Source: All Africa
Interview: Dr. Muhammadu Mai, General Manager, FCT Hospitals Management Board, Abuja, speaks with Victoria Awom and Judd Leonard-Okafor on factors responsible for the antenatal woes of pregnant women in the FCT,

disclosing that nearly 700 medical personnel are being employed and deployed to Abuja hospitals.

Where do expectant mothers get your free antenatal care?

Only in nine satellite hospitals.

Which are?

All of them, minus Maitama, Asokoro and Wuse. The nine satellite hospitals are in Gwarimpa, Kubwa, Nyanya, Bwari, Kwali, Karshi, Abaji, Rubushi, and Kuje.

Then why is Wuse congested? Women there have told us they have to come over to sleep in hospital so they can get antenatal care.

Wuse is right in the middle of the city. See where Maitama is--do you get even bus going to Maitama? The problem is that Wuse is the most accessible hospital. It is also one of our oldest hospitals. It is right within where people live. Most people don't live in Maitama--you know, the average person, me and you.

It is improper for a pregnant woman to come to pass the night in the hospital to access antenatal care. So, what's the board doing to stop it?

We are doing a patient appointment system. We have computerised the appointment system and put patients in time bands. So we say, for instance, between eight and 10 o'clock is a time band for appointment. So all the people you will see will be people who are meant for appointment between eight and ten. Then there will be another time band, with a small buffer of, let's say, thirty minutes, between ten-thirty and twelve-thirty. Then from maybe, one o'clock to three o'clock. And people are booked and given a slip indicating their time band, and that's the way it is going to work. Come in groups of maybe 30 or 40 at this time band. So, the other women, don't come because your time band is for later that day.

The number of people who would come in within those time bands, would you be able to attend to all of them?

Absolutely; we have done the statistics. We have looked at the amount of time we spend on patients. The time band is meant to target that number.

That's how many?

I wouldn't know. This is the job of medical records. But it takes care of the number that comes. Within the time band you have given them you should be able to clear them and deal with another set of patients. This is what happens in developed parts of the world. You don't go to clinic and find 20 people waiting. If you have an appointment to see a doctor abroad, in the maximum you will see two or three people in that room, because they have organised it in such a way that you come and go, and as you are going, somebody else is coming. People don't sit waiting.

Do you have enough human resources to handle this?

We have no challenge in human resources. It's challenge of space that we have. That's what people need to understand. These hospitals were built for FCT then at inception. The hospitals have become locked in by development around them. They cannot expand anymore. They are dealing with much larger populations.

If there is no room for expansion, isn't it possible to build annexes in different locations?

We are building new hospitals and expanding satellite hospitals. If you go to our satellite hospitals: Gwarimpa, Kubwa, Nyanya, you will see projects; maternity sections, theatre sections, clinics are being built.

But it is known that some of the new ones being built--Karu, for one--are being handed over to foreigners--you call it private partnership. And the charges are higher. How do you justify it?

Only one hospital has been leased out. It has not even been leased out a hundred percent; half of the hospital is still going to be used as a public hospital. In addition to Karu, there is a hospital in Utako, 250 beds, being built, and another in Zuba. Beyond this, the FCT is building three new cottage hospitals--one in Nyanya, one in Deidei, one in Gwagwalada. The contracts have been awarded, some of them have been mobilised to site. We are not unaware of the explosion of the population in the city. To meet that explosion, the FCT is building new facilities and expanding existing facilities, especially in satellite areas, because the ones in the city, you cannot expand them--there is no space for expansion.

Fees at private facilities are higher. How would the common woman access these services if you are going to be leasing out the hospitals?

This is a policy issue of the government on which I cannot comment. What FCT is doing is to experiment with public-private partnership. Let's see how it works. And you know health is a broad range. We have the very common illnesses that we can manage.

Every day, we have illnesses, and whether you like it or not, people fall sick and they require this service and it is not available in Nigeria. Where do they end up? They go to Egypt, India, Dubai; they go all over the world.

So FCT said, let's have this experiment where we can allow a hospital that is based in India come and provide this service in Nigeria. It is taking care of people who have a requirement for healthcare that our system locally cannot provide. Instead of them travelling abroad, we say, let's try...can we do this internally? This is the experiment.

But it was built by the government. Why would you build a hospital for foreigners to come and run? Why not encourage them to build their own?

This is a public-private partnership arrangement. It's the way it'is done

About the free antenatal care: how is it done?

The free antenatal care is an initiative of the FCT administration which commenced in 2008. The idea of the scheme is to remove finance as a barrier to women accessing antenatal services. In fact, it's not just free antenatal, it's free maternity. This service takes care of the woman from the moment she walks into antenatal clinic through the whole of her pregnancy, through delivery, through six weeks post-delivery. And it is 100% free. What it means is, from your antenatal card, drugs, antenatal investigations--including ultrasound, blood and urine test, everything a pregnant woman needs--through delivery, whether normal delivery, instrumental delivery or by caesarean section, is completely free. FCT established a budget line for it.

How are you coping with population? We visited Kubwa hospital, and it was the same issue--more women sitting down. Many women, few people to take care of them. And also because of space constraint, you have women just putting to bed and another waiting for her to finish up.

If you observed there in Kubwa, there are new buildings being constructed as we speak. But again, when you say something is free, you cannot reject people. Since we started the Free Antenatal Care in 2008 till date, the budget has almost tripled. It has tripled but the government is still paying. Patients come from areas far from the FCT, not even neighbouring states. They arrive in the FCT, stay with a relation, register with the hospital and get free Caesarean Section. There is no way of saying, you are not from FCT. It's not written on anybody's face. Moreover, FCT is every body's state. We have pressure from the neighbouring states for a lot of our services.

When are we going to see the new hospitals in Dei-Dei and Gwagwalada?

The construction commenced this year. The awards were given this year. By mid next year or towards the end of next year, it should be on board.

Considering the rapid rise in demand for your services and the financial implication, do you think you can sustain the free services?

Government envisages what we are seeing and in the process of budgeting it has to make allowance for them. The government is committed. It is not just providing free maternity care, the FCT administration is providing free medical care for under-five children. The free under-five health initiative was launched last year. That is the reason for the numbers you see in the hospitals.

Do you do periodic expansion planning, because in the next 10 years, what you are providing now will be inadequate?

The Federal ministry of health has fashioned what they call the five - year Strategic Health Development Plan for the entire nation. FCT has approved its own Five- Year Strategic Health Development Plan. The plan takes care of what you are talking about now. After another five years there will be another Five-Year strategic Health Plan saying this is where we are now, this is where we expect to be in the next five years. We have to make projections.

You have not said much about staffing. How are you keeping up your services in the area of staff to provide the services?

The FCT has employed over 700 health professionals made up of consultants, medical doctors, pharmacists, nurses, and all the various cadres. Right now they are being deployed to the hospitals and the numbers are going to increase. We hope that service delivery will improve.

FCT is doing major equipment upgrade in our major hospitals. Asokoro hospital is getting a brand new 64 slide CT scanner. It is being installed as we speak.

First time in the entire northern part of this country, we are getting digital mammographic machines in Maitama and Asokoro.

We are building cylinder refill plant in our hospitals so we don't have to go buying oxygen. We produce our oxygen on site in our hospitals.

So much is being done apart from the hospitals that are being built.

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