Dr. Mininim Oseji has completed four LSHTM courses, with the most recent being the Diploma in Health Systems Management in 2007. She currently balances two roles; Permanent Secretary for Delta State Ministry of Health (SMOH), Asaba and National President of the Medical Women’s Association of Nigeria (MWAN). Here, we discuss how she has been responding to the outbreak and how Nigeria’s response has affected her work.
How has the COVID-19 outbreak affected you and your work?
COVID-19 is changing the way the world thinks and behaves. It is also changing the way we practice medicine and provide health care services. Personally, I had to undergo self-isolation on return from my vacation in New York and London in March 2020, so I could not resume work on time. I then resumed work after a full lockdown had been imposed in Delta State where I reside. I was always using face masks and observed physical distancing during meetings and training programmes on COVID-19 during this period. We also commenced a series of virtual meetings. When the lock down was partially lifted, I continued to observe all of these measures.
How has your countries response to the outbreak affected your work?
Nigeria’s response to COVID-19 has been evolving with guidelines being developed and circulated regularly by the Nigerian Centre for Disease Control. Training of relevant health workers and step down training was prompt. However, the widespread utilisation of face masks came in as a late intervention and scaling up of testing is ongoing.
The provision of Personal Protective Equipment for health workers has not been satisfactory which has led to low morale and paranoia among some health workers. The various levels of government have been providing incentives for health workers, particularly those on the frontline. So far, the measures taken have helped to curb the spread of the disease in Delta State where I live and work. The first case was reported on 8 April 2020 and we have 28 cases as of 19 May 2020. The response has led to the scaling down of a lot of routine health activities and an increased use of virtual resources for communication at work.
How have you been responding to the outbreak for MWAN?
In order for MWAN to make a significant contribution to mitigating the impact of the coronavirus pandemic locally and globally, the National Secretariat set up a nine person volunteer COVID-19 team, led by myself. The team is coordinating a five-point response which includes:
1. Sensitisation on preventive measures using print and social media.
2. Donation of reusable face masks to the elderly.
3. Promoting tele-medicine.
4. Continuous medical education on COVID-19 using online resources.
5. Response to SOS from Italian Medical Women via Medical Women International Association.
The National Secretariat released a press statement on COVID-19 on 4 April 2020 and circulated a reporting template for documentation on cases of COVID-19 for research purposes on 4 May 2020.
How have you been responding to the outbreak for SMOH?
The advent of the COVID-19 pandemic was seen as an opportunity to strengthen various weak aspects of the health sector in Delta State. As Permanent Secretary, I embarked on a Health Systems Strengthening Initiative to ensure the sustainability and institutionalisation of lessons learned when the pandemic is over. Stakeholders in the health sector were requested to submit their activities in response to COVID-19 as well as proposed plans of action in the coming weeks. These responses were collated and a zoom meeting was organised on 15 May 2020 to discuss the way forward. The next steps include:
1. SMOH to liaise with Delta State Contributory Health Insurance Commission (DSCHIC) on the use of available ICT resources in DSCHIC, as well as the COVID-19 application that is being used in 15 States.
2. The SMOH should lead the effort in incorporating tele-medicine.
3. SMOH to increase communication at all levels.
4. Discharged COVID-19 patients who are willing should be identified and appointed as COVID-19 ambassadors to raise awareness about the disease to help fight stigmatisation.
5. Efforts to decentralise testing should be intensified.
6. Case managers should use the circulated case report template to document all suspected, probable and confirmed cases, and submit to SMOH.
7. Daily ward rounds should be conducted by case managers. Any doctor who is not willing to do a daily ward can request to be removed from the case managing teams.
8. Copies of all applications for funding should be forwarded to the Permanent Secretary SMOH for follow up.
9. Equipment needs of treatment centres should be determined and addressed urgently.
10. The insurance status of all confirmed cases should be determined.
11. COVID-19 testing should be carried out for health workers before they start their shifts in the treatment centre and about 2 days before they depart for their break, so that they have the results on time.
12. Schools of Health Technology, Nursing and Midwifery should commence e-learning programmes for their students.
13. Online stepping down and follow up of the productivity enhancement workshop will be carried out by the office of the Permanent Secretary, Ministry of Health, Asaba.
14. COVID-19 activities should be gradually mainstreamed into routine care to enable sustainability and a more cost-effective response.
How has LSHTM’s training helped you during this outbreak?
COVID-19 has provided me with an opportunity to utilise my training in Tropical Medicine and Hygiene as well as Travel Medicine. The free online course on COVID-19 run by LSHTM helped me understand more on the epidemiology of COVID-19 and the type of research efforts that have led to the global response. I have been able to compare responses from different countries as well as obtain guidelines for managing COVID-19 in vulnerable groups, such as pregnant women and children. It also gave me an opportunity to share my experience with others as well as learn from theirs.