Explanations offered follow a narrative: the first tranche of the bonus was not enough to pay for the renovation planned. With the N124m left over from the first $1.5m still running, the state government expected SOML would get a regular $1.5m every year.
Any additional fund over the $1.5m was for the state government, which had a right over the incoming bonus. In fact, any additional funds to SOML were a favour from the state government.
But when the first 25% of $10.6m bonus was not enough to pay for planned contracts, the order came to halt SOML.
Sources say the order to stop the programme was never communicated in writing. But the programme halted nonetheless.
The state programme manager Sabitu Tsafe would not respond to questions about the programme.
“The first money we receive is about 25% of the total money which is not enough for the renovations at hand. As a result, we suspended all the activities,” an insider said.
“If for instance the total money earmarked for renovation of three general hospitals is 1.9 billion naira, and you have 1 billion naira, you should give us. There is no need to wait till you have N900 million before we carry out the renovations.
“Does it mean during that time, we won’t be doing anything? Let’s do everything concurrently.”
Another source close to Zamfara’s work plan said, “I believe they just want to mismanage the money and go but our problem in Zamfara is that nobody wants to talk.”
Daily Trust in November reached Suleiman Gummi, the former health commissioner under whom SOML started, to get his sense of SOML implementation.
Gummi had handed over to Liman after a cabinet shuffle in January. He said since handing over and leaving the ministry, he “couldn’t give account”.
“I handed over the affairs of the ministry for the past eight months. It is not fair for me to give account of that ministry,” he said.
Days later, Daily Trust reached Liman, who head Zamfara health ministry when SOML was halted.
He said, “Better speak to the permanent secretary. I’m not in a position to speak to you now on that. Let me talk to the permanent secretary to talk to you. I will call him.”
Daily Trust had previously in October visited Zamfara and spoken with Habibu Yalwa, the permanent secretary of the state health ministry. He said he had no permission to comment on SOML, insisting the commissioner—already months away in politics since winning APC state chairmanship in May—was the face of the programme.
He noted up until then, no replacement had been named for Liman, nor did he definitively resign his position as commissioner.
And that stalls the programme, inasmuch as it needs administrative approval.
Daily Trust asked whether the state government controls SOML, even though SOML funds are separate from Zamfara’s coffers.
The insider at the health ministry replies a resounding yes. “Who appoints the commissioners? Who are the approving officers for SOML? The commissioners and the perm secs are the approving officers. If you don’t have approval, what do you do?
“In as much everything you have to do, you have to write and obtain approval and that approval is not forthcoming, what do you do?” he said.
“But there is no commissioner,” Daily Trust replied.
“He gave the directives,” the source responded.
Zamfara buys ambulance with SOML but there's no certainty it will contribute to its SOML assessment
Zamfara’s SOML raises questions: how much control the state has over SOML funding and decisions and how much the national office of SOML in the federal health ministry have over work plans it approves for states.
Daily Trust had been in touch with SOML national coordinator Ibrahim Kana but reached him with further questions about the programme’s independence while he was away in Washington, DC.
He responded to the first question. “We approve plans for the states but not necessarily telling them what to do. The main focus of the programme in terms of funds flow is restructuring its flow, allowing states take substantial decisions with responsibility. However, we reserve the right to prevent states from spending their funds on areas we know are not going to influence [primary health care]. This happened at various times when states want to build big hospitals or diagnostic centres. We also reserve the right to send auditors to them.”
To the second question, he responded: “The fact that the state does not have a commissioner doesn’t prevent them from working. We operate with the system and not persons or individuals. We expect the permanent secretary to convene a steering committee meeting and forge ahead. After all, [following] transitions, there are no commissioners, so it is not new.”
Maternity ward at a PHC in the capital of Zamfara, months after SOML was halted
Hauwawu Mohammed and Jummai Abubakar works at a primary health centre at Tudun Wada, right in the heart of the capital, that caters to thousands who live around it.
On average, up to 40 women attend antenatal clinic there weekly, and three give birth every day.
The maternity room contains two beds donated by a nongovernment organisation. Four other beds are used in one ward. A second ward has no bed at all.
Drugs in the centre’s pharmacy come in two kinds: one sourced free from the anti-malaria partners and another subsidised on a revolving fund model.
Both women feel their patients are better off, they say on a visit to the centre.
Across health centres, dilapidation in the face of millions of naira that can make a difference is apparent, says one source, who works with a development partner in the state.
“As it is now, it is only in Zamfara that if you go to most of our facilities sometimes the officers in charge of those facilities especially those local government areas, they have to be pursuing animals,” she said.
“In so many places, you will see delivery beds supported by stones in Zamfara State. In most cases, a woman will be in labour and rain will be dripping on her forehead. And we have the resources, but we are not willing to address it.”