Infographics: Eighty Percent of PHCs in 15 States Do Not Meet NPHCDA Standard, Unfit for COVID19 Vaccination — CODE
As Nigeria continues to battle COVID-19 pandemic, with more than 166,730 cases and 2,117 deaths already recorded, only 20 percent of the Primary Health Care Centres in fifteen states are functional, research investigations and tracking conducted by leading Civil Society Organisation, CODE has revealed.
Nigeria’s health sector has struggled to meet up with modern standards in terms of quality, efficiency, and accessibility to its vast population. With the outbreak of the coronavirus pandemic, the wide devastating gaps in the health system became more pronounced, as citizens at rural and semi-urban communities particularly grappled with poor healthcare amidst a pandemic.
In March 2021, Nigeria received 3.92 million doses of AstraZeneca COVID-19 vaccines, the first trench of the expected 16 million doses, according to an announcement made by the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Faisal Shuaib.
Concerned by the condition of the Primary Healthcare Centres (PHCs) where average citizens receive treatment, and where COVID vaccines would be stored and administered, CODE through its social accountability initiative, Follow The Money, commenced tracking the distribution of these vaccines and assessed the preparedness as well as the quality of Primary Healthcare Centres across the country to receive and administer the vaccines at the community level.
This research was birthed as part of the objectives of the COVID-19 Transparency and Accountability project supported by Conrad Hilton Foundation and Skoll Foundation, currently being implemented by Follow The Money, BudgIT Foundation and Global Integrity across 7 African countries to assess government’s transparency & accountability in the management of COVID intervention funds and support to citizens.
Follow The Money champions in 15 states – Cross River, Yobe, Bauchi, Gombe, Taraba, Abia, Anambra, Imo, Ebonyi, Benue, Kogi, Nasarawa, Plateau, Kebbi, Osun – across the 6 geopolitical zones of Nigeria, assessed the readiness of 90 PHCs to receive, store and effectively administer vaccines with the purpose to equally drive quality standardisation of PHCs in Nigeria.
CODE and OXFAM are implementing a project on the Power of Voices Partnership (PVP) fair for All project within 6 extractive states- Delta, Imo, Akwa Ibom, Cross River, Rivers and FCT. The project seeks to build capacity and raise awareness on the socio-economic costs associated with the Nigerian extractives sector.
PVP will focused on advocating for improved governance in the sector to ensure that corporations operate in human rights and conflict-sensitive demeanour. This project seeks to address by building new structures and strengthening existing ones to achieve sustained efforts and interventions across communities, the private sector and the government. Influence policy debates and other initiatives to ensure sustained and judicious management of tax revenue, other revenues within the extractive sector while promoting accountability.
The Power of Voices Partnership (PVP)- Fair for All (F4A) program, therefore, shall be used to amplify civic education and advocacies to promote:
Prudent management of natural resources (oil and gas)
Fair natural resources governance
Fair taxation that energizes voice(s) of socially oppressed and marginalized segments of society, particularly, women, through:
Other programmatic propositions are;
Fiscal inclusion through participatory needs assessment (community and shadow budgeting),
Tracking of expenditures (public procurement) mobilizing for fair taxation and participatory democratic rights and empowerment through (collective) voices.
Through PVP, CODE will strengthen community voices and increase awareness on the socio-economic costs of challenges within the Nigerian extractives sector pertaining to the marginalisation of host communities. It will also advocate improved corporate governance in operations and the management of human rights in these communities.
One of the objectives of the project is to promote transparency and efficient management of State budgets for the extractive sector.
To achieve the project objectives our team will strengthen the capacity of local organizations and citizens to increase the level of accountability of public actors within the extractive sectors. The project also seeks to raise awareness within the civic space, schools and the public through outreaches and followthemoney radio.
There are several benefits to be derived by the time President Muhammadu Buhari finally appends his signature to the Federal Audit Bill, passed by the National Assembly (NASS).
The Eight (8th) Senate, had in May 2018, passed a Bill for the establishment of the Federal Audit Service Commission, in line with Mr. President’s government’s anti-corruption fight.
The Bill was read the third time and passed at a plenary session presided over by then President of the Senate, Bukola Saraki. The Senate mandated its leadership to engage the executive with a view to getting Buhari to sign the bill before the end of the 8th NASS.
Chairman of the Senate Committee on Public Accounts (then), Matthew Urhoghide, while presenting his report, said: “This Bill is very important to the nation as passing it into law will form the bedrock for fighting corruption, which is one of the cardinal objectives of the President’s administration.
“It will empower the Office of the Auditor-General of the Federation, who has the constitutional mandate of auditing all accounts of the federation to nip corruption in the bud, ensure transparency in government transactions.”
Urhoghide added: “The Bill will address acute manpower shortage, existing in the Office of the Auditor-General of the Federation and bring it in tandem with supreme audit institutions and international best practices, as obtained in other climes such as South Africa, Ghana, and the United Kingdom.”
The Audit Bill, for the records, was not new to the 8th Senate. It was first passed by the House of Representatives in April 2016 and transmitted to the Senate for concurrence. The Senate passed the Bill on Thursday, March 1, 2018. But due to disparities in the version passed by the two chambers, a conference committee was set up to reconcile areas of differences. The Bill was eventually harmonized and passed by both chambers. The harmonized copy was forwarded to Mr. President for assent on January 8, 2019.
Sadly, the Audit Bill has since become orphaned, two years after its passage by NASS. The Bill was prematurely ‘murdered’ by the refusal of Mr. President to give it his assent. The Bill, among other things, will greatly assist in blocking revenue leakages and curtail corruption, when it finally becomes a law. Civil Society Organisations (CSOs) such as Connected Development (CODE), has always been in the vanguard of anti-corruption.
Specifically, CODE, in collaboration with OXFAM Novib, is galvanizing Nigerians against corruption, through its various advocacy programs, one of which is massively mobilizing citizens to support the entrenchment of an audit law. It has since kick-started an online campaign, soliciting Nigerians to sign a petition, with a view to pressuring the government into assenting to the Audit Bill.
CODE noted that the Office of the Auditor-General for the Federation plays a vital role in public financial management and anti-corruption measures, especially by ensuring compliance with financial rules and regulations and due process in public expenditure.
It, however, said that, currently, political interference and Constitutional constraints have limited the independence and functioning of the AGF. “The AGF currently lacks the oversight powers to enforce its mandate and there are no sanction measures against defaulting bodies and persons in place. This results in gross financial recklessness and public fund embezzlement that deprive the Nigerian government and people of money needed for development, in sectors such as health and education,” it added.
According to CODE, “the Office of the Attorney General of the Federation (OAGF) reported that 65 MDAs had never submitted their financial statements for audit since January 12, 2017, when he assumed office. “Furthermore, the 2017 Audit Report published by the Office of Auditor General for the Federation had defaulting MDAs rising to 265, up from the 160 defiant ones in 2016.
“The AGF report noted that as of April 2018, 109 agencies had not submitted their financial statements beyond 2013, while 76 agencies last submitted for the 2010 financial year.”
While calling on President Buhari to assent to the Audit Bill, the civil society body, said the passage of the Bill will be a major feat in the fight against corruption and would ensure that MDAs submit their yearly audited financial accounts to the Auditor General for the Federation. Hence, preventing corruption, illicit financial flows, bribery, abuse of public office/trust, money laundering and mismanagement of public funds as reported in the Malabu/Dan Etete Case.
Similarly, both the Senate and House of Representatives Public Account Committees, have insisted that the Audit Bill that was passed in the 8th Assembly, which the President did not assent, remains very sacrosanct and would be resuscitated by the 9th Assembly.
The Chairman, Public Account Committee of the Senate, Sen. Urhoghide, and his House of Representatives counterpart, Hon. Busayo Oluwole-Oke, who co-chaired a session of stakeholders on the Audit Bill, said the 9th NASS will breathe a new life into the Bill and ensure its passage again.
Both Sen. Urhoghide and Hon. Oluwole-Oke lamented that the nation’s current audit practice does not meet the global best practices and that necessary reforms that would empower and enable the office of the Auditor General of the Federation to function optimally and efficiently are imperative.
They spoke at a 3-day Stakeholders Consultative/Technical Session on the Audit Bill organized for members and staff of the Senate, House of Representatives Public Account Committees, and the Office of the Auditor-General of the Federation (OAuGF) in Abuja, last October.
Head, Technical Support, Partnership to Engage, Reform, and Learn (PERL) Engaged Citizens (EC), Mr. John Mutu, who facilitated the session explained that it was aimed at finding a common solution to ensure that the Audit Bill succeeds in becoming a law.
Mutu explained that the main objective of the session is to provide a platform for the National Assembly’s Public Account Committees (NASS PACs), the Office of the Auditor-General of the Federation (OAuGF) and the Presidency to reflect and review the Audit Bill, so as to identify areas of concerns that prevented the President from giving his assent to the Bill.
At the session, Urhoghide, noted: “We have to ensure proper auditing of the spending of public money. If we strengthen the office of the Auditor-General, it will block leakages and we will save a lot of money and this will also check corruption drastically”.
On his part, Oluwole-Oke said if the Bill becomes law, it would enable the Auditor General to carry out his duties very efficiently and effectively. “Unfortunately, the President withheld his assent even without giving reasons. Now the Bill is dead constitutionally. But we shall resuscitate it since our House rules give us the provision to start from where we stopped in the 8th Assembly,” he pointed out.
National Team Leader, Engaged Citizens Pillar (ECP) of DFID’s Partnership to Engage Reform and Learn (PERL), Dr. Adiya Ode, during the auspicious session, noted that having the audit law in place would strengthen the Auditor General to perform his functions well, and also send a signal to corrupt people that they would be exposed and prosecuted.
Experts and scholars in their various presentations during the technical session, equally maintained that without the audit law in place, it might be very difficult to achieve thorough auditing and that the nation’s revenue would continue to leak, particularly in the government agencies that generate revenue for the nation.
It is incontrovertible that the absence of an audit law has given rise to impunity in the use of public resources in several MDAs. This is evidenced in the limitless numbers of probes conducted on key agencies of government, which completely indicted them of malpractices of different sorts.
The absence of proper auditing in the MDAs is also responsible for the fusion of unwarranted projects in the budget of most MDAs. Projects are not subjected to either procurement, financial, or performance audits.
It is therefore incumbent on the President Buhari-led government, to activate every necessary mechanism that will bolster its anti-graft fight.
The country direly needs a robust, and well-articulated audit law that will not only guide accounting officers and other responsible parties involved in the MDAs on the standard procedures in the application of public funds but will also encourage performance in programs and budgeting in the MDAs.
That is why Mr. President must once again, diligently re-scan the Audit Bill, carefully identify grey areas in the current Bill, and then facilitate the process for quick harmonization of the perceived grey areas with NASS, before proceeding to sign the bill into law.
Having a ‘progressive-defined’ audit law in place will indeed serve as an elixir for his government’s war against corruption.
The North Eastern, Niger Delta and Middle Belt regions of Nigeria have been witnessing several conflicts and fatalities in recent times. These include terrorism, militancy and the crisis between herdsmen & their host, respectively. In the light of this, on Monday, 28 November, CODE participated in the Peace and Security Working Group (PSWG) Meeting hosted by the Nigeria Stability and Reconciliation Programme (NSRP). The PSWG is a platform for peace and security analysis, advocacy, coordination and capacity building. The platform is made up of several Civil Society Actors, international donors/agencies, and foreign embassies.
During the meeting, organizations such as Centre for Democracy & Development, NSRP, Foundation for Partnership Initiatives in the Niger Delta etc. gave updates on their current activities in ensuring peace and security in the country. CODE on its part intimated the participants of its peace and security works in two areas: 1). Comparative electoral processes research and activities, so as to promote the use of information technology in electioneering in order to reduce violence during elections. CODE observed the United States Presidential Election and was able to draw lessons from the exercise which could be employed in Nigeria to ensure improved electoral processes and violence reduction. CODE was also asked to make a presentation in the next PSWG meeting in January, 2017 on the observation and experiences regarding this. 2). CODE has a campaign on ensuring transparency and accountability in the implementation of humanitarian funds in the North Eastern (NE) part of the country. In this light, CODE is tracking the governmental implementation of N53 billion provided by international donors for the rehabilitation of the NE zone.
During the meeting, a new name, Peace and Security Network (PSN) was also recommended for PSWG. This is for perfect representation of the mandate of the coordination group. PSN is indeed an important platform for stakeholderial coordination on peace and security activities and strategies to prevent & manage conflicts around the country. Its’ our hope that the platform implements its strategies to ensure political stability in the country so as for a favorable environment for economic activities and Foreign Direct Investment attraction.
A leading NGO Connected development [CODE] has called on government at all level to take up one of its responsibilities by ensuring proper facilities are put in place in various primary health care centers in Nigeria.
Following the release of $1.5million dollars from World Bank to the 36 states respectively including the Federal Capital Territory as part of the World Bank supported “Save One million Lives” the Follow the Money team of CODE visited 6 states respectively to assess the state of the PHCs to track the implementation of these funds. These states are Akwa Ibom, Enugu, Kano, Kogi, Osun and Yobe.
Findings from the field visit to each of the states are appalling as most of the Primary Health Centres are facing several reprehensible and elementary challenges. Generically, most of them have no improved water supply, electricity, security, quarters for hospital staffers; there is no stationed doctor, and the toilet facilities are in a mess. Furthermore, because of these challenges, the PHCs do not operate 24/7, cannot admit or treat sick people and lack sufficient tables & chairs.
Some key Findings:
Follow The money team visited Kantudu in Makoda LGA of Kano State. They found out that the PHC serves 2,500 people, all coming from 13 surrounding villages. The PHC was built 5-6 years ago as a senatorial project in Makoda LGA. The PHC has one male and female ward, which are not presently functioning. There are only three staffers with one community health worker who are not certified health professionals.
During the interactive section with the head of community Alhaji Muhammad Musa, and the community association said that they have reached out to the government of Kano twice on the state of the health centre in Kantudu, but there was no response. “We hope this campaign with ONE and CODE will make the government of Kano look at the plight of our health center so that our people can start using it” says Malam Ali, the medical head at the PHC.
In Yobe State
We were in Lantenwa, Yobe where a Primary Health Care is in a messy situation. The PHC in Lantenwa is in Lantewa village, Lantewa ward, Tarmuwa LGA. It serves a population of 13,400 under 5 yrs; 10-15 patients daily, 70-105 weekly. Speaking to the head community ,AuduLantewa, mentioned that the dispensary has been dilapidated for more than 7 years, he added that dispensary situation is critical and he personally reported the issue to local authorities several times. He further lamented that “Lantewa is the gathering centre of four neighbouring with approximately 7,000 registered voters, as such, we should get better things from the government” he said
In Kogi State
We went to the PHC to find out if the implementation of the fund is ongoing as well as to track the implementation of the N10.5 million earmarked by the National Primary Health care Development Agency for the rehabilitation of the PHC. On reaching there, there was no such intervention taking place. The Officer in Charge (OIC) said it was the first time she was hearing of such. The village head whom we paid a courtesy visit to also said he has never heard of such. We then went to the Operational Base of the NsitIbom LGA’s Health Centres and the Director of the base told us that she has never heard of such fund for the PHC’s rehabilitation
In Osun State
Our team went on ground to track the $1.5m earmarked by the World Bank and the Federal Government of Nigeria for the Saving One Million Lives Initiative and all we could see while on the field is nothing to write home about. From our findings, the facility is meant to serve 11 villages which are: Gboore, Alajue-Logun, Asunmo, Ayegbami, Agbopa, Jagun-Odomu, Olodan, Aladie, Amosun, Seesa, Akiribiti amongst others. In total, the target population which the facility is meant to serve is 12,498. 498 of the population are children less than one year, the Primary Health Care Centre has a monthly target of 42 patients, but it ends up serving more than 400 on an average.
Consequently, a Freedom of Information letters was sent to the concerned government institutions and offices for a breakdown of the funds usage, implementation window and respective contractors, especially the governmental institutions concerned, to instantaneously start the implementation of these funds, ensure transparency & accountability in the funds’ implementation, and make government data open in line with the Open Government Partnership.
Follow The Money is a growing movement currently in 32 states of the country, held community outreaches to 10 primary health facilities in Kano, Yobe, Osun, and found out that all were in a state of dysfunction, even with the funds that have been released to the states to upgrade the primary health care “Most of the Clinic at the PHC in the 5 states that our community reporters visited were in an abandoned state, lacks basic healthcare amenities and needs urgent attention to serve people at local communities.” affirmed Hamzat Lawal, CODE’s Chief Executive & Co-Founder, Follow The Money.
He stressed that annually, over 70,000 children below age 5 in Nigeria die due to poor access to healthcare and sanitation-related illnesses (UNICEF). Lawal urged government actions to serve the people by improving better service delivery while ensuring transparency and accountability.
A non-governmental organisation Follow The Money, an initiative of Connected Development (CODE)Connected Development (CODE) is set to launch “Virtual Newsroom.
The products from the Virtual Newsroom is set to further engage and empower more marginalized people in rural communities to enhance their livelihoods.
Speaking at an In-house training organised by CODE, the monitoring and Evaluation Officer, Oludotun Babayemi said Follow The Money is planning a virtual newsroom that will run 24 hours – several times in a month with the objective of strengthening the voice of 95 million Nigerians leaving in rural communities in Nigeria, while increasing their participation in governance.
He said it’s important to have a participatory kind of discussion on how the newsroom is meant to look like, who’s doing what and create a larger workflow other than the one we have been using.
“We are talking about a newsroom that has over 60 reporters reporting into it from remote places. This means we need a robust, scalable and efficient framework other than the one we were using before. We thought it will be good to have a meeting to deliberate, discuss, make comments and suggestions about how the newsroom is meant to look like and also decide on the future of Follow The money,”he said.
The Monitoring and Evaluation officer, said Follow the Money is always motivated by stories from rural communities, which never gets into the mainstream media, adding that every time there is a visit , they hear about new stories, not just for the success alone but of failures of communities that are still ailing other than the ones that are focused on.
He added that it is always motivating that the group can do more and can have more people to do more.
“We are looking at the massive strength in the young people that we have, we can engage more of them and we can also have more communities that will be proactively vigilant in ensuring transparency and accountability of funds meant for their communities as well. These are the motivation for Follow The Money,” he said.
Speaking on the challenges, Babayemi said the challenges the movement might face is keeping that of retaining human resources and availability of financial resources
“Some people might leave at some point because we can’t bring in 60-75 people and expect them to only be focused on our mission and goal. Some people would think of something else such as thinking of another movement from there. Both are the critical challenges we are looking forward to as we move on.,”he said
He further called on the general public to be on the lookout for new radio programs that will come up especially Follow the Money radio, adding that radio is what people in the rural communities rely on to get information.
Mr. Babayemi explained that Follow the Money radio will be used in increasing rural community participation on governance as it concerns implementation of funds meant for capital projects in their communities l.
“ They should look out for some of our bulletins and prints that we would want to share with them on the money we are following and money for the community and also on what the government is saying about such money should be something interesting the communities should be looking forward to,”he said.
Well in the next 15 years, the vision will be to see the present 95 million Nigerians living in rural communities listening and engaging their leaders through the Follow the Money Radio, likewise, seeing 50% of that population sending in feedback to Follow the Money via SMS and our various online portal. Mr Babayemi noted
He said these target audience could also be able to read about Follow the Money In online and offline bulletins or magazines.
“In essence, seeing Follow the Money as a community mechanism where they can also read about their own community, and get their voices amplified is the future we see through Follow the Money and I hope that we will be able to achieve that,” he said.
Minister of Environment, Amina Mohammed, who has been one of the major influencers of Sustainable Development Goals (SDGs) launched late last year in New Yok has reiterated her stance on SDGs once again at the inaugural town hall meeting tagged ‘Buharimeter’in Abuja yesterday.
Amina posited that the role environment plays in actualising each of these Global Goals (SDGs) cannot be overemphasised hence it’s important that all Nigerian citizens get involved in its implementations so as to accelerate and maximise its impacts on our nation’s overall economic growth. ‘We cannot leave everything for the government to do, Yes, Ministers are public servants and it is a privileged to be one, but things would only work perfectly if we can earn your cooperation and work together in achieving all these goals. She stated that this administration would ensure that its delivers on all its promises at addressing security issues, ensuring steady infrastructural development and revamping the economy.
The Minister, who had earlier visited the lead poisoning affected communities in Niger State like Shikira, mentioned that the emergency response to remediation of these communities would commence as soon as the fund for the remediation is approved by the Federal Government. “In collaboration with Ministry of Solid Minerals, we will commence the remediation of these affected communities in Niger State’ she alluded.
The Buharimeter Townhall Meeting was organised by Centre For Democracy and Development (CDD) aimed at assessing the one year in office of President Muhammadu Buhari and his All Progressives Congress (APC) government. The event had five federal Ministers in attendance namely: Lai Mohammed (Information and Culture), Babatunde Fashola (Power, Works, and Housing), Audu Ogbeh (Agriculture and Rural Development), Amina Mohammed (Environment), and Udo Udoma (Budget and National Planning).