Continuation of Memorandum of Understanding. Follow up meeting was done by Dr. Ogunkoya with Professor Akinkugbe as regards involvement of ANPA in Nigerian Medical Care.

Professor Akinkugbe informed Dr. Ogunkoya on the projects initiated by the Nigerian government, which he is the chairman, the report of which is summarized below:

Ministerial Committee Report on standardization of Equipments for Teaching Hospitals and other Federal Healthcare Institutions in Nigeria.

The following teaching hospitals are considered:

1. * ABU
2. Aminu Kano University, Kano
3. * Jos University
4. * Lagos University
5. Nnamdi Azikwe, Nnewi
6. Obafemi Awolowo University
7. Otibor Okhae Teaching Hospital, Irrua, Edo State
8. University of Benin
9. * University of Ibadan
10. University of Calabar
11. Usmanu Dan Fodiyo University, Sokoto
12. * University of Ilorin
13. * University of Maiduguri
14. * University of Nigeria, Enugu
15. * University of P/Harcourt

Orthopedic Hospitals (3)
Neuropsych Hospitals (8)
Eye Specialist Hospitals (3)
Medical Centers (22)

The either institutions with asterisk are already completed and are waiting commissioning period.

The first two to be commissioned are ABU and University of Ibadan. Professor Akinkugbe would like ANPA to come for the commissioning if possible and to articulate a position on the role it can play in the healthcare of the country. A date in late November is anticipated for the commission of the University of Ibadan and he intends to send ANPA a letter of invitation. Professor Akinkugbe is not sure if the commissioning of the University of Ibadan will take place as planned in light of the present conditions with presidency; he will let us know with time.
For your information, a member of the Ministerial Committee report includes:
1. Prof. Akinkugbe - Chairman UCH Ibadan
2. Dr. D. Araf – University of Port Harcourt
3. Dr. Chief Sonny Kuku – Obafemi Awolowo University – Ife
4. Dr. Chief Long John – Aminu Kano University, Kano
5. Professor Fakeye – University of Ilorin, Ilorin
6. Professor Mbonu – Nnamdi Azikwe University Nnewi
7. Professor Yakubu – Chief Medical Director, Ahmadu Bello University, Zaria
8. Dr. Garba Idris – Dept of Hosp. Services FMOH, Abuja
9. Mrs. A. B. Ogu – Dept of Health Planning & Research – FMOH, Abuja
10. Professor Durosiimi-Ett - Chief Medical Director – National Hosp. Abuja
11. Dr. Idowu Koledade – Fed School of Dental Technology & Therapy, Enugu

There responsibilities include:

a) To examine the equipment needs of a teaching hospital and submit list of equipment apparatus and machinery that should be in a teaching hospital.
b) Identify maintenance needs of such equipments as well as the required manpower needed for maintenance.
c) Specify types of equipment capacity, brand names and manufactures of all needed equipment.
d) Submit any other proposals, which will enhance the effective and efficient utilization of the funds that are available for these hospitals.
e) Recommend any other measures that will enhance full availability of all modern diagnostic and treatment facilities for effective tertiary health care delivery.

The Committee summarized cost as follows:

15 – Teaching Hospital = 22.449 billion Naira
3 – Orthopedic Hospitals = 2.321 billion Naira
8 – Neuropsych Hospitals = 1.338 billion Naira
1 – National Eye Center = 0.655 billion Naira
1 – National Ear care center = 0.616 billion Naira
23 – Federal Medical Centers = 8.584 billion Naira

Total Estimated Cost: Projected at 35.965 billion Naira
And 30% markup, 10% infrastructure and service support
Total Estimated Cost: 50 billion Naira.

The committee researched exhausted listing of Unit Cost of equipment and Brand Names for each area of specialty.

The committee recommended strategies in acquisitions of new equipment and suggested that the government should take account of:

1. Involvement of users from the beginning
2. Reference for Suppliers with wide experience track records.
3. Scrupulous attention to installation, commissioning, sourcing of spare parts, guarantee, maintence repairs, and training agreements.

The methods of purchasing suggested by the committee is as follows, the committee suggested selective or open Tendering Procedure:

1. Bulk Purchasing – This encourage s supplier to establish outpost in the country for maintenance and servicing. The disadvantage is that the supplier may hold user at ransom, especially if the equipment is custom built with peculiar specifications.
2. Wet-Leasing – The supplier brings equipment, install, commission, provides spare parts, regular service, trained personnel to operate them.
Advantage:
a) Transparency friendly-chances of buyer or supplier to inflate cost is less than bulk purchasing.
b) New version can be brought to replace old with cost implication.
c) This does not tie down capital although user does not end up owing equipment, but would have gotten value for money.

The committee recommended a 50/50 Basis of Acquisition with a time frame to appraise merit.

The Committee also recommended consideration for-factory-refurbished, used-but-functioning equipment.

They recommended encouraging, indigenous efforts to manufacture and fabricate equipments starting with less expensive once.

The committee also suggested manpower training for maintenance at Enugu, Zaria, Maiduguri and Lagos.