Nigeria: Health Sector Response Strategy - 2017/2018

Introduction

This document is intended to guide readers through planned Health Sector interventions in North East Nigeria over an 18-month period (Jan 2017 – June 2018) in response to the humanitarian crisis and attendant health emergency. This strategy is in line with the National Heath Sector Response to Humanitarian Crisis Plan for the NE, developed by the Federal Ministry of Health and the State Specific operational plan developed by the Six states of the NE including Borno State Ministry of Health (SMOH). It will further assist in ensuring a wider reduction in emergency related morbidity and mortality across Borno, Adamawa and Yobe States which are states severely affected by the crisis. The success of this strategy will in part depend upon the health sector funds received to carry out the humanitarian activities set in this document.

The current picture is of protracted conflict and a continuing active insurgency. Many areas have now become more accessible, however insecurity remains and the pattern of safe accessibility on the ground remains liable to local changes and reversals not in control of the health sector.
The ongoing conflict in north-eastern Nigeria has caused widespread devastation, generating a crisis that affects the health of more than 6.9 million people in Adamawa, Borno and Yobe States. Of these, 5.9 million people including; all IDPs, children under 5, females of reproductive health age, the elderly, and the host community population under the poverty level are the most vulnerable and in need of health intervention.

Health facilities in the conflict affected areas have been completely or partially damaged leaving them unable to deliver adequate health provision. According to the Health Resources Availability Monitoring System report (HeRAMS)1 , one third of more than 700 health facilities in Borno State have been completely destroyed. Of those facilities remaining, one third is not functioning at all.

High morbidity, excessive mortality and high rate of severe malnutrition cases have been a consistent feature. Besides the ongoing polio and measles outbreaks, malaria continues to be the major cause of morbidity and the main cause of mortality among children under 5. It is also expected that there will be an increase in respiratory infections and the potential for a cholera outbreak and/or meningitis in the coming months. Although improving, the disease surveillance, alert and outbreak response system have been seriously eroded at a time of high population vulnerability and increasing likelihood of outbreaks.

The State Government and health partner’s capacity to respond has been overstretched with the continued increasing requirements. Capacity has been reduced to such an extent that in Borno State there is virtually no secondary health provision outside of the capital Maiduguri and access to primary services is limited and not comprehensive in most locations.

Revitalizing and strengthening of the health system is vital. Re-establishing functional, staffed and supplied health facilities to cover vulnerable populations and moving away from mobile services must be a priority for the health sector in 2017/8.