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Nigeria: dispatches from the field 13th to 22nd November 2019

22nd November 2019

I am here in Nigeria, where PSA has been working since 2016 to support Kaduna and Niger States with funding from the Bill and Melinda Gates Foundation to transform their public health supply chains. I’m excited to share that these two states show that, despite its complexity, true Transformation (with a capital ‘T’) is possible! There has been great progress all round in warehousing, inventory and order management, distribution using outsourced models, data visibility, workforce capacity and capability, and procurement, all of which will lead to improved access to quality-assured medicines at the health facility level. All this would not have been possible without state-level ownership and stewardship from the most senior state leaders.

Pharm Ramatu showing the new pharma-grade warehouse funded by the Kaduna State government (13th November 2019)

In Kaduna, His Excellency the Governor, Mallam Nasir Ahmad El-Rufa’I, has been a champion of supply chain transformation from day one and continues to fulfill his campaign promises to the people. In Niger State, Governor Alhaji Abubakar Sani Bello and his wife, First Lady Dr Amina Abubakar Bello, have also been true champions of supply chain transformation.

In lending their support, these leaders have been equally matched in enthusiasm by their appointees, who have worked tirelessly to drive the changes as leaders of the supply chain in their states: in Kaduna, the former Honorable Commissioner for Health, Dr Paul Dogo, and Pharm. Ramatu Abdulkadir, the Executive Secretary for the Kaduna State Health Supplies Management Agency; and in Niger, the former Honourable Commissioner for Health Dr Mustapha Jibril, the current Honorable Commissioner for Health Dr M.M. Makusidi, and Pharm Dr Mohammed Audi, Executive Director, Niger State Drugs and Hospital Consumables Management Agency. These individuals have continued to work at transforming their supply chains into high-performing ones.

In Kaduna, I met with the Executive Secretary for the Kaduna Drug Supplies Management Agency, Pharm Ramatu, along with other key stakeholders from various agencies that affect and are affected by supply chain operations.

I then traveled to Minna, Niger, where my first visit was to the Niger Central Medical Store to see the progress of the transformation there. I met with the First Lady, who was also visiting to see the progress, as she has been the leading champion for this initiative.

Pamela Steele, CEO, PSA with the First Lady of Niger State, Dr Amina Bello, at the Central Medical Store, Niger

Her Excellency the wife of the State Governor, Dr Amina Bello, and the Central Medical Store Team.

During this week, PSA and the Niger Drug Management Agency also held a workshop involving health facilities in the transformation pilot and as key stakeholders to get their feedback on the improvement looking at the transformation from their angle on what has improved compared to before the transformation. The event was officiated by Honourable Commissioner for Health Dr Makusidi, who expressed his office’s continued support for the transformation.

DMA Director of Procurement facilitating the workshop in Minna (19th November 2019)

Health facilities and Ministry of Health staff at the feedback workshop in Minna (19th November 2019)

While in Niger, I trained the Niger State Change Management Team of the Niger Supply Chain Transformation to develop a strategy and business model using the business model canvas tool to map future supply chain directions and goals.

The Transformation Team with the First Lady at her house (20 November 2019)

My trip was crowned by dinner at the governor’s house, hosted by the First Lady. During the dinner, there was further discussion on the Drug Management Agency’s readiness to meet the demands of the newly launched Health Insurance Scheme.

The trip ended with a visit to the Senator Dr Idris Ibrahim Kuta Memorial Primary Health Care Centre, Chanchaga Local Government, Minna. I saw their small pharmacy and store and met some hard-working health workers.

Pam chatting with health centre workers (21 November 2019)

Health facility medicine store serving over 200 patients per day (21 November 2019)

I also saw a baby that had been born just an hour into my visit. (I was glad to see baby and mother looking well.)

New-born baby at the facility, not yet named but looking well 21 November 2019

If someone had told me three years ago that the transformation we are now witnessing would be realised, I would have struggled to believe it. But I am always reminded of the late President Mandela’s words: ‘It always seems impossible until it is done.’  Today we see that, where there is leadership with a vision and commitment for transformation and the right leaders hungry for change that would improve health outcomes, anything is possible.

Niger Drug Management Agency presenting at the strategy training in Minna (20th November 2019)

In both Kaduna and Niger States, the governance of supply chain systems are being strengthened. Adequate funding for health commodities and public health supply chains is a key priority of the government. The leadership is being very deliberate about addressing deficiencies in human resources, capacity, and capability, and information systems are putting out the data needed to make strategic evidence-based decisions. During my journey, I congratulated Pharm Ramatu in Kaduna and Pharm Dr Audi in Niger and encouraged them to keep their eyes focused on the goal: to steer the transformation to its end to achieve its full aims.

PSA Nigeria Team, Minna, 19 November 2019

PSA will continue to support your efforts! Thanks to the PSA team above who have been working hard to support the States on their transformation journey. I’ll be back soon!

by Pamela Steele