AKINOLA OLUWOLE
Research officer for COUNTDOWN NTD project in Nigeria. Interested in spatial disease mapping, monitoring and evaluation of intervention & control programs, implementation research & Health System
Location Nigeria
Activity
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AKINOLA OLUWOLE made a comment
I am glad I am able to complete this course, it has really wet my appetite to look into research on health system strengthening
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@MaryAtienoOjoo you are very correct, everyone is trying to protect their territory, a good example is the need for integration of health programme which has not work because some people are afraid that they will loose the power and control they currently have
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I think the role of the leadership in terms of the political will and the readiness to achieve the universal health coverage are part factors that may influence the question we ask.
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AKINOLA OLUWOLE made a comment
The role/performance of public sector in health system in Nigeria is compromised, some relied on user fees, like in most primary health care, they have to pay for some services
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AKINOLA OLUWOLE made a comment
This is an interesting scenarios and if care is not taken, the government own facilities will be redundant and no one will patronize it again. My option will be to Heavily regulate the private sector and focus on partnerships, incentives, contracting arrangements and other approaches that will improve quality and coverage of private sector services, to plug...
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Yes, there a lot of privately funded public service provision e.g the german leprosy mission is funding provision of services for people that TB disease where the health workers are employed by the government
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What will drive providers to be more focused on the areas of responsiveness and gaining/maintaining consumer trust is the need to increase patronage because there is more options and choice of health care services to be made
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AKINOLA OLUWOLE made a comment
service delivery and leadership
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AKINOLA OLUWOLE made a comment
Looking forward to the course
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Yes training health workers is often the first (and maybe ONLY) quality improvement strategy which shows poor understanding of health system strengthening
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AKINOLA OLUWOLE made a comment
There are partially in place in my settings
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AKINOLA OLUWOLE made a comment
for recommendation one, A department of data and hospital records will be set up. There is need to employ an M and E officer
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Reduce the number of birthing centres, but have teams of skilled birth attendants in each centre to support each other. The drugs and supply chain will be simplified, as there are fewer hubs of greater expertise, and referral pathways to the hospital will be simpler to arrange. The challenge of this is that accessibility to some community may be a challenge as...
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I agree with you on this
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One would have missed the issue of privacy and pain relief mentioned by the women
One would have missed the issue the issue of the link between health workers and communities raised by the health planners
The issue of support from managers raised by the health workers -
AKINOLA OLUWOLE made a comment
It is interesting to see the different frameworks for quality of care, if I were to be asked this question before undergoing this course, I would have readily be biased to prefer the perspective framework but having gone through this course, I think the health system frame work will be the best approach to understand the quality of care
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AKINOLA OLUWOLE made a comment
I am not sure if there is plan to do so in my context from the health system perspective, however there is an agencies i.e National Emergency Management Agency who are responsible for managing emergency life threatening situations by coordinating resources towards efficient and effective disaster prevention, preparedness, mitigation and response but I dont...
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My response we be that we will continue with our current approach (i.e having our own supply chain management) so that we can meet the demand of our donors but then call for a stakeholder meeting with the government to discuss how to strenghten the SCM system so that there will be timely delivery of the ART medicines. We will identify the bottle next set up...
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@GeertHAGHEBAERT I also agree with this
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In my country both approach is used depending on the health programme The advantages is that in the push system ensures that health products are always available, at the health facilities while in a pull system, the needed supply are provided in adequate quantity. tThe disadvantage is that here is usually the challenge of mismatch of sully and product...
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For me some first step is to create an institution where people can be trained on supply chain or introduce it as a curriculum and a compulsory course at higher institution for pharmacist
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In my country, the following three are the top challenges
1. Fragmentation of the supply chain system with different donors and poor coordination between them;
2. Under resource staff capacity
3. weak data management -
AKINOLA OLUWOLE made a comment
I look forward to learn
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@AyubaJalvaBathnna I agree with this
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We need population data by district, the expected number of health professionals that will be produced by year and an analysis of how the people are using the various services available
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@EricSatdakGukas I also agreed with you on this matter
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@EricSatdakGukas I also agree with this, respecting the diversity of the health workforce will bring about expected health outcomes and equity
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AKINOLA OLUWOLE made a comment
In my own opinion, the health work diversity is a good one as helps in division of labour and designation of roles and responsibilities
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I total agree with you submissions, the theory of plurality of the medical profession is a hard nut to crack particular because the people at the helm of affairs and policy making are the doctors
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AKINOLA OLUWOLE made a comment
The strategy to retain health workers in the underserved population is a compulsory posting policy and rotation of health workers posting. This is effective where there is enforcement of the policies by the head of health services at the local government
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factors the influence the carde mix of health professionals may be 1.The kind of formal training that exist in such country e.g availability of institution for training such carde of health system, secondly the demand for such carde of persons by the populations. If most people in the country will prefer to see a doctor than seeing a nurse, then the hospital...
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AKINOLA OLUWOLE made a comment
I sounds interesting, looking forward to learn
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@ObafemiBabalola NHA 2006 to 2009 also reveal that Household out of Pocket continues to be a major contributor of Total Health Expenditure in Nigeria
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you could check this https://www.checod.org/national-health-account-2010-and-2016-checod-fmoh-and-nbs/# for 2010to 2016
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AKINOLA OLUWOLE replied to AbdulMumin Ahmed
@ChukwudiUchennaOnwudiwe I agree corruption is a major hindrance to increase in fiscal space for health care in Nigeria
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AKINOLA OLUWOLE made a comment
The policy is that the role of government in health care is a public good
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AKINOLA OLUWOLE made a comment
Raising revenues from indirect taxes for health care is equitable if it is charge on luxury goods and sin taxes like tobacco and not on common foods
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AKINOLA OLUWOLE made a comment
The most important impact as far as I am concern is Impoverishment (due to high medical fees)
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AKINOLA OLUWOLE made a comment
Looking forward to learn
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AKINOLA OLUWOLE made a comment
It is an interesting module
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I agree with this and in addition there is the need to involve all stakeholders in the implementation of strategies that you are planning to use
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Integration of CHW into the formal health system will help increase community access to health services particularly the major health needs of the community. However, the challenge is that they may be overburden with responsibility or often given roles that they have not really developed skill for. The community may also begin to see them as skilled health...
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In Ethiopia, the challenge of weak infrastructure, insufficient health resourcing and minimal community participation was tackled by establishing the Health Extension Worker program to improve rural primary health services through a community-based approach
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AKINOLA OLUWOLE made a comment
Appropriate selection of CHW, quality training provided to them, quality supervision, good incentive package and good integration into formal health system and local communities
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Paying or not paying community health worker is a contextual and need to be critically considered. The major challenge is the variation in the amount received by CHW from different health programme implemented in the same community. This usually poses a challenge when a particular programme pays its CHW more than what another programme does. A good example...
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AKINOLA OLUWOLE made a comment
Decentralization is a good practice but it the district or local government level is not given some level of autonomy it can lead to more inequality in the allocation of rseources
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AKINOLA OLUWOLE made a comment
Across the functions Elbonia district has moderate decision space because they have some level of control and decision on what happens at their district but are guided by a policy provided by MoH but In Ruritania, the district health has narrow decision space because most of all they do is to implement the policies development by the MoH without any input
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AKINOLA OLUWOLE made a comment
In my country, Nigeria, I can say there is a wide decision space in terms of management of human resources, the State and local government has autonomy to manage their staff but in terms of adding or removing specific health programme and using finances, the state has a wide decision space but the Local government has narrow decision space
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I also agree with this
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AKINOLA OLUWOLE made a comment
The international donors are the main drivers of national health policies in Nigeria. There is less funding by the government, hence they have less control on the policies
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In my own area, one of the weakness is inclusiveness, when the beneficiaries of the planned health programme are not carried along with the planning, such programme may fail even if there is funds to execute it. Inclusion of performance monitoring and feedback process to allow for learning, continuous improvement, and timely corrective measures is a good...
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One of the major barrier to intervention in my country, Nigeria is lack of interest of political leaders at the sub-national and district level in financing health care services simply because it does not generate immediate income, hence no funds is release for budget from the ministry of health. This is why most health intervention programme depend solely on...
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AKINOLA OLUWOLE made a comment
It was an eye opener session for me and has increase my interest in the subject of strengthening health system to reduce inequalities in my society
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AKINOLA OLUWOLE made a comment
In my opinion, the thai model is the best and most sustainable approach if we want to meet the SDG goal 3 and ensure no one is left behind it terms of access to health care services
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In both countries, increase in government budget for health care services is one of the major reasons for the success achieved. In addition, the involvement of communities in health care planning in Rwanda and Promoting primary care centres in Thailand contributed to the success achieved
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AKINOLA OLUWOLE made a comment
other financial barriers that were not address is informal payments by midwifery and lack of care for older children. The distance of the health facility to disadvantage group is one of the non financial barrier that is there. We need to assess if the Cambodian health system target the socially excluded group like the migrant and the disable
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AKINOLA OLUWOLE made a comment
It was an eye openner for me, I am getting passionate about health system strengthening
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The impact of these changes is that the interest of the group of people where most of the funding for health comes will determine the aspect of the health system that will be developed e.g for example if most of the spending is out of pocket spending then we will expect an inversion of the pyramid of health system where those who have the money go to the...
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AKINOLA OLUWOLE made a comment
The federal/National are the over resourced and over utilized while the primary health care are the under resourced and under utilized, the main drivers is lack of quality service delivery and inadequate staffing of the primary health care resulting from poor investment in primary health care services
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AKINOLA OLUWOLE replied to Cheryl Chia
@MatthewReeve I known of one of the state in Nigeria, where the sitting governor invest in the primary health care by equipping it with medical facilities and staffs making people to patronize the primary health care service but this investment has not been sustained by the new administration hence changing the narrative
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AKINOLA OLUWOLE replied to Cheryl Chia
There will be need for a lot of sensitization as many people has lost confidence in the close to community care/primary health care
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AKINOLA OLUWOLE made a comment
wow this is interesting, I see the negative feedback loop play out in my own environment, especially with the introduction of NHIS policy which helps to reduce the cost of health care services. The population of people at the NHIS session is high with limited number of health care staff, hence people will prefer to do self medication if they experience a...
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AKINOLA OLUWOLE made a comment
To make it easier for anyone to understand
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@MatthewReeve I completely agree with you, for us to meet the UCH all the three dimension must be critically considered
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AKINOLA OLUWOLE made a comment
I believe non of these is out of health system strengthen. I think corruption is one of the main challenge of health system strengthen in developing countries
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I totally agree with you
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AKINOLA OLUWOLE made a comment
Hello, I am Dr Akinola Oluwole, I work with Sightsavers, Nigeria Country Office on the COUNTDOWN research programme which aimed at addressing implementation challenges and bottle necks to successful implementation on NTD programme. One of the focus of COUNTDOWN project is how to strengthen the health system to be able to deliver effectively on NTD...
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AKINOLA OLUWOLE made a comment
Hello everyone, I am pleased to join the course among my expectation is to learn how the health system can be strengthen to take charge of disease control programme instead of it being run as a parallel programme
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AKINOLA OLUWOLE made a comment
It has been an interesting course, I can confidently say i know wha trachoma is and all the process involved in planning and establishing a trachoma elimination programme in an endemic area
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it has been a wonderful experience for me in the past five weeks
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AKINOLA OLUWOLE made a comment
The level of rigor is required so as to ensure the elimination of trachoma as a public health problem is sustainable after post validation
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Kudos to the good leadership role played by the Minitry of Health of Morocco Kingdom
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I think the success made in Morocco can be hinged on the action of the ministry of health which was adopting a policy of decentralisation and devolution thereby enabling the health service to maximise available resources for trachoma prevention in endemic regions. which resulted into development of a localised approach. This policy can be copied by the...
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The issue of quality data can not be overemphasized, as it is germane for trachoma elimination programme so also other intervention programmes. My experience as an independent monitor for MDA programmes during the APOC lifetime, one of the challenges at the Local government level is shortage of mectizan in some community and excess of it in another community....
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I observed that in the graph where we have decision for S, the prevalence value imputed is >1 for both Yes and NO decisions for all the stages (Baseline, Impact survey and Surveillance) is this an error or I got it wrong, Please can someone explain ?
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AKINOLA OLUWOLE made a comment
This is very educative, the internal factors that may affect process indicators in trachoma elimination include improper planning, delay in release of funds for outreach, poor/incomplete data collection
external factors include: raining seasons, environmental hazard, insecurity -
AKINOLA OLUWOLE replied to Mehwish Saghir
I agree with you Monde
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AKINOLA OLUWOLE made a comment
This week is very interesting with a lot to learn from the Trachoma Elimination programme in Uganda, it is evident that collaboration is the key to effective implementation of F and E part of the SAFE strategy for Trachoma Elimination programme.
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AKINOLA OLUWOLE made a comment
Trachoma programmes need to carefully consider partners’ motivation to work together on F&E activities in order to get them committed to the elimination programme. Every organization has its goal, mission and their way of doing things, no partner will be interested in
1. A programme that does not fit into their vision and mission
2. That will increase... -
AKINOLA OLUWOLE made a comment
This is an interesting and educative session, it gives me a practical understanding of the steps to go by to conduct a situational analysis of F and E aspect of the SAFE strategy to eliminate trachoma and other steps that will be followed in order to successfully implement the F and E aspect of the SAFE strategy to eliminate trachoma a district level.
In...
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AKINOLA OLUWOLE made a comment
Availability of women is a major factor to consider when planning for MDA in a trachoma endemic community or else meeting the targetat of at least 80% coverage will only be a mirage
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AKINOLA OLUWOLE made a comment
Availability of women is a major factor to consider when planning for MDA in a trachoma endemic community or else meeting the targetat of at least 80% coverage will only be a mirage
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AKINOLA OLUWOLE made a comment
wow, interesting and very educative presentation
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In my own opinion, Lack of awareness and Poor sanitation. I choose this options because I think it is less expensive, easy to implement and sustainable. In addition, one leads to another, if a strong awareness is created in the community which will include emphasizing the need to maintain a good sanitation. I am sure, this can be done by the community...
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Yes Luret, I complete share your opinion
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AKINOLA OLUWOLE made a comment
The course has been quite interesting and informative
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AKINOLA OLUWOLE made a comment
From reports, what has been the major factor responsible for a lower coverage of MDA for trachoma elimination programme
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AKINOLA OLUWOLE made a comment
In addition to what others have said, gender specific MDA coverage is important because to get the children that are under age of five, you need the mother or caregiver (usually a women) to bring them and also help in the administration of the tetracycline eye ointment. However, to get the women to participate in the MDA, they need the consent of the husband
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I agree with you Nicola and Angelia, another way to go in getting the Nomadic tribe is to get the contact of the leader and communicate with him the plan MDA and where and when they can get their people. My experience with the Nomatic Fulani in the southwestern Nigeria is that they are receptive to anything that has to do with their health and that of their...
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AKINOLA OLUWOLE made a comment
wow, it is amazing that the drug is safe for pregnant women, however, I am curious, is it safe for pregnant women no matter the status of the pregnancy?
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AKINOLA OLUWOLE made a comment
Please is Azithromycin the same thing as zithromycin
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AKINOLA OLUWOLE made a comment
wow, interesting course in week 2, I have learnt from the different experiences shared by people who are involved in eye care programme from different location. Although I dont have any practical experience to share now, partaking in this course and reading the experience of people is an experience that I can rely on to be part of TAP in Ogun State, if...
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This is a good management system, it allows stakeholders for trachoma elimination programme at different levels to have access and monitor information about trachoma treatment at his/her level and that is of interest to him using simple query
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This is a good management system, it allows stakeholders for trachoma elimination programme at different levels to have access and monitor information about trachoma treatment at his/her level and that is of interest to him using simple query
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I agree with you, I think an experienced trichiasis surgeon should handle a severe cases of trichiasis while a less severe cases can be given to newly trained surgeon
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I agree with you Nicola
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AKINOLA OLUWOLE made a comment
The idea of an eye ambassador was a good one, however I am curious to know the implication on planning for the surgery to prevent blinding from Trachoma in terms of
a. Time frame between identifying a patient that need surgery and when the patient will be ready for surgery.
b. Incentives for eye ambassadors
c. Number of eye ambassador that is needed for X... -
wow, that is high
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AKINOLA OLUWOLE made a comment
Esmael, In addition women are more involved in activities which attract flies that transmit Chlamydia trachomatis than men e.g washing of toilet, cleaning of the environment which may have been littered by feaces, preparing of food (e.g fishes and meat) e.t.c
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Esmael that is clearly my thought, people depend on testimony of others in the community or an individual with the same condition who has had a successful surgery to make their decision