"High insecurity, difficult terrain and lack of health workers, medicines, equipment and basic amenities such as safe water are making access to essential, lifesaving healthcare extremely difficult," says Dr Wondi Alemu, WHO representative in Nigeria.
WHO has been working with the Borno State ministry of health to set up a health resources availability monitoring system (known as HeRAMS) to collect information on the availability of health resources and services in this humanitarian crisis.
The first report from this new system has identified 743 health facilities in Borno State, of which 35% are completely destroyed, another 29% partially damaged and only 34% intact. About 100 temporary health facilities have been set up to support the response, of which 49 are emergency clinics for displaced people living in camps.
Of the 481 health facilities that have not been destroyed, 31% of them are not functioning, mostly as a result of lack of access due to insecurity. Almost 60% of health facilities have no access to safe water (32% have no access to any water at all) and three out of four (73%) facilities do not have enough chlorine stocks to decontaminate the water used in the facility.
"The information from this system is critical to identify gaps that need to be addressed urgently," says Kadai Baba Gana, deputy director for planning, research and statistics in the Borno State ministry of health and the HeRAMS task team chairman. "This will help us to better coordinate and monitor the response and guide the allocation of scarce resources."
HeRAMS is a rapid online system used to monitor which health facilities, services and resources are available and accessible in emergency settings. Health workers are trained by WHO to enter key information into the system about the clinic or hospital where they work. This information includes the kind of services the facility can provide, whether the infrastructure has essential resources like electricity and water, the skills of health workers, and the type of services, equipment and medicines available as well as support received from external partners. Information is updated regularly to help monitor improvements or new gaps in services.
Around 60% of the health facilities in north-eastern Nigeria are currently being supported by one or more of the 18 health partners responding to the crisis.
However, more resources are needed. The United Nations and partners need $94m to provide health services to 6m people, more than half of them children, in this crisis. Of this share, WHO needs $31m to deliver on its response plans in 2017.
