PROF. JOHN OKENIYI’S SIX-MONTH PROGRESS REPORT AS CMD, OAUTHC, ILE-IFE

Yesterday marked six months since I have been the Chief Medical Director of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife.

I am deeply honoured to have been appointed by His Excellency President Bola Ahmed Tinubu, GCFR, as the substantive CMD of our dear hospital.

This historic appointment marked a significant milestone as the first alumnus of both OAU and OAUTHC to hold this esteemed position. Despite encounters posed by prevailing industrial tensions, I remain committed to leading with diligence, integrity, and a profound sense of purpose.

Before assuming office, I recognized the need for urgent reforms as our hospital faces significant yet familiar challenges. My gratitude goes to Prof. Lateef Salawu, my immediate acting predecessor, for an excellent handover note. However, certain issues became only apparent upon my resumption and all of them demanded a quick understudy, prompt intervention, and immediate revitalization. My vision and mission remain clear: to collaborate with all stakeholders to enhance and ensure excellent healthcare service delivery, training, and research. My fervent prayer is that together, we will make good on this dream. I humbly present to the hospital community the transcript of my journey this past six months at the helm of our affairs.

EMPLOYMENT-RELATED ISSUES

• Resolved the age-long issues of career stagnation in the laundry and tailoring unit.
• Resolved the issue of 400 junior staff embroiled in appointment irregularities.
• Approved government minimum wage for all categories of casual staff.
• Resolved 13-month arrears of hazard allowance.
• Payment of accrued accident-free awards to drivers to enhance productivity.
• Transparent Intern Appointments: Recent intern appointments followed extant rules and regulations. The guidance of the Federal Ministry of Health and Social Welfare (FMoH&SW) was sought and obtained. And, departing from past practices, slots were not allocated or sold as appointments were based on merit.
• Following the directive of the Honourable Minister of Health and Social Welfare, We conducted successful transparent suitability tests to address the over-establishment that followed the maladministration of the 2022 employment waiver. The results and reports have been forwarded to the Ministry appropriately.

LEADERSHIP APPOINTMENTS

• Prof. (Mrs) Josephine A.E. Eziyi: Chairman, Medical Advisory Committee (MAC) – the first female to be so appointed in the Institution.
• Mr Olajide Olanrewaju Omonije: Acting Director of Administration – deployed from the Office of the Head of the Civil Service of the Federation.
• Dr. Akinwumi Komolafe: Deputy Chairman, Medical Advisory Committee.
• Mrs. Olabisi Ajayi: Ag. Head, Nursing Services.
• Mr. Babatunde Akanji: Ag. Head, Medical Laboratory Services.

Miscellaneous Improvements

• Anti-sexual harassment policy.
• Accreditations and Technology:
• Full accreditation certificates successfully sought and obtained for our various postgraduate training programmes.
• PCR Laboratory accredited to International Standards.

• Electronic Medical Recording: Deployment progress in IHU is now at 25% completion. We have ensured a plan for 100% deployment in Eleyele and the IGC.
• Ijesa Geriatric Centre Unit: We have received donations of medical equipment and consumables worth over One billion Naira.
• Wesley Guild Hospital Unit:
• We have attracted the donation of a fully functional post-graduate automated Chemical Pathology and Haematology Laboratory, and the Female & Male Surgical Ward.
• Donation of Theatre equipment and power generator to the Fistula Centre.
• The Enoch and Folu Adeboye Foundation donated a five-suite Renal Dialysis Unit (under construction).
• Work will soon commence on the rebuilding of the Isolation ward and an Addiction Centre.
• IHU:
• Commissioned a four-bedroom apartment built by the Africa Research Group for Oncology (ARGO).
• We got bed-sheet donations from Sooko Ogunwusi Family.
• Infrastructural Development: Enhancing facilities within the IHU.
• We are vigorously pursuing a new masterplan wherein the Hospital Administration shall be in the Old Phase I Staff Quarters away from the Central Clinical Area. We have begun the spadework for the proposed Finance and Account Building, the new GOPD Building, and the Male and Female Surgical Wards.
• We commenced various civil maintenance on residential buildings, roads, plumbing works, drainages, car parks, perimeter fencing, and painting.
• Image Rebranding: Corporate Services and SERVICOM are leading the Hospital image rebranding:
• Redesigned Hospital Logo.
• Re-launched official social media handles.
• New letterheads.
• Feasibility study for a Public Health FM broadcast Radio.

• OAUTHC College of Nursing Funding: Management, the PTF and the Student Union have signed a tripartite MOU to ensure adequate tuition and funding.
• Federal Character Commission (FCC) Merit Award:
• Recognized the Hospital’s compliance with the mission of the Commission.
• Demonstrating commitment to fairness and equity.
• Collaborations: We have signed memoranda of understanding (MOUs) with three universities, facilitating training for undergraduate nursing and medical laboratory science students.

ACCOUNTING AND AUDIT CONTROL

• GIFMIS: We have ensured that only eligible beneficiaries (“non-regular”) receive payments from the Government Integrated Financial Management System (GIFMIS) platform, adhering to financial rules and regulations.
• Cash Planning Committee and Management Finance Committee: These committees now meet regularly to set priorities, and boost payment transparency, morale and confidence in transactions with the Hospital.
• Debt Clearance: We have cleared significant backlogs of debts owed to pharmaceutical companies, the Ibadan Electricity Distribution Company and other contractors although the debt profile of the Hospital remains daunting.
• Electronic Medical Records Integration: Pursuing full integration of accounting and audit processes using Electronic Medical Records, aligning with national policy objectives. We have attained a little short of 25% implementation.

These measures enhance fiscal management and accountability within OAUTHC.

TRANSPORT UNIT

In the past six months, modest but noteworthy progress has been made within the Transport Unit:

• Vehicle Restoration:
  • Ten unserviceable duty vehicles and two ambulances have been repaired and restored to full functionality using the cash advance system. Our sole tractor and an additional five vehicles are under repair.
• New Ambulances: The Hospital procured two new ambulances.
• Fuel Security: Efficient audit and check systems have significantly reduced incidents of fuel and diesel discrepancy.

WATER SUPPLY

Management has been aggressive in reticulating the wards and offices to existing wells and boreholes and we are weaning off the very expensive distribution of water using tankers.

SECURITY ARCHITECTURE ENHANCEMENT

• Restructuring: The Security Unit has been relocated from the Directorate of Administration (General Administration) to the Office of the CMD in alignment with the directive from the Federal Ministry of Health and Social Welfare (FMoHSW). The Chief Security Officer now reports directly to the CMD (who is the chief administrative and chief accounting officer of the Institution), thus ensuring robust security measures and timely response to intelligence reports.
• Leadership Appointment: The Acting Head of the Security Unit has been officially confirmed based on seniority, character, merit, and competence. Additionally, a new security task force was inaugurated.
• Enhanced Surveillance: Critical administrative areas now have CCTV installations and more will be deployed to the various known flashpoints.
• Salary Arrears Resolution: Outstanding salary arrears in the hundreds of millions owed to outsourced security contractors for years have been resolved. OAUTHC cracker remuneration was upgraded.

CATERING AND DIETARY SYSTEM

• Dietitians’ Role Enhancement: Dietitians rather than the catering unit now coordinate all patient meals, aligning with global best practices while the catering unit handles Management meetings and cafeteria administration.
• Financial Streamlining: A revolving fund account for catering and dietary services has been established with a seed fund instituted for efficiency.
• Efficient Procurement:  Conflicts of interest have been identified and countermeasures instituted. We have streamlined food item sourcing to eliminate bottlenecks.
• Call meals: The process has been audited with revelations of abuse necessitating ticketing and other prudent measures.

ENGINEERING SERVICES

• Project Supervision Enhancement:
• Addressed poor project supervision and execution by Engineers.
• Users’ departments now participate in Bills of Quantities (BOQ) preparation after contract awards.
• Oxygen Plant Restoration: Management has restored Oxygen production to full capacity with turnaround maintenance. We now produce oxygen steadily and are about to procure additional cylinders to enhance the commercialization of oxygen sales to other facilities.
• Oxygen Production Policies: We now better track our oxygen flow chain with inventory and branding of our cylinders. We have also abolished diesel-based oxygen production.
• Power Supply: The Management has repaired three major diesel generators. We have also connected the Paediatric Surgical complex to the Phase IV unit to improve the usage of the Paediatric Surgical Theatre. New generators have been procured for the WGH and Eleyele. The Management is actively pursuing the migration of the supply line to the WGH, Ilesa to the 33 KVA band A grade.

ENVIRONMENT

• Salary Arrears Cleared: Backlogs of salary arrears owed to outsourced cleaners are being settled.
• Weed Clearance:
• Overgrown weeds have been removed, restoring the Hospital’s aesthetics.
• Collaborative efforts with the Environmental Health Department.
• Tools and Materials Procurement:
• Management has included procurement of essential tools and materials for the Environmental Health Department in the 2024 Capital project.
• Management has invested in over 1,000 tree seedlings to be planted to landscape the link road this season.
• Kerb Painting: Management led Hospital staff to paint kerbs on December 16, 2023, as part of the beautification process. The Association of Resident Doctors also led a similar painting of kerbs in Phase II, IHU. These actions enhance the Hospital’s environment and safety.

ADMINISTRATIVE REFORMS

The OAUTHC Directorate of Administration grappled with pressing issues, including allegations of unlawful recruitment, job racketeering, inadequate documentation, and disciplinary lapses. Additionally, the staffing imbalance, with a disproportionate non-clinical-to-clinical ratio continues to pose challenges. Addressing these concerns is critical for the comprehensive transformation of the institution.

Thus, we have implemented the following:

• Enhanced Communication: We now engage regularly with Unit and Department Heads, emphasizing professionalism, transparency, and dedication in their roles.
• Appointment of additional Physicians-in-Charge and Unit Administrators.
• Stakeholder Engagement:
• Aligning with the Renewed Agenda of the President of Nigeria for improved federal attention and funding.
• We continue to engage trade unions, Royal Fathers, community leaders, and development partners to promote harmony and development.

• Revised Public Service Rules (PSR): We have circulated the updated PSR to all staff and professional groups to bring to their sufficient notice issues of general inefficiency and misconduct such as lateness, and unauthorized disclosures.
• Organized Retreat: Staff Training & Adherence to PSR:
• Facilitated a two-day retreat and sensitization program for Management Staff all Directors, Service Chiefs, and Heads of Departments.
• Emphasized strict adherence to the PSR through expert-led sessions.
• We have sought and obtained budgetary provisions for a new administrative building and digitalisation of the Hospital administration.

ANTI-CORRUPTION MEASURES

• We collaborated with the Independent Corrupt Practices and Other Related Offences Commission (ICPC) to re-launch the Anti-Corruption Transparency Unit (ACTU) after years of inactivity.
• ACTU now actively participate in recruitment and procurement processes.
• We ensure that the Unit has full autonomy to function independently.
• We demonstrated our commitment to this course by hosting the 2023 Anti-Corruption and Transparency Day, garnering media attention.
• As a deterrent, cases of indiscipline and acts concerning corruption are now promptly referred to ACTU and the ICPC as necessary.
• To further establish our unwavering commitment to combating corruption within the Hospital, we now transparently disclose the Bills of Quality for all contracts, allowing for end-user and public scrutiny.
• The Hospital has temporarily halted bulk procurements of Petrol and Diesel fuel due to perennial unexplained losses in the fuel reserves at the Maintenance Unit.
• The mortuary services are currently in a very deplorable state, and this is currently under the watchful eye of anticorruption agencies, corrective steps are being taken to revitalize both mortuaries.

Through these measures, we have shown our commitment to transparency, ethics, and meritocracy. It is hoped that these would stabilize the Hospital and restore integrity and efficiency within the Hospital.

It is noteworthy that Management under my administration is yet to implement a budget of its own, but we have only tried to apply prudent prioritisation in the face of biting resource constraints.

PERSISTENT CHALLENGES

Management under my administration is still grappling with several issues some of which are highlighted below:

1. Paucity of critically needed clinical staff.
2. Outstanding promotions and confirmation of appointments.
3. Complex industrial relations.
4. Corrupt Practices.
5. Infrastructural decadence.
6. Poor development of the OAUTHC official website.
7. Poor funding.
8. Poor deployment of Electronic Medical Recording System.
9. Poor and Erratic power supply and investment in alternatives e.g. solar and inverters.
10. Lingering Security Challenges: Regrettably, our Institution has faced relentless attacks of miscreancy, cyberbullying, and campaigns of malicious falsehoods. These barrages, at times, have come with violent threats to lives and property. They heightened following our implementation of policy directives by the FMoH&SW against illegally recruited staff and those involved in over-employment. We urge all concerned parties from within and without the Institution, to seek resolution through legal channels and appropriate authorities and allow the full restoration of safety and peace that fosters development.

I wish to thank every staff and our host Communities, and the Royalties and Political leadership of Imesi-Ile, Ilesa, and Ile-Ife for their patience, understanding, and support. I am also grateful for the support from the Police and other law enforcement agencies. Like Oliver Twist, we however crave more of your support, constructive engagement, and collaboration.

I remain grateful to the Coordinating Minister of the Federal Ministry of Health and Social Welfare, Prof. Muhammed Ali Pate, and the President of Nigeria, His Excellency, Bola Ahmed Tinubu, GCFR for the confidence reposed in me as we align with his Renewed Hope Agenda and God Almighty for providing the enablement.

Professor John A.O. Okeniyi,

Chief Medical Director, OAUTHC, Ile-Ife.