I WOULD DIE A FULFILLED PERSON IF NIGERIA CAN ACHIEVE UNIVERSAL HEALTH COVERAGE - DR. BETTA EDU

Dr. Betta Edu is the first Director General of the Cross River State Primary Health Care Development Agency. She is a strong and consistent young woman who is passionate about rendering humanitarian services within and across the state. Dr. Edu who bags a master degree in Public Health from the London School of Hygiene and Tropical Medicine is an ambassador of the State of Arkansas, USA. 


For her devoted Humanitarian and Community Development service since her resumption in office as the Director General of the Primary Health Care Development Agency, Dr Betta Edu is Glance Personality.

-THE FIRST THING YOU THINK OF IN THE MORNING.-

The first thing I think about in the morning is Prayer; because my entire life and being is dependent on God. Therefore, I start by committing my day, and everything into His hands; asking for His help and favour through the day.

-THE MAJOR ADJECTIVES THAT DESCRIBES YOU?-

Passion and Energy

-ON HOW IT FEELS BEING THE FIRST DIRECTOR GENERAL (DG) OF THE CROSS RIVER PRIMARY HEALTH CARE DEVELOPMENT AGENCY (CRPHCDA)?-

It feels like a lot of responsibility; a lot is expected of me. You know, the most tasking part of any job is the fundamental stage. When you do not get it right from the very beginning, it will be difficult to get it right at any other points. Starting an agency, building a structure that never was, trying to put people together to make the Primary health work; is a lot of responsibility, and I am glad God has been there, helping me through it.

-ON THE MAJOR CHALLENGES FACED AT THE BEGINNING-

First, the major challenge for me was getting the agency going. I was first employed by the Cross River State Government as the special adviser to the Governor of Community and Primary health care. There was no agency then, so one of my first assignments and task was to get an agency going, that is; to have Cross River State establish and run an agency. So, I went about doing that, with all the key stakeholders, which were relevant to that mission, and together we were able to come up with that agency, which the governor approved on the 19th of August. Also we had challenges of having the staff; the remaining who were at the local government level, whom we are still trying to move, as the process is ongoing, hoping to finalize them. Other tooting challenges includes; financial, which the country and state are going through a period of recession. We are trying to see how we can harness funds and mobilize resources from all angles, to ensure we can get quality health care service delivery at the Primary level.

Another CHALLENGE would be, well I would say is a little of shock, expressed by so many people, you know, a young person in government, heading a parastatal of that sort. A lot of people asked, ‘are you sure you would be able to do this?’, but we were able to overcome all of that, and we are glad that overtime we have been able to build up confidence.

-INSIGHT OF YOUR PROFESSIONAL RESPONSIBILITIES.-

Well, if you say my professional responsibility, I am a medical doctor by profession, and my responsibility is basically to help humanity and save lives, that is; anything to keep people alive, not just alive, but living a quality life, is basically my responsibility. At the level of the agency, my responsibility is to see to it that I build the primary health care system, which is within the health sector. You know for many years, the government both at federal and state level, have taken the attention of primary health care, and added it among-st other tars of care; the secondary care, the tertiary care, and so on. In recent times, attention has been paid to the primary health care. There is a health pyramid, where you have a large based and it gradually thins its way up. At the top are the tertiary institutions; the teaching hospitals, government hospitals, and next you have the secondary institution, but the base is the primary health facility. The base is the biggest component of a pyramid, showing that most persons at least ninety-five percent of the population, should be able to access care at the primary health level in their local community. If the cases are too difficult to handle, they are then referred to the secondary level of care. This level, the primary level, has been neglected a lot, so if you go to communities, you do not have health centers that are viable. There are no health workers present to render services to our people; sometimes they run out of drugs and they are many other issues at that level. But, the attention of the administration of his Excellency Senator Professor Ben Ayade, to revitalize the primary health sector, has enabled us to meet the medical needs of the people at that sector. So far that’s what we are working on, and we’ve recorded a lot of achievements in that sector, but a lot more needs to be done.

-ABOUT HER DECISION TO WORK FOR THE CROSS RIVER SATE HEALTH CARE AGENCY?-

I have always hungered for a platform, to reach out to people in the rural communities, to the poorest of the poor, to the indigent members of our society. Before I was given this appointment, at least twice a year, I would go to a village, where they do not have access to quality health care, and I would carry out free health activities on my own, without any support or contribution from anyone. I go to these communities, identify them, and gather a group of doctors and volunteers from the Christian medical association. We put ourselves together, go into these communities, and render medical services to them. That has been my passion, my drive; to see that we have a healthier population and that people who do not have access to these facilities are met with them. It has been a long standing passion which I have been working on, and this creates a big platform to reach these people who are very passionate to change their health care story.

-ABOUT THE ORGANIZATION AND WHAT IT STANDS FOR?-

This is Cross River state primary health care development agency, it has the mandate to coordinate and implement all primary health care activities in the state. And you know previously that, different ministries, agencies, and departments, were handling bits and pieces of the primary health care, and there was duplication of activities, wastage; things were not really working well. From the national and state level, they thought we should get an agency which would take up all of these responsibilities, and hold them accountable if they do not deliver on their mandate. So, that was the catalyst that led to the birth of both the National and now the Cross River State primary health care development agency. We are presently working with the strategy of revitalizing at least one primary health care facility in every ward. We have about 196 wards in Cross River state, and we want to ensure that all primary health care facilities are functional in all of those wards. By functional we mean a hundred percent; their drugs, the right mix of staff available to offer; health services, maternal services, services of children under the age of five (5), and these services who run 24 hours 7days in a week without stop, serving as the hub for other primary health care facilities in that ward, so they can refer to them. The Governor, his Excellency who is very passionate about the primary health care, has also been of great help to the agency, he has employed 18 medical doctors across the 18 local government areas in Cross River State, this is to ensure we boost service delivery, and the quality of the workers employed in those local government levels.

-ON THE RECENT BILL REGARDING AFFORDABLE AND EFFECTIVE HEALTH CARE AT THE RURAL LEVEL WHICH WAS RECENTLY PASSED INTO LAW,-

This is for all Cross-Riverians, and everyone resident in cross river state. It is the state health insurance bill tagged, ‘Ayade Care’. The idea behind it is to provide smart sustaining form of medical financing that will; prevent individuals and families from having catastrophic health expenditure, and getting impoverished before time. This is sustainable being that we will all share the risk and benefits. Imagine a family with someone suffering from cancer or hepatitis B, you know how many millions it will take to give that person care for the disease, or to be able to take care of that person amatively throughout the period the person is suffering from the disease. It will take a whole lot and could lead to families being impoverished. We are saying, rather than having those families pay those huge bills, even as little as malaria; you know there are some anti-malaria drugs sold for a thousand two hundred, eight hundred naira, if you have to treat three or four people in a family you know how much it will cost. Government is saying, put a thousand naira into the central purse, then we would all have to bare the weight and burden of a person being treated. There are some exemptions in that policy, which exempts; pregnant women, children under five, the elderly, the very poor in the society who truly cannot be able to afford it, people living with HIV/AIDS, as well as persons who are mentally or physically challenged. This is just a form of sacrifice; a brother lending a hand, or support to another brother, all of us sharing our problems together, that is what AYADE CARE IS ABOUT.

-HOW IT WILL BE FUNDED?-

First and foremost, like I said previously; a sum of one thousand naira is expected to be paid by every capable Cross-riverian for their health care insurance, apart from the exemptions made earlier. Secondly, the state government would equally have to source for partners who would support the Ayade care, also we expect donations and gifts from persons. Budgetary allocations would be made to fund the health care.

-WHERE IT WILL OPERATE FROM & THE STRUCTURES THAT HAS BEEN BEING SET IN PLACE TO ENSURE IT RUNS SMOOTHLY?-

They would operate from Cross River state, they would be an agency which has already been signed into law and so, it is left for the governor to appoint the Director General and members of the board, but basically there would be an agency called; ‘The Cross River state health insurance scheme’, that would; coordinate, monitor, and control all that has to do with the health insurance scheme, which is the AYADE CARE.

There are several structures, one is the fact that the governor has stated that we run the whole place as transparent as possible, money would not be held by government agencies, but outside the government agencies, they will be of course third party administrators, like the HMO’s that are credible and well known world over. We will also have our partnerships with international bodies, they too would put an eye; checking to see that the process remains accountable and transparent.

We would make sure to carry everyone along, making the process as transparent as possible; we need to build trust. Insurance is about trust, you trust that; if I put my money into this, I will be able to get the benefits and returns for my money.

-WHAT PERSONAL QUALITIES DOES ONE REQUIRE FOR THIS LINE OF WORK?-

For my kind of job, I think you must be; God fearing, passionate, and compassionate, people oriented (how can I give people a better life? How can I make life better for someone who is not able to afford it?), those should be your mind set. So I feel, if people are God fearing and disciplined, accountable and transparent enough in their dealings, committed to work, diligent and also energetic; because you need the energy to be around the state which is very humongous. You know, we have more than 131 primary health care centers across the state, monitoring must be at high level to assure the quality of services delivered in the primary health centers. You must have your eyes on the staff, to ensure they carry out their duties at the right time, and you must be able to communicate with communities, build trust, discuss with stakeholders, get them to buy into the intervention which you are bringing on board, and equally help them to take control of the monitoring process, so they can monitor those who have been sent to work in their communities and bring information back to the agency. So, it needs a lot of diligence, passion for the job, and above all; You really need to Fear God, because if you do and realize that someday, you have to give account of what it is that you rendered, then you render that service with the mind-set that you are accountable to someone who sees anything, whether in secret or in the open; who will judge you based on what you have done. With that mind set you would not want to falter, you would want to do your part to see that primary health care is best in Cross River state.

-LESSONS LEARNT ON THIS JOB? AND WHAT DO YOU ENJOY MOST ABOUT YOUR JOB?-

I think one of my greatest lesson is ‘patience’. I am used to being on the fast lane before now, if something has to be done, I have to get it done right away using the right means, but I have learnt patience, in quote ‘patience, in capital letters PATIENCE. It is a demanding task, not everybody sees the vison you see, but everyone has the same drive frequency, but then everybody or as many people must be carried along to help achieve the goals you want to achieve. As a team player and a leader, we try our best to carry people along. I have learned patience and I have learnt to put my trust in God because, most of the things that happen are not physical, they are of the spirit and so, if God is on your side you attract more; blessings, open doors, favour; and I have equally learnt that hard work pays. The more I have been to communities, interacting with people, going out doing my job; I am beginning to see results, and beginning to have evidence that hard work pays. So I have learnt a lot about; leadership, teamwork, hard work, patience, interaction with people, and even networking too, a lot about networking; practical experience with community participation.

-HOW SHE WOULD LIKE TO BE REMEMBERED AFTER HER TENURE IN OFFICE-

First, I would like to be remembered as one of the persons that gave birth to the Cross River state primary health care development agency. I would love to be remembered as a Director General who was able to set a system in place for primary health care to become functional. To be remembered as a director that achieved one functional primary health care center, in each ward in Cross River state. I would also like to be remembered for involving communities to bring their solutions to their health care challenges, in the communities where they reside. A few other things like; setting up a proper drug revolving form system for the primary health care, to ensure that they have drugs making the system more accountable and transparent, such that everyone can indeed benefit from it. And I would love to be remembered for the state health insurance scheme, as part of the people who worked hard to ensure that the scheme came on board, and that it stood the test of time.

-ON HER ULTIMATE CAREER ACHIEVEMENT-

"I would die a fulfilled person if Nigeria, Cross River state can achieve universal health coverage. That for me is going to be like the highest point of everything I’m doing." If you go to the United Kingdom, they have the NHS, a wonderful system that helps the United Kingdom achieve the universal health coverage. You can walk into a clinic and receive care without being asked for money, it is beautiful, it is one of the beautiful things I enjoyed living in the United Kingdom, living in London. I just hope working with stakeholders at different levels, we would be able to achieve that in Nigeria; for the future and lots of beautiful things. And if you ask me, I want to be the United Nations Secretary General, this has been my biggest dream.