How Gov. Ugwuanyi’s Visionary Leadership Transformed Enugu’s Primary Healthcare Sector
By Ikechukwu Odu
Making huge investments in the health sector to revamp an ailing health system has not been the preoccupation of many state governments in Nigeria. But for Enugu State Governor, Ifeanyi Ugwuanyi, it is a way of life.
The governor signaled his competence and commitment in delivery of healthcare services in the state when, in 2020, the whole world was struck by the outbreak of the dreaded Covid-19 pandemic, which brought several governments on their toes, but he fought the pandemic to a commendable standstill in the state.
How he did the magic
In Nigeria, of all the levels of healthcare services, primary healthcare has been adjudged as the bedrock of the country’s health system, given that it is the first level of contact between Nigerians and the nation’s health system.
This explains why the Federal Government, in 1992, established the National Primary Health Care Development Agency (NPHCDA), to improve and support primary healthcare services in the country.
But for a nation like Nigeria with an adult mortality rate of 34.25 deaths per 100 population according to World Health Organization (WHO) statistics, there was a need to prioritize and domesticate the agency in local council areas of the 36 states of the federation and the Federal Capital Territory (FCT) Abuja.
While some other states domesticated the agency in their states, Enugu could not follow suit. What looked like a Primary HealthCare Agency in the state was existing as a public health unit under the State Ministry of Health at that time.
But, shortly after his assumption of office, Governor Ugwuanyi, determined to change the ugly narrative in the state, established the Enugu State Primary Health Care Development Agency (ENS- PHCDA) in 2017 with core mandate of ensuring adequate and accessible healthcare services in various local government areas of the state and also with emphasis on preventing and providing basic treatment for illnesses.
However, when the agency began to wobble and struggled to meet up with its mandate, the visionary Governor was disturbed and, consequently, resumed hunting for a public health professional with a mixture of leadership traits and cognate expertise in healthcare services delivery.
In 2019, there was a new dawn in the agency when the governor announced the appointment of Dr. George Ugwu as the Executive Secretary and Chief Executive Officer of ENS-PHCDA. The ebullient and enterprising public health expert began driving the core mandates of the agency with delectable panache.
As a renowned consultant obstetrician and gynecologist, Dr. Ugwu’s giant strides in the state’s primary healthcare sector did not come as a surprise to many.
Before his appointment, he had served as Chairman of Nigeria Medical Association (NMA) and also Associate Dean and Consultant at the College of Medicine University of Nigeria, Nsukka, UNN.
So, having been armed with the requisite experience and passion for healthcare delivery, the medical practitioner wasted no time to set the ball rolling on assumption of office.
“I met a primary healthcare system that was rudimentary. Just a few rooms were all we had as our office. All of the programmes and healthcare activities that were supposed to be carried out following up with the NPHCDA were in deficit,” Dr. Ugwu said.
However, with the assistance of Governor Ugwuanyi, the Executive Secretary began his plan to rejig and reposition the primary healthcare in the state by training and overhauling staff members of the agency for improved performance.
On Governor Ugwuanyi’s approach that precipitated the success stories in the state’s health sector, Dr. Ugwu revealed, “Governor Ifeanyi Ugwuanyi sat down and decided to overhaul and rejig the primary healthcare system in the state. He took specific steps to ensure that the ugly story of primary healthcare was changed.
“Upon my appointment, we had to bring up to him what the deficiencies in the primary healthcare were and he, quickly within a very short moment, relocated us into a befitting office here in Coal City Garden Estate, GRA, Enugu.
“He also provided us with the necessary gadgets to work with. Then, he went further to appoint a board to complement and supervise the ENS- PHCDA as required by law.”
Accolades, testimonies pour in
It did not take long for Dr. Ugwu to observe that the governor has swelling love for the primary healthcare sector. So, when he began to support the agency in repositioning the healthcare services in the state, the Executive Secretary was not surprised.
“Frankly speaking, I think the governor’s position and attention to health actually increased health indices in the state. The governor has been showing much interest in health issues. Any time we are doing flag-off (of any health programme), he was always coming in person and hears our demands and accomplishes them,” said Sir Philip Ugwueze, the state coordinator of the NPHCDA.
Mr. Fabian Nebo, the Director, Community Health Services and State Health Educator of the Enugu State Primary Health Care Development Agency, also narrates how the emergence of Dr. Ugwu as Executive Secretary of the agency ended years of untold administrative and infrastructural challenges in the agency.
He said, “As soon as the agency commenced, you know, we started from nothing especially with regards to structure. Some other things such as laws came. And then after a period of time there was a change of leadership.
“After the change of leadership, Dr. George O. Ugwu, the current Executive Secretary of this agency assumed office and that was when the unimaginable started happening at the agency,” he said.
Starting from the structure
“This office we are in now is a new structure. We were at Okpara Avenue in an open space. But we now have this new structure with all manners of facilities and medical equipment, ” he equally added.
Mr. Nebo noted that the giant strides in the health sector in the state have attracted many partners who now support health activities in the state.
The State Health Educator also lauded the governor for the accomplishments recorded in the state’s health sector.
“We call him a governor with a passion for health. And since he came on board, he has been approving and releasing funds for most of our requests,” he said of Governor Ugwuanyi.
Like Governor Ugwuanyi, the ENS-PHCDA Boss, Dr. Ugwu has also been praised for his landmark achievements in the state’s primary healthcare sector.
Barely three years into Dr. Ugwu’s administration as the Executive Secretary of the agency, there is no doubt that the astute medical practitioner has not only translated his visions to concrete realities, but has also exceeded the expectations of many given his soaring achievements in the primary health services in the state.
The Commissioner for Health in Enugu State, Dr. Ikechukwu Obi, lavished praise on Governor Ugwuanyi and Dr. Ugwu, for their enormous efforts and attendant accomplishments recorded in the primary health care sector in the state.
“Ugwuanyi touched the entire healthcare system in the state – Primary, secondary and Tertiary. He multiplied his plans for the healthcare and sped up the plans he had outlined,” he began.
Seven new Type-3 Health centres built in Enugu
Unsatisfied by the lofty feat coupled with his hunger for more accomplishments, Governor Ugwuanyi constructed and equipped seven brand new model Type-3 Primary Healthcare centres in seven Local Government Areas in the state spread across the three senatorial zones in the state.
The benefitted council areas include: Nkanu East, Ezeagu, Udenu, Igbo-Eze South, Uzo-Uwani, Isi-Uzo and Igbo-Etiti.
“These seven Type-3 Primary Healthcare Facilities have now been staffed. New staff have been employed – doctors, nurses, community health officers, security men, accountant and so on – and then giving services in these Primary Healthcare centres,” the state health commissioner said.
“I went to one of those Type-3 primary health centres and it is on record, the two doctors that were employed there have done several caesarean sections, they have done myomectomy surgery (removal of fibroid). They have also done hysterectomy (removal of the uterus).
“So, the facilities are built, they are staffed and they are performing surgeries,” Dr. Obi, an associate professor of public health, stated.
Beyond these interventions, Governor Ugwuanyi has continued to show enormous support and commitment towards improving healthcare services in the state. For example, recently, the governor devoted vast sums of money to renovate and upgrade about four existing primary health centres to model Type-3 primary healthcare centre, all comprising residential quarters for doctors and nurses.
The addition of the doctors’ quarters ended the difficulty experienced by many doctors who were hardly available at rural facilities as they often have to shuttle between their rural workplace and their residence in the urban area.
Speaking on recent improvement at the Type-3 Health centres, the ENS-PHCDA boss said, “We also have alternative water supply as each Type-3 PHC has a bore hole, regular power supply, enough spaces for Out Patient Department.”
He added, “as I speak to you, our dear governor, Rt. Hon. Dr. Ifeanyichukwu Lawrence Ugwuanyi will soon conclude arrangements through the ENS-PHCDA to employ about 80 mid wives who would be deployed to various PHCs in Enugu State to continue to improve our services, also via Basic Healthcare Provision Fund (BHCPF) programme.
“In fact, this model Type-3 Health Centres now serve as referral centres for Primary Health Care services.”
Dr. Ugwu also said more than N600,000 has been disbursed for the reconstruction and supply of health commodities in primary healthcare centres in all political wards in the state.
He said the funding was possible because of the governor’s insistence that the state should be part of the BHCPF programme of Nigeria through the agency.
Furthermore, the governor procured and distributed several solar-powered vaccine refrigerators to end decades of inability to preserve vaccine for improved services.
Also, the ENS-PHCDA, under Dr. George Ugwu’s watch, has continued to blaze the trail in virtually all aspects of primary healthcare services in the state.
The agency’s swift response and efforts to support the global fight against the corona virus pandemic have been linked to emergence of Enugu State as the state with lowest case of covid-19 patients in the country.
Again, the agency was prompt with efficient and immediate vaccination of Enugu residents following the receipt of the vaccines.
Earlier, in February 2020, determined to end Polio and other immunizable diseases in the state, the ENS-PHCDA, under Dr. Ugwu’s watch, flagged off the 2020 National Immunization Plus Days for children between the ages of O to 5 years. The ceremony which was performed by the wife of the governor, Her Excellency, Mrs. Monica Ugwuanyi, held at the Primary Health Care Centre, Ibagwa-Aka, Igbo-Eze South Local Government Area.
In October of the same year, the agency also held a ceremony to mark the official flag-off of the Modified Integrated Free Medical Outreach pragramme.
The ceremony, which held at Nsukka Primary Health Centre, was performed by Mrs. Ugwuanyi.
The First Lady, who was represented by Honourable Commissioner for Health, Dr. Ikechukwu Obi, also presented free medical supplies and supplements to the agency.
In December 2021, the agency officially held a flag off of the Covid-19 mass vaccination campaign at Abakpa-Nike Health Center, Enugu State, which was performed by Governor Ugwuanyi.
Gov. Ugwuanyi, represented by his deputy, Hon. Mrs. Cecilia Ezeilo, also used the occasion to launch the Basic Healthcare Provision Fund Programme Implementation in Enugu State, explaining that the two important and closely related programmes in the health sector were commenced together in order to launch frontal attack on the Coronavirus pandemic.
“Investment in health is actually in economy. It only takes a little time. Similar to investment in Education because it is the educated and healthy population that will be productive. That’s why you see responsible governments like Governor Ugwuanyi investing so much in health, quietly and effectively for the future,” Dr. Ugwu said.
The governor, working with the agency, has also marshalled out plan to build at least one health centre in all the 291 wards of the state.
To match up with the governor’s vision for the health sector in the state, the agency rolled out some health programmes, including the introduction of new vaccines at the renovated and newly constructed health centres.
Equipped with relevant medical equipment and other supplies, the majestic structures have now become the choicest destinations for patients seeking medical treatments in the state.
WHO, Council Chair, others laud Gov. Ugwuanyi and Dr. Ugwu
Hon. Solomon Onah, the Chairman of Udenu Local Government Area said the health sector in the state was in a “very worrisome state” before the Governor’s intervention especially during the Covid-19 outbreak.
“It was in a very worrisome condition before the assistance of the governor,” said Hon. Onah, who is also the chairman of Association of Local Government of Nigeria in Enugu State.
He said beyond the Type-3 primary healthcare centre built in his council, the governor also constructed a Cottage hospital in the area.
Mrs. Nneka Odoh, the Officer in-charge at Obolla-Affor Comprehensive Health Centre in the council area, said the governor’s administration brought desired changes in the state’s health sector.
Mrs. Odoh, who has worked in the facility for more than 10 years, recalled her experiences before the governor intervened.
“There was a time we had leaking roof in this place. I can’t forget the day this place was flooded and patients were running helter-skelter. Even the ceiling and the beds. They were in terrible state. But since governor Ugwuanyi came in, he changed the face of this Obollo-Afor Comprehensive Health Centre. We can’t thank him enough,” she narrated.
For Hon. Sam Okechukwu Ngene, a member of Enugu State House of Assembly, the choice of Dr. George Ugwu as head of the agency brought instant improvements into the state’s primary healthcare sector.
“After the creation of that agency, of course, you can trust our governor, Ifeanyi Ugwuanyi, who took time and had a very wonderful eagle eye and was able to pick somebody like Dr. George Ugwu to be the Executive Secretary of the agency. He has made a lot of difference since he came on board,” he said.
Hon. Ngene, who is also the Chairman, House Committee on Health in the State Assembly, said the state legislature has continued to assist the agency to enact laws for its efficient operation.
Mrs. Joy Anorue, the acting Co-ordinator of the World Health Organization (WHO) Enugu State Chapter, said the agency has fared well in its responsibilities given the available results of performance indicators.
She said, “By way of assessing, the agency is doing well. They are up in programme implementation. There is no programme that has come to Enugu State that the Enugu State Primary Healthcare Development Agency did not participate in.”
More giant strides, rain of awards
The agency, under Dr. Ugwu, has continued to pull strings in several health programmes across the state.
In 2020 and also in 2021, Enugu State recorded 100% success in target polio vaccination. For 2020, the targeted 35,775 children for vaccination was exceeded after about 37, 852, representing above 100%, were vaccinated. Also, in 2021, the agency exceeded the target of 1,014,953 children aged between 0 to 5 years.
Consequently, these giant strides have not gone unnoticed. The agency and state government have continued to bag a number of recognitions and awards due to the giant strides in the primary healthcare sector in the state.
For instance, in December, 2021, Dr. Ugwu and Governor Ugwuanyi were also honoured with awards of excellence by the Federal Radio Corporation of Nigeria (FRCN) Enugu Zonal Office, in recognition of their outstanding response to Covid-19 outbreak in the state.
Again, in August, 2022, an international organization called, “ONE campaign,” recognized Enugu State as the second highest performing State, after FCT, in Primary Healthcare Service Delivery in Nigeria between 2019 and 2021.
Mr. Stanley Achonu, the country’s Director of “ONE campaign,” presented the award of recognition to the Executive Secretary of the agency, Dr. George Ugwu.
Dr. Ugwu was equally applauded for the successes the agency has recorded so far, under his watch, including its great impact in safeguarding the health of residents of the state, especially in the fight against Yellow Fever, Cholera, Covid-19 pandemic, and all childhood related diseases, which earned the state the award.
Despite all these achievements, Dr. Ugwu is not resting on his oars.
The ENS-PHCDA Boss said, “We want to make primary healthcare in Enugu State strong, effective, dependable and reliable. And the governor has done the foundation and has also taken off.”