12 lessons from the last 12 months. Pt 1
This time last year, I was getting ready for my inauguration. I got sworn in on the 31st August 2020 and commenced work on the 1st of September 2020. It’s been exactly 12 months since I took the leap and like I promised in my last journal, below are 12 things (in no particular order), that I have learned in the past 12 months:
Lesson 1: Be mindful of your biases; every part is important
There is a story about Obasanjo responding to 2 of his Ministers, (who were making an impassioned plea for more resources to be sent to their ministry rather than the other) with a threat to swap their ministries, if they continued arguing about which ministry was more important.
I met a ministry with fragmented coordination of functions and roles. The State Primary Health Care Development Agency for instance, felt they had long been marginalised by the State Ministry of Health and were keen to establish their independence. The Hospital Management Board felt they were the step-child, and the State Ministry of Health and the Teaching Hospital had a subtle but noticeable rivalry (like co-wives). Each agency/institution considered itself the most important, with others only as adjutants.
Worse still was that even within the ministry, there were intra-departmental contentions. It was not uncommon to hear statements like “if we situate that initiative at the teaching hospital, the Ministry won’t have oversight” or “the malaria program should be under us at the primary healthcare development agency” or “we need our own program and team different from what they have”
This subtle intolerance for one another, could be attributed to human biases, limited clarity in job functions and poor coordination of the different MDAs.
I realised early enough that by bringing together the heads of the different agencies and institutions within the health sector, I could bridge that gap. Afterall, I was the Commissioner for Health and Human Services, not the Commissioner for health programs, or primary care or public health security.
A quarterly intra-sectoral meeting instituted earlier this year, has allowed us reshape the terms of engagement. The meeting provides the different institutions the platform to share their progress, offers an opportunity for feedback and ensures clarification of functions. All of which have helped to foster harmony, increase transparency and engender trust within the team.
People now better appreciate the different roles played by others and are more willing to collaborate. There are still instances where statements such as “we need the funding more, Honourable Commissioner, can they get support through another source?” are expressed, but this is a much better place to be as it indicates a focus on resource allocation rather than the cynicism and passive aggression expressed towards one another, this time last year.
Lesson 2: Mission Impossible or 1+1 = 11 (Motomatics)
Outcomes in healthcare unlike other sectors take a long time to bear fruit and are often intangible. For instance, if I tell Seyi the pepper seller that we have reduced neonatal mortality by half, he’s unlikely to appreciate the importance, compared to a road built in his community.
Yet, as policy makers, improving health outcomes is what we should be most concerned about. With a maximum of two years as Commissioner (our administration ends in October 2022), I would have to compress about 4 years of work into 1.5 years if I was going to be able to show some results.
In the past 12 months, we’ve had to pluck all the low hanging fruits by leveraging every single support we could muster. We have renovated 45 plus primary health facilities, with support from multiple partners, we have equipped these facilities by leveraging existing relationships with colleagues in the private sector. We have bolstered our public health security capacity with the establishment of a fully functional laboratory, we have improved our ability to manage critical care cases with the establishment of an oxygen plant. We have put in place a continuous quality improvement plan in selected primary health centres and increased the number of health workers at service delivery points. These amongst many other tangible projects are embedded within a broader long-term vision, which we are locking in, by establishing the relevant laws and policies.
What seemed like mission impossible just a year ago, now looks like 1+1 = 11.
Lesson 3: Excellent work can only thrive in a favourable environment
Whatever success we have recorded as a ministry in the last year can be attributed to the favourable authorising environment that we are privileged to have under the leadership of His Excellency, Dr John Kayode Fayemi.
He has demonstrably displayed support and signalling to create a favourable environment for me to deliver, and I am grateful for that.
Equally important is the team he has assembled. My colleagues in the ministries of Budget, Finance, Justice, Bureau of Public Procurement, Office of the Development Partnerships, Office of Strategy and Communications and the Secretary to the State Government to mention just a few, are all stellar individuals who understand clearly the linkages between health, productivity, economic growth and development. This has made my work easier.
Lesson 4: To stay relevant, you have to re-invent yourself at least 3 times
One of my mentors said to me about 4 years ago, “Banji, in a lifetime, to stay relevant you would have to re-invent yourself at least 3 times”. I thought that was really profound given the rapidly changing nature of work globally. I started off post medical school in the private sector working with a Health Maintenance Organisation (HMO). For a long while I thought that was going to be my niche. To strengthen my capacity in this area, I got an advanced degree in health economics. However, I left the private sector for the not-for-profit development sector and in the last one year, I have been in public office; focusing on policy, programme implementation and health financing reform. I do not know how many times I may have to re-invent myself but one thing I’m sure of, is that it will have to happen again.
Lesson 5: You’re only as good as your last gig
As I reflect on my work history, I realise most of my work experiences and jobs have been based on referrals from people who knew me from afar. For instance, I did some free work for a friend who happened to be related to the then Minister of State for Health (I didn’t know they were related). He subsequently referred me to the then Minister of State for Health, so I moved back to Nigeria and worked with him for three months. Following that, I went on to work with HSDF, and also got referred to the former Minister of Health, who in turn appointed me as the technical lead for the Basic Health Care Provision Fund, from that opportunity I got a gig with the World Bank and now I am a Public Servant.
In all of these, one thing that has remained consistent is the fact that one opportunity always led to the other. A key thing I’ve learned along the way is to do every job like it’s my last. Sometimes, the job may be thankless, sometimes you may not get the credit for your work or the rewards that should come with it, but you have to keep doing better. I would advise that younger people focus on doing excellent work and forget the glory. Eventually, it will show, your work will speak for you and when you leave, there will be a clear difference. If you’re good today, be better tomorrow, and if you’re better, then become the best. Always be progressive because, you’re only as good as your last gig.
Lesson 6: “Ta ló sopé kò pò kè” changes everything
Since I resumed in Ado-Ekiti, I’ve been within the State for most of the time, but every now and then, engagements take me out of town, most times to Abuja. It appears as though anytime I visit Abuja there is always some new development. New structures, restaurants and a lot more. Either the city was waiting for me to step away or there’s an influx of new money or the pace of development has always been the same and I’m only noticing because I’ve been away for a bit. Whatever the reason is, Abuja, in the evergreen words of Rexxie, is giving some OPP vibes, ó pò pa!