Enugu State, Nigeria: 2nd Scaling up of MCH Project

On July 6th, 2013, the scaling up of the pilot project "Quality Assurance in Obstetrics in a Comprehensive Approach" – initiated and supported by RFPD – started in Enugu. This is the second scaling up project of the successful pilot project, in which maternal mortality was reduced by 60% and fetal mortality by 15%. This second replication of our model was again co-funded; this time by the Else Kröner-Fresenius-Stiftung, Germany, facilitated by RFPD.

The project has got a total budget of € 369,147 (~ US$ 486,000) - including the outside co-funding - and is based on a Matching Grant with a total amount of US$ 162,750 (~ € 126,000) sponsored by the Rotary Clubs of Schwalmstadt, Baden, Enns, Liezen, Braunau, Gmunden and Freistadt as well as Rotary Districts 1820, 1910, 1920 and the Rotary Foundation. The project is implemented by the Rotary Club Trans Ekulu, Enugu.

RFPD CEO Robert Zinser, RFPD Chair Austria and gynecologist Peter Neuner and filmmaker Mark Zdunnek, Rotary Club Köln-Ambassador, attended the opening ceremony accompanied by traditional rulers, the chairman of the local community Ammuri, doctors, midwives and nurses of participating hospitals, many Rotarians and a crowd of about 800 women, men and children. The delegation from Germany and Austria visited the participating primary and secondary hospitals and had meetings with the Commissioner of Health, the Speaker of the Parliament and also with the Governor of Enugu State. All of them granted their full support to the overall goal of the project, which is that the system of quality assurance will become part of the health system, after the Rotary Project has ended.

We also visited remote areas where very poor people live and saw the huge demand for improvement of the rural primary health centers included in our project. There is lack of water and power in the hospitals and some roads are in such a bad condition that pregnant women cannot be safely transported to emergency hospitals when complications arise. Therefore, we used a chance to approach ministers and high officials in charge for such deficits and encountered understanding for our request to improve the infrastructure, which we will follow up.

During this visit to Nigeria we also monitored the first scaling up project in FCT Abuja and Ondo State. Robert Zinser and the local chair of this project, PDG Kola Owoka, RFPD Chair of Nigeria, had a meeting with the Commissioner of Health in Ondo State, in which we also draw attention to the above mentioned overall goal of the scaling up project. The State Governor and the Commissioner of Health of Ondo State - both medical doctors - started a new program some time ago to reduce the first delay (delay in deciding to seek care) and the second delay (delay in reaching appropriate care); in order to overcome the third delay (delay in receiving adequate care at health facilities) a special hospital was built and the infrastructure of some hospitals was improved. The Commissioner welcomed quality assurance as a great contribution and indicated that Ondo State will add this to their program. Similar discussions were held with government officials in FCT Abuja.

In our meeting with the Director of family health services of the Ministry of Health of the Federal Capital Territory (FCT) Abuja, we received full support for our project. The ministry asked Rotary to replicate the project also in the south-west of Nigeria, so that the system of quality assurance is introduced in all major districts of Nigeria which will facilitate the integration of the system into the health system.