Partnership for Reviving Routine Immunization in Northern Nigeria;
Maternal Newborn and Child Health Initiative

> What we’re doing > Future plans and events

Future plans and events

We are tracking seven key areas or outputs in 2012 -2013. Each of these is highlighted below:

Output 1 Governance
Output 2 – Human Resources (HR)
Output 3 – Systems and services
Output 4 – Operations Research (OR)
Output 5 – Information management
Output 6 – Communication and demand
Output 7 – Federal level

Output 1 - Governance:

Government commitment and resources are essential for sustainable delivery of maternal, newborn and child health (MNCH) services at all levels of government.

“Bringing PHC under one roof”: At state level, particularly in Zamfara and Yobe, the programme will support four areas – strengthening the capacity of the new Boards; restructuring systems, especially finance and human resources; placing services and systems under the new structures; and repositioning of all bodies to their new roles and responsibilities. At federal level, following the acceptance of “Bringing PHC under one roof” as policy, we will work with other stakeholders to ensure rollout.

Minimum service package MSP (MSP) / free Maternal, Newborn and Child Health (MNCH) care: The model for costing MSP and free MNCH services, developed in 2011, will be packaged for use at state and federal levels. High level meetings will be held to showcase the tool. It is hoped that this will lead to wider acceptance and use as a tool to develop a service delivery or investment plan. In addition, we will continue to track progress with the free NHIS schemes.

Advocacy:  The revised approach will see greater emphasis resting at state level and with the state teams. Progress in key advocacy areas will be monitored.

Pooled funds: Experience with the Gunduma pool fund in Jigawa and the PHC fund in Zamfara will be documented and shared as models that can be used elsewhere in Nigeria.

Planning, budgeting and performance reviews: a major focus will be on linking these three activities and ensuring that state Ministries regularly review progress against agreed plans.

Collaborating with SPARC and SAVI: Two of the DFID lead programmes (State Partnership for Accountability, Responsiveness and Capability and the State Accountability and Voice Initiative) have arrived to strengthen governance related activities in Katsina, Yobe and Zamfara.


Output 2Human Resources (HR)

Human resources for health (HRH) are at the core of successful PHC services and in the states the mix and distribution is affected by politics. It is hoped that the arrival of SAVI and SPARC will strengthen activities in this output.

Continue to strengthen HRH committees: This is a key activity to ensure that these committees function optimally .

Health Resource Information System (HRIS):  The target is to ensure reliable and up to date HRH information available on staff distribution and skill mix in target facilities in Clusters 1, 2 and 3 so as to allow HR managers and committees information for advocacy and management purposes.

Support to new SPHCDA Boards: The purpose will be to strengthen the HR components within these new structures for optimal and efficient management of HR resources.

Training school accreditation: we will advocate for and assist the training schools to get accreditation.


Output 3Systems and services

High quality MNCH services need a strong underlying system that provides the necessary drugs, transportation, equipment and supervision. The cluster approach is firmly entrenched and 2012 will see rollout into clusters 3,4 and 5.

Maternal, newborn and child health care

Midwives service scheme (MSS): support for this in 2012 will include developing and implementing a retention strategy, induction in clusters 4&5, training and supportive supervision and documentation of lessons learnt.

Emergency obstetric care (EOC): ongoing LSS training in old and new clusters, evaluation of impact and strengthening the referral system.

Quality improvement (QI): building QI teams at state and facility levels, supporting maternal and perinatal death reviews, exploring QI initiatives through performance based financing (PBF).

Maternal: ongoing support for training and commodity supply for focused antenatal care (FANC), postnatal care (PNC) and family planning (FP).

Newborn and child: supporting the community based service delivery (CBSD) initiative, kangaroo mother care, integrated management of childhood illnesses (IMCI) training and general child health services.

Immunisation: supporting the new vaccine initiative (Penta and MenAfric), seizing all opportunities to strengthen routine immunisation (RI) services including integrating RI with MNCH services and the polio eradication initiative (PEI), and minimising missed opportunities for RI.


Sustainable Drug Supply Systems: rolling out to clusters 2,3&4, strengthening the central medical store (CMS) and the facility health committees (FHCs) to play an oversight role, support CBSD schemes and integrate free health care and SDSS.

Rehabilitation, equipment and transport: continue to support roll out all the way to cluster 6.

Integrated supportive supervision (ISS): key focus is to institutionalise the ISS system and link this to the performance review system.


Output 4Operations Research (OR)

Through operational research, PRRINN-MNCH aims to transform maternal, newborn and child health in Northern Nigeria by establishing an organisational home and institutionalising evidence-based approaches to improving health policy, decision-making and programming.  

Dissemination of findings: advocacy to translate research findings into policy, plans and practice.

Expand pilots: cross output collaboration to expand and rollout pilots – namely PBF, CBSD and the emergency transport scheme (ETS).

Institutional strengthening: training of OR governance institutions and preparing the Health Demographic  Surveillance System (HDSS) site for registration with the InDepth Network and state Ministry of Health management.


Output 5Information Management

Knowledge management is high on PRRINN-MNCH’s agenda: improved data collection systems, innovative information technological methods, and improved data quality can strengthen the management of a health care system and can be used to document and disseminate learning and successes.  

Routine Health Management Information System (HMIS): continue to strengthen the routine system with an increasing emphasis on data quality and use of data.

Knowledge management: this is the year for the programme to capture and record all the important initiatives and innovations across the seven outputs.

Monitoring and evaluation (M&E): continue to strengthen the system and document the impact on programme functioning.


Output 6Communication and Demand

PRRINN-MNCH’s community engagement strategy is built on a thorough understanding of the barriers of awareness, access, acceptability and affordability that prevent people from using MNCH and RI services. By working with communities, the programme can build demand and use of services and improve health outcomes.  

Community engagement (CE): roll out model to clusters 4,5&6; institutionalise the model through engagement with SPHCDA Boards, Islamiyya schools, the national union of road transport workers (NURTW) and through developing guidelines and strengthening LGA demand creation teams.

Community based service delivery (CBSD): rollout the model, train the community health extension workers (CHEWs), strengthen the safe spaces (SS) programme and revise manuals and tools.

Communication: review health promotion policies and provide training; produce and disseminate various communication materials; work closely with religious leaders.


Output 7Federal Level

Ongoing efforts at federal level will strengthen the links between what is happening at state level and the need to get this information into federal level discussions and policy.

“Bringing PHC under one roof”: collaborate with other partners to ensure effective rollout of the policy and the implementation guidelines.

Peer and Participatory Rapid Health Appraisal for Action (PPRHAA): package and share this approach at federal level to ensure wider adoption.

Advocacy: strengthen Health Reform Foundation of Nigeria (HERFON’s) advocacy capacity and assist in the development of regulations for the health bill.

Immunisation: use all opportunities to strengthen RI; strengthen the cold chain; follow up on recommendations from the PEI study and the effective vaccine management (EVM) assessment.

Midwives service scheme (MSS): continue with support for training and reviews; introduce the maternal death review approach piloted by our programme.

Leveraging extra resources: continue with support for the Global Alliance for Vaccines Initiative (GAVI) fund, support the Millennium Development Goal (MDG) fund review process and continue tracking the National Health Insurance Scheme (NHIS).