DR. RISEN AGIOBU

DESIGNATION: DIRECTOR OF PRIMARY HEALTH CARE

Dr. Risen Agiobu obtained MBBS degree in 1980 at the University of Nigeria Nsukka and MPH in 1987 from the University of Lagos. He became an associate fellow of the West African College of Community Physician in 1994 and a fellow of the National College of Community Physician in 1996. He is also a member of the MBA class of 1997 in the University of Science And Technology, Rivers State.

Dr. Agiobu started his career in curative medicine. He served in the then general hospital Port Harcourt as a medical officer from 1983 to 1985. He was the head of Ogu general hospital from 1985 to 1986. He also served briefly in Niger hospital between 1986 and 1987.

Dr. Agiobu switched to preventive medicine in 1983. He served in several local Government Areas as their primary health care coordinator, Etche local Government Area from 1977 to 2002, Eleme local Government Area from 2006 to 2007.

He was appointed the Rivers State Coordinator of Immunization in 2007, a post he held until May 2008 when he was elevated to the post of Director of Primary Health Care in the State.

Dr. Agiobu has attended several conferences and workshops. He has also produced several seminar and conferences papers. He had been member of several committees one of which was to produce policy guideline for health in Rivers State.

The PHC department is the organ of the Ministry of health responsible for achieving the goals, objectives and the direction of the state government in relation to Health care service delivery. The department coordinates and supervises all primary health care programmes and activities.

The state comes up with the policy direction but the translation of this into reality or in operational terms is a function of the PHC department. This involves situation analysis, identification of needs and priority setting. The department takes into consideration the feasibility of identified interventions, the available resources, target setting, strategies to achieve targets and indicators to measure achievement. Most PHC programmes follow these basic concepts and are coordinated and supervised by the PHC department be it at the Local Government Area (LGA) or state level.

The department collaborates with partner agencies; WHO, UNICEF, EU PRIME and other organizations to achieve set goals. The PHC department is also responsible for monitoring and evaluating all the activities of the various components. It is involved in training and capacity building.

IMMUNIZATION UNIT

The head of this unit is the State Immunization Officer (SIO). This unit is responsible for immunizing children against the vaccine preventable diseases namely: Poliomyelitis, Tetanus, Diphtheria, Pertusis, Measles, Yellow fever, Hepatitis B and Tuberculosis.


Immunization activities are carried put through:

1. Routine immunization: This takes place in all the 354 primary health care facilities in the state when caregivers take their children in specific days of the week to the health facilities to get them immunized Women of child bearing age are given tetanus vaccine.
2. Supplemental Immunization: This is immunization campaign carried out periodically to boost routine immunization or when there is a threat of an epidemic. It is National Immunization Days (NIDs) when it is carried out at the same time throughout the country; State Immunization Days (SIDs) or mop up when it is restricted to a state and Local Immunization Days (LIDs) when the campaign covers a particular Local Government Area (LGA).

The state has a cold store which is well equipped to maintain the potency of the vaccines. These vaccines are also available all the time and can be accessed at the nearest health facility.

The target immunization coverage for the state in 2008 is 80%. Dp3 coverage is used as the indicator to measure coverage and the state has recorded 79% by October 2008.


MATERNAL AND CHILD HEALTH/FAMILY PLANNING & SAFE MOTHERHOOD.

Four interrelated units are involved in rendering maternal and child health services in the PHC department namely:

1. Reproductive Health and Family Planning (FP).
2. Safe Motherhood
3. Women in Health
4. School Health

The goal of maternal and child health/family planning services in the state is to ensure that:

• Women remain healthy when not pregnant
• Remain healthy throughout pregnancy
• Have safe delivery
• Have healthy babies
• The child remains healthy and attains optimal development
• The families control their fertility

The services also assist couples who have difficulty in having babies. These services are available to individuals, families and communities in the various primary health care facilities in the 23 LGAs of the state.


In 2007, the state recorded 2,408 normal deliveries with no maternal death and 706 accessed our family planning services.


The state government is now constructing 130 model health facilities, 5 in each LGA which will be adequately equipped to improve services. Also health personnel are being reoriented, retrained and more staff employed to render quality services.


NUTRITION UNIT

The general goal of this unit i as to contribute to the reduction of morbidity and mortality of persons in the state through uplifting their feeding habits.


Functions of the unit include:

• Nutrition education and public awareness.
• Evaluation of nutritional status.
• Food supplementation and fortification.
• Dietary diversification and food production.
• Nutrition rehabilitation and
• Coordination

Achievements

Growth monitoring was undertaken in 6 health facilities in PHALGA. A total of 9707 under 5 children were weighed during the first quarter, the result showed that 13.8% were malnourished and 5.9% were severely malnourished. Caregivers were educated on food habits and proper nutrition. Also between 23rd and 26th of February 2008, 756,435 children were administered with Vitamin A.


MONITORING, EVALUATION AND SUPERVISION UNIT

This is the health information unit of the PHC Department. The goal of this unit is to develop a dynamic and responsive system that will provide information for planning, management and operational function of primary health care activities.


As a result of the importance attached to this unit a consultant is appointed to head the unit. This has enabled the unit to undertake active supervision of activities in the 23 LGAs.


HEALTH EDUCATION UNIT

The health education unit is the enlightenment organ of the state ministry of health. The unit creates awareness on prevailing health problems/issues, proffers solution for reducing them through effective communication to improve knowledge, attitude and practice. Health education cuts across all the other components/units of PHC.


Achievements

The unit trained 56 student nurses on practical skills in information dissemination in February 2008 and also developed education messages and materials for the first and second rounds of National immunization plus days (NIPDS) In February and March 2008.


The following activities were also carried out between January and June 2008.

• Reorientation of social mobilization officers at the 23 LGAS.
• Training and retraining of town announcers at the ward level for information dissemination at the grass-root and
• Engagement of ward focal persons to distribute information,
• Education and communication (IEC) materials to churches and schools to increase awareness on polio immunization.

Other elements covered by PHC include:

• Adequate supply of basic water and sanitation
• Prevention and control of locally endemic diseases and injuries.
• Appropriate treatment of common diseases and injuries.
• Provision of essential drugs.
• Mental health
• Control of HIV/AIDS.

PLAN OF ACTION FOR PHC

1. The direction of the state is to provide comprehensive and integrated health care service delivery to the people of the state.
2. Bridge the existing gaps with regards to infrastructure, human resources, finance and service delivery.

INFRASTRUCTURE

Most primary health care facilities are in a dilapidated state as a result of neglect over the years. After several consultations with stakeholders, the state government embarked on the building of 130 model facilities, 5 in each local government area. It is envisaged that this will decongest the secondary and tertiary health care facilities. Many are in the process of being completed while Churchill Model Primary Health Centre has been completed and commissioned for use.

HUMAN RESOURCES

Any plan that does not give priority to the development of human resource will sure crumble. The provision of a well motivated workforce in quality and quantity is given particular attention.


The state government has held reorientation and retraining workshop for all the personnel in the Ministry of health and secondary health care facilities. The retraining of PHC health personnel will soon be accomplished. Training and retraining will be a continuous exercise so as to update the knowledge and skill of all personnel. Emphasis is also on filling all numerical gaps in the workforce. In this respect, the moribund school of Midwifery will be reopened. Those that have retired but not tired whose services are still necessary will be engaged on a contractual basis.

In addition advertisement has already been made for applications to be submitted for recruitment and employment to complement the existing workforce in areas of need. It is envisaged that in due course the state will meet up the required minimum health package.

FINANCING

The health of the people is the priority of the state government. In this respect health has been allocated the highest budget in order to execute all the intended programmes and activities.

Service Delivery

The goal is to refocus and re-brand PHC services so as to achieve the desired impact.

The community will play a vital role.

1. Upsurge in service demand is expected.
2. A two way referral system will be emphasized and attained.
3. PHC will give quality services to at least 70% of the population.

In conclusion the state is determined to put in place sustainable PHC structures that will empower people to take full responsibility for their own health.