Dr. Oyebanji Filani is a trained Physician and Health Economist with working experience in the United Kingdom and Nigeria. Oyebanji has 17 years of experience in the design and implementation of health financing and health reforms.
In 2020, he was appointed as the Commissioner for Health and Human Services in Ekiti State Nigeria. In his less than 2 years in this role, the State has recorded an increase of over 300% in development partner investments in the State’s health sector, with these investments spanning across health financing, infrastructure, service delivery, and innovation.
In addition, under his leadership, Ekiti State was recognized as the best-performing state in the country for disease surveillance and response.
Oyebanji has employed a systems-thinking approach in addressing health service delivery in Ekiti State. For instance, he established in partnership with the Massachusetts Institute of Technology Governance Lab (MIT/GOVLAB) and Co-creation hub, Nigeria’s first Governance Innovation Accelerator Challenge.
Using human-centered design and social science, the initiative has developed two solutions to address statewide health challenges in quality-of-care delivery and public health security.
In 2019-2020, he served as the Technical Director of the Basic Health Care Provision Fund (BHCPF), a Federal Government of Nigeria initiative with dedicated funding of $150m, equivalent to 1% of Nigeria’s annual revenue.
In his capacity as technical director, he provided thought leadership on the program, drove its implementation, and ensured performance indicators were met in the 36 States of Nigeria.
Between 2016 and 2019, Oyebanji served as the Senior Technical Adviser to the immediate past Federal Minister of Health in Nigeria. In this role, he led the data and analytical work that enabled the mobilization of an annual $180m domestic and development partner resources under the BHCPF, and the provision of $2.7bn for the National Strategy for Routine Immunization and Primary Healthcare Systems under the GAVI partnership. He also provided thought leadership and coordination across several work streams for the office of the Minister.
Over a 3-year period, Oyebanji served as a member of the Technical Committee of the World Bank/USAID-led Annual Universal Health Coverage (UHC) Forum, helping to provide strategic guidance and development of discussion materials.
He also served on the Advisory Committee for the Strategic Purchasing Africa Resource Center (SPARC), a Bill and Melinda Gates Funded program, focused on strengthening strategic purchase expertise in sub-Saharan Africa.
Oyebanji also served on an Advisory Board to develop a global Health Equity Program of Action (an implementation framework to support the country's efforts in reducing health inequities) led by the O’Neill Institute at Georgetown University USA.
He currently serves on the Technical Expert Advisory Committee of the Fair Process for Financing UHC, a joint initiative of the Norwegian Institute of Public Health and the World Bank.
In 2014, he co-designed a Federal level Flagship Social Protection Program and co-developed the concept document and cost model for the program, working with a multi-sectoral team with representations from 11 Ministries, Departments, and Agencies.
He has extensive practical experience with the application of economic analysis in shaping policy and programming. Whilst in the UK, he led the analysis of knock-on costs for non-cancer screening programs initiated by the UK’s National Health Service (NHS), with a view to strengthening health service delivery.
Between 2009 and 2010, he worked as a medical service and quality assurance officer at Expatcare Health International, a Health Maintenance Organization. In this role, he led the coordination, implementation, and monitoring of managed care operations, medical services delivery, and quality assurance mechanisms for the organization.
Oyebanji currently serves as the Chairperson of the Nigeria Health Commissioners Forum, where he guides his colleagues on critical health systems reform issues at the sub-national level.
His interests are in data and analytics for Health Financing and the use of evidence to inform decision-making.
Please tell us about yourself (educational qualification and experience)
My name is Oyebanji Filani. I am the Commissioner for Health and Human Services in Ekiti State Nigeria. As Commissioner, I lead the development of policies and I provide strategic oversight on the implementation of innovative and sustainable programmes, toward fulfilling Universal Health Coverage in Ekiti State. I oversee the entirety of the State’s health sector which includes the State Ministry of Health and all its agencies.
I am also the Chairperson of the Nigeria Commissioners for Health Forum, which is an incorporated body of sub-national health leaders in Nigeria.
Prior to becoming a Public Servant, I was the Technical Director for Nigeria’s Basic Health Care Provision Fund (BHCPF), a Federal Government of Nigeria initiative aimed at addressing how primary health care is financed and delivered.
I was also the Senior Technical Advisor to the former Minister of Health, Professor Isaac F. Adewole. In these roles, I provided leadership for the implementation of national initiatives, I led engagements with political and health leaders across the 36 states, as well as international and local partners. I also have experience working in the United Kingdom’s National Health Service.
I am an alumnus of the College of Medicine, University of Lagos State and I also hold a degree in Health Economics and Health Policy from the University of Birmingham.
We understand that ensuring healthy lives and promoting wellbeing is one of the Sustainable Development Goals, could you share the health priorities in your state in line with achieving SDG3?
As a government, our health priorities can be categorized into the following key parameters and they are:
Human Resources: is key to ensuring that when people get to a health facility, there’s an adequate number of skilled health providers to attend to their needs. To create equitable access to skilled healthcare services, especially in PHCs, we reshuffled nurses and midwives to ensure that underserved interior communities had skilled personnel. We also established the National Youth Service Corp (NYSC) medical fellowship, in which Corper Doctors were actively encouraged to work in rural settings within State. During the pilot of this fellowship, there was 99% retainment of the Doctors posted to rural areas. Despite the paucity of funds, we recruited additional doctors into the State’s health system and retrained over 500 nurses to enable them to provide quality services.
Infrastructure: Without the right infrastructure, health workers cannot provide quality services and people will not be encouraged to utilize health services. Recognizing this, we invested heavily in the renovation of 14 out of 22 General Hospitals and 100 out of 177 Primary Healthcare Centres (PHCs) which were also provided with new equipment. The secondary healthcare facilities were equipped with modern facilities that most lacked, enabling them to actually provide advanced medical services to complement the PHCs as proper referral centers.
Commodities: In 2021, we established the Ekiti State Drugs and Medical Commodities Management Agency (DMA). This agency has signed an MOU with leading Nigerian pharmaceuticals to ensure constant availability and price stability of quality drugs and medical supplies. This will ensure that whenever a person seeks medical care, there will always be quality drugs and consumables in the health facilities, at an affordable price.
Demand Creation and use
To create demand and reduce the financial burden of health services, especially for vulnerable populations, the State has purchased an explicit and guaranteed set of services for the population under its Health Insurance program. Currently, these services are available for pregnant women and under-five children at designated PHCs and an additional 100,000 persons will be enrolled in the State Health Insurance Scheme. The State health education/risk communications department also creates awareness of available services and facilities through mass media and direct community engagement.
Public Health Response
Following the COVID-19 pandemic, we recognized the need to build and strengthen essential public health facilities and functions, that will not only respond to the pandemic but position the State for timely and resilient outbreak preparedness and response. To this end, the State government increased the capital budget expenditure by 200% in 2021 to invest more in healthcare and epidemic preparedness/response. This enabled the investment of about 100 million naira in establishing a molecular laboratory and a public health laboratory to improve testing and diagnosis. The State surveillance systems were also strengthened, 17 Emergency Operations Centres (EOCs) were established across the State (1 per LGA) to enable quick detection and response to health events and 145 COVID-19 sample collection sites were set up across all LGAs. We are also currently working with a good number of partners to ensure that every eligible person in Ekiti State gets vaccinated. The State has also consistently been recognized as the best performing State in disease surveillance.
Quality of care
To improve the quality of care, we are creating an enabling legal environment to enforce standards and adequate monitoring of healthcare services and providers. This will ensure that the public is protected from fake, non-credentialed, or minimally certified health providers and from healthcare facilities that do not adhere to the standards of care. We also launched the Ekiti State Ambulance Service (EKSAMS) which will enable the prevention of avoidable deaths and disabilities from medical emergencies in Ekiti State through the provision of high-quality and timely emergency medical services and transport.
The NGF Secretariat is championing PHC strengthening through the PHC Challenge Fund, could you share some of the things your state is doing around strengthening PHC in your state?
In line with the Federal Ministry of Health’s policy of 1 PHC per ward, we have established at least one Primary Healthcare Centre in all the 177 Wards in Ekiti State. These Primary Healthcare Centres like I mentioned earlier, were renovated and furnished with new equipment, key of which are 189 solar direct drive refrigerators distributed to all the PHCs to ensure optimum vaccine cold chain. Key secondary facilities were also renovated to serve as referral facilities. Nurses were also reshuffled within Senatorial zones to ensure equitable distribution of staff and over 500 PHC personnel were re-trained to provide better services. With the establishment of the State Drugs and Medical Supplies agency, and the MOU with leading pharmaceuticals, we have largely addressed the issue of drug stockouts and price instability in PHCs.
On the demand side, we disbursed 62,495,245 naira to 122 PHCs under the Basic Health Care Provision Fund (BHCPF). This fund allowed the renovation of PHCs and the provision/purchase of an explicit package of free health services for pregnant women, under-five children, and other vulnerable groups which have created an increased demand for health services at the community level. Over 5,000 persons are currently benefiting from the State Health Insurance Scheme and at least 120,000 persons will benefit in the coming phase of the programme.
Can you share some of the major challenges you face in providing solutions for PHC strengthening in your state?
Prior to 2020, most PHCs in the State faced operational challenges that contributed to poor quality of care and this affected the demand for services in PHCs.
Also, decayed infrastructure, inadequate human resources, stock out of essential drugs and commodities, and poor adherence to infection prevention precautions were also major challenges.
However, with increased investment in healthcare, we have been able to improve these conditions through the interventions mentioned above.
With regards to the PHC- Leadership challenge, could you share some of your expectations from the NGF team to facilitate the improvement of the PHC system in your state?
I consider the NGF a central coordinating unit that helps States achieve their stated goals. So far, they have played that role excellently and we are proud of the work that they do. With reference to PHC improvement in States, we believe the NGF will continue to support State's engagements with partners and also continue to use its health scorecard to drive competitive engagement among States.
Kindly share any closing thoughts you have with us
With the COVID-19 pandemic, health care leaders and policymakers, in general, must recognize the need to invest and build a resilient and sustainable health system. This requires deliberate investments in people, systems, and processes that work. In Ekiti, we are committed to this. Our goal as a government is to leave behind for the incoming administration, a system that works.
By Isioma Ononye,
Social Media Officer