DEPARTMENT OF PUBLIC HEALTH SERVICES AND DISEASE CONTROL
The department serves the statutory function of promoting good health, prolonging life, and preventing diseases by ensuring public health safety plus other associated functions backed by the Public Health Law, Cap 103, Laws of Rivers State, (1999). The department carries out its functions through seventeen units/programs. Unit heads/Programme managers oversee the day-to-day implementation of disease control programs across the tiers of health service delivery in order to achieve the ideals of public health safety and promote global health security, The Department is led by the Director of Public health and Disease Control Services.
The epidemiology unit performs continuous scrutiny over 44 priority diseases, conditions and health events around the State. The surveillance strategies being used include Event-Based Surveillance (EBS) and Indicator-Based Surveillance (IBS). This is done using both electronic and routine data transmission systems. The electronic data transmission system is aided by the Surveillance Outbreak Response Management and Analysis System (SORMAS) reporting platform which is very efficient and real time. Outbreak control is achieved by Incident Management System supported by the Public Health Emergency Operations Centre which was established in 2019.
STATE AIDS/STI CONTROL PROGRAM (SASCP)
The SASCP is responsible for the coordination of the State HIV, STI Control Program and associated programmes including the Hepatitis elimination Program. It also coordinates the innovative and pioneer integrated disease screening and treatment services at high volume sites in the State. Together with Centre for Disease Control and the Institute of Human Virology of Nigeria, SASCP is on course to achieve epidemic control technically referred to as 95-95-95 targets by year 2030. His Excellency, the Governor of Rivers State on the 26th of June, 2019 graciously approved user fees waiver for Persons Living with HIV/AIDS (PLHIV) to HIV access services at the facilities in the State. From available State data, the SURGE effort through the SASCP has so far achieved 92-99-87 (2022), in line with the UNAIDS 95-95-95 targets. More so, laboratory services have been strengthened at the State Teaching Hospital for viral load assay with three PCR machines ensuite at the facility to serve the State and environs. Most importantly, the SASCP and USCDC-IHVN co-created and pioneered the innovative – Clinical Mentors’ Programme, which has been fully integrated into the country’s Treatment Guideline for HIV treatment & Care programme and launched by the Hon Minister of Health as a recommended paradigm for programming in the county. Within a period of two years, the treatment gap in the State has been remarkably reduced. The Rivers SASCP has won several national merit awards and international recognition in attestation to its recent efficiency in programming.
It has several sub-units including, HIV Testing Services, Prevention of Mother to Child Transmission, Anti-Retroviral Treatment Services, etc.
STATE TUBERCULOSIS AND LEPROSY CONTROL PROGRAM (STBLCP)
The Tuberculosis and Leprosy Control Unit supervises the creation and maintenance of access to the control and treatment of Tuberculosis, leprosy, and Buruli Ulcer in the State expanding Directly Observed Treatment Short Course Centres (DOTS) and continuously improving access to care for persons with mycobacterium Tuberculosis infection. DOTS centres can be found in select Government and Private Health Facilities across the State. The unit has strategic surveillance for multi-drug resistant tuberculosis and has expanded gene expert sites for rapid point-of-service diagnosis and commencement of drug-sensitive treatment services. Despite the COVID-19 pandemic, the State has continued to increase TB diagnosis and treatment. In fact, the Tuberculosis and Leprosy Control Programme has become quite innovative using structures of the pandemic to support case findings. With several awards from the country programme, the STBLCP has very successful cure rates for the sub-unit treatment programmes and the case-finding yield has remained amongst the best in the country.
STATE MALARIA ELIMINATION PROGRAMME
The Federal, State Government, private health sector and indeed the entire people of Nigeria are committed to intensive actions to attain the goal of a malaria-free Nigeria. The goal is to reduce the malaria burden to pre-elimination levels and bring malaria-related mortality to zero. State Malaria Elimination Programme along with supporting partners are seeking sustainable, indigenous, and creative solutions in line with the strategies promoted by the World Health Organisation to ensure a reduction in the burden of Malaria. These include the use of long-lasting insecticide-treated nets, integrated approach to vector control, prompt diagnosis of malaria, and use of artemisinin-based combinations dugs for treatment. This is in combination with health promotion, capacity building, strengthening of laboratory services and strategic surveillance.
NEGLECTED TROPICAL DISEASE CONTROL PROGRAM
Eradication of Neglected Tropical Diseases (NTDs) is mostly found where poor access to adequate water, sanitation, and basic hygiene subsists. They are caused by a variety of pathogens such as bacteria, protozoa, and parasitic worms (helminths) etc. Mass deworming in schools was implemented in 21 LGAs out of the 23 LGAs in Rivers State for Soil Transmitted Helminths (STH). Thirteen out of 23 LGAs are carrying out deworming in the communities for Lymphatic Filariasis (LF). The mapping status of the remaining two LGAs for STH and 13 LGAs for LF are not of public health importance and therefore do not qualify them for Mass treatment. The data system relies heavily on the DHIS. The effort is geared toward the reduction in the disease burden of neglected tropical diseases.
Our functions include occupational Health, School Health, Food Hygiene, Water Hygiene, Building/Housing Hygiene, Disease Vector/Pest Control, Prosecution/Legal duties, regulation of markets, Abattoirs/Slaughter Houses hygiene and training of students on internship. The main statutory function includes maintaining hygiene and abating nuisance in the interest of public safety. The Unit is enabled for inspection, regulation, and enforcement of Public Health laws to ensure safety and health promotion. Environmental Health services are of utmost importance, especially in cosmopolitan and developing cities in the State.
SEXUAL AND GENDER-BASED VIOLENCE (SGBV)
Sexual and Gender-Based Violence (SGBV) is a unit in the Public Health Department that coordinates holistic care (medical management, psychological first Aid care, mental care, and social support) to survivors of sexual and gender-based violence of all groups; that is, men, women, children, boys, and girls. Sexual and Gender-Based Violence is any act of violent behaviour that results in or is likely to result in physical, sexual, or psychological harm or suffering to an individual including threats of such acts, coercion, or arbitrary deprivation of liberty, whether occurring in public or in private life because of one’s gender. This unit has become very relevant to support victims and coordinating a holistic approach to addressing the menace of SGBV.
The objectives of the programme in the State:
To coordinate response activities towards management, prevention, rehabilitation of SGBV survivors and data collection of cases in the state.
To reduce the health, social, economic, psychological, religious, and educational consequences of SGBV in Rivers State.
The nutrition coordinates the achievement of the following
Adoption and implementation of strategies for the promotion, protection, and support of breastfeeding; enhance the effectiveness of the Rivers State Breastfeeding Collective Committee and optimize infant and young child feeding practices state-wide. Galvanize action on protecting breastfeeding to improve public health.
Propagate the International Code of Marketing of Breast Milk Substitute, the relevant subsequent World Health Assembly Resolutions, and the National Regulations for implementation and compliance monitoring.
Assess the prevalence, severity, and distribution of specific micronutrient deficiencies and other forms of malnutrition in vulnerable population.
Measure the coverage of national/subnational nutrition interventions.
Assess the prevalence of food insecurity and identify other key factors at individual and household-level (Eg. Education) associated with micronutrient status and dietary intake in a vulnerable population.
Capacity building on knowledge and skills of State nutrition health workers.
The unit also works with all stakeholders across the three Boards of care and parastatals ensuring that nutrition services are in line with the national policies and best global standards.
MATERNAL PERINATAL DEATH SURVEILLANCE RESPONSE
The main thrust of MPDSR is using Facility and Community channels to ascertain peculiar causes of death in the target population, outline modalities to identify them routinely and modifications in healthcare provision, and ensure precise response by actors in the responsible sphere (Facility or Community) to reduce and possibly eliminate Maternal and Perinatal Mortality. This initiative is geared towards eliminating preventable causes of maternal and preventable deaths such as - Ante Partum Haemorrhage, -Hypertensive Emergencies, -Post Partum Haemorrhage, -Obstructive Deliveries, -Birth asphyxia, -Prematurity
Services are provided via:
Facility MPDSR – Public and Private (Primary Health Centres, Secondary and Tertiary Health Facilities)
Community MPDSR (PHC and Public)
NON-COMMUNICABLE DISEASES UNIT
Non-Communicable diseases (NCDs) unit is responsible for the program on the prevention and control of NCDs in the State. NCDs are chronic diseases that are not transmissible from one person to another and are insidious. This disease group is quite broad, however, in Nigeria, we have the priority NCDs which are Cardiovascular diseases, Chronic Respiratory diseases, Cancers, Diabetes, Sickle Cell disease and other inherited bleeding disorders, and Road Traffic Accidents. Others are Oral health, Mental and Neurological diseases and Violence. These diseases have shared modifiable risk factors which include unhealthy diet, sedentary lifestyle, smoking tobacco products, harmful use of alcohol and environmental pollution and it could also result from chronic infectious processes like Human Papilloma Virus (HPV), Hepatitis B (HBV) and Helicobacter Pylori infections. The objectives of the program are
Formulation of evidence-based policies on NCDs
Screening and treatment
FAMILY PLANNING UNIT
The Family Planning Unit is responsible for ensuring the provision and coordination of family planning services in the State. Its goal is to ensure that Women of Childbearing Age access services in all Health Facilities that provide Family Planning through:
i. Behaviour Change Communication and Demand Generation
ii. Service Delivery and Access
iii. Contraceptives and Supplies
iv. Research, Monitoring & Evaluation, Training, and Data.
Modern Methods of contraception being promoted include:
• Long-acting reversible contraception - the implant and intrauterine device (IUD)
• Hormonal contraception - the pill or the Depo Provera injection.
(including the innovative self-administered DMP-SC)
• Barrier methods – condoms.
• Emergency contraception.
• Fertility awareness.
• Permanent contraception – vasectomy and tubal ligation.
Reasons to Support Family Planning include
• Improving maternal health and child survival.
• Reducing the number of abortions overall, especially unsafe abortion
• Preventing sexually transmitted infections (STIs), including HIV/AIDS.
• Empowering women.
• Promoting social and economic development and security.
• Protecting the environment.
The Family Planning unit is strategically positioned to ensure that the State offers opportunities for family health, family development, and informed planning services in order for the State to benefit maximally from the projected demographic transition.
ADOLESCENT AND YOUNG PEOPLE.
The adolescent unit is responsible for coordinating and supervising adolescent health and supporting their developmental milestones. Its aim as a unit is to collaborate with MDAs, relevant stakeholders, and implementing partners in the state to address common prevailing health challenges amongst adolescents and young people. The Technical Working Group Platform brings together representatives and stakeholders to foster innovative, strategic, and sustainable responses to adolescent health. The unit objectives represent a reflection of the national consensus on the most critical concerns for adolescents and young adults and cover the following areas.
• Unintentional Injury
• Mental Health & Substance Abuse
• Reproductive Health
• Chronic Diseases etc
The unit also commemorates the yearly International Adolescent Health Week (IAHW) and keeps continuous scrutiny on determinants of health amongst adolescents and young people in the State.
SAFE MOTHERHOOD UNIT
Safe Motherhood means, ensuring that all women have access to the information and services they need to go safely through pregnancy, labour, and post-natal.
The Vision of Safe Motherhood is that “No woman undergoing pregnancy/labour or childbirth should suffer injury, loss of her life nor that of her unborn baby as a result of pregnancy/labour”. The Goal of the Safe Motherhood unit is to accelerate the reduction of Maternal and Newborn mortality and morbidity rates to achieve Sustainable Development Goal 3(SDG 3). The specific objectives include providing skilled attendance during pregnancy, birth, and during postnatal periods at all levels of the healthcare delivery system (Capacity building of Health Care Workers) and improving and strengthening the capacity of families and communities, in order to improve household/community care in Maternal, Newborn and Child Health (MNCH).
The Targets of the Safe Motherhood Unit in Rivers State include
Reduce Maternal, Newborn and Child Health (MNCH) morbidity/mortality from 576/100,000 in 2019 to 374/100,000 in 2022 (
Organize Training to improve Skill Birth Attendance to Delivery
Integrated Supportive Supervision and Monitoring of MNCH activities
Coordinate Quarterly MNCH Core Technical Committee Meeting
HEALTH PROMOTION UNIT
Health promotion coordinates all aspects of Health education, lifestyle modification, and the promotion of acceptable nutritional values for public health safety. In addition, the State Health Promotion Unit supports all programmes across the various unit, departments, and agencies of the State Health sector. It operates the Risk Communication Pillar of the Public Health Emergency Operations Centre (PHEOC) with a view to accelerating disease control and promoting contextual preventive behaviour where citizens are health aware, supporting all efforts that promote productivity and sustainable development in the health sector.
The unit is responsible for awareness creation and demand generation for health services by employing different strategies to disseminate health information and build the capacity of stakeholders to embrace health programs.
Health Education is commonly used as a powerful tool to address inequities through community engagement and grassroots-led actions. It ensures that priority health and social concerns are those expressed by the community and not determined top-down utilizing mass media, Advocacy, Communication, and Social mobilization (ACSM).
PUBLIC HEALTH LABORATORY
Public Health Laboratory is charged with diagnostic and investigative aspects of preventive Health Care.
The Public Laboratory is charged with the following duties:
Analysis of food, water and liquor consumed in the state.
Mapping, monitoring and analysis of water quality.
Laboratory support in control of epidemic disease outbreaks in the state.
Support the state epidemiology unit and other relevant agencies for diseases of public health importance.
Test specimen from persons, food and beverages implicated in food borne disease outbreak to identify causes and sources.
Training of Medical and Health Personnel from health institutions and students on industrial training from higher institutions.
Support function of peripheral health center laboratory (Referral).