifts.
The Katsina State SOML program is proud to have helped in saving the lives of a mother and her conjoined twins that were safely delivered by one of the locum doctors deployed to Kaita Local Government Area, an extremely complicated case that otherwise would have resulted in the tragic death of both the mother and the babies.
While all the 6 pillars have been accorded all the necessary attention, the 4th pillar, which is scaling up access to essential medicines and commodities, has been more prominent because the intervention made in this area by providing essential medicines that are otherwise unaffordable, cut across all the other pillars. This include the provision of anti-malaria drugs, immunization vaccines, ACT1 and 4, SP, ORS, ampicillin, paracetamol etc.
Particularly, in the aspect of malaria control, mosquito nets were distributed to prevent any exposure to mosquitoes so that malaria would not even be contracted let alone be cured.
But one of the major achievements recorded by the program so far has been the introduction of the telemedicine initiative where 3 mobile phones are assigned to every healthcare center in the state so as to facilitate communication between locum doctors, locum nurses and the official in-charge in case of any emergency and other related cases.
Of the three phones, one is assigned to the locum doctor, one to the locum nurse on duty and the other to the healthcare facility. In addition, a closed whatsapp group is created for such purposes accessible only with the phones. The phone number of a given facility is conspicuously pasted on a wall. Communication expenses between these personnel are completely covered by the SOML program.
Another vital achievement is the introduction of the integrated supportive supervision, where all the healthcare centers in Katsina State are periodically supervised and graded so as to monitor their general activities; how and whether they make adequate use of drugs and equipment, their general maintenance of the facility and so on. In that regard, there is a prepared comprehensive checklist that serves as a guide during this supervision, the aim of which is to identify areas of strength and weakness so as to offer constructive criticisms. The key areas of interest are:
- Infrastructure: the things considered here include cleanliness of the health facility, provision of hand washing water and sanitizer, medical waste management, sharp containers, a working mobile phone, latrine, lightening, waiting area and consultation room.
- Basic equipment
- Human resource/HMIS/ management
- Outpatient Service provision
- Immunization service provision
- Prenatal and postnatal care provision
- Skilled birth attendance
- Family planning service provision
- HIV care
A supervisory team consists of a doctor, a nurse, and one other person, mostly, a pharmacist. SOML program has bought 2 vehicles to facilitate the process of supervision.
Another area where the program has recorded a significant achievement is in skill or enhancement programs that it organizes periodically for nurses, so as to keep them up to date with the current knowledge and skills of their profession. One of such trainings is the Mandatory Continued Professional Development Program (MCPDP), after which SOML program renewed the licenses of the participants.
Nevertheless, in spite of all the recorded achievements, lack of sensitization on the part of the beneficiaries has remained the greatest challenge to the progress of SOML PforR.