Presentation on theme: "The Adamawa Primary Health Care System"— Presentation transcript:
1 The Adamawa Primary Health Care System Dr Abdullahi Dauda BelelChairman, Adamawa SPHCDA, Nigeria23rd April 2014
2 Presentation Outline Background Information PBF Introduction Progress in implementationResultsWhat’s Responsible?
3 Background Information Adamawa State is located in Northeast of NigeriaProjected 2014 Population of 3,87mHas 21 LGAs and 226 WardsAmong the 5 poorest States in NigeriaA major contributor to the Nigeria’s poor health indicatorsHealth sector has very minimum private sector participation while the public facilities are in a deplorable State
4 In Nigeria, Health centers suffer from underlying systemic issues What you will see at a primary health care center:Relatively abundant workers (among top in SSA)Chronic stock-outs of essential drugs (Avg. 55%)Lack of minimum equipment (Avg. 25% equipped)Poor sanitation/waste managementIdle health workers/absenteeism (Avg. 29%)Correct mgmt. of maternal complication (17.3%)No patients (Avg. 1.5 patients per day)Underlying systemic issues:Fragmentation and poor coordination between federal, state and local govt levelsUnclear accountability and poor performance review to strengthen itNo incentives to good or poor performanceNo cash and autonomy at health facilitiesShunSource: Service Delivery Indicator (SDI) Survey, 2013LON-AAA
6 Background Information The entire sector is currently under reform, using PBF as a strategyThe State is piloting PBF for GON but adopted it as strategy for strengthening the health systemFocused primarily on strengthening the Ward Health System (WHS) and Primary Health Care Under One Roof (PHCOUR)Ensuring that funds are made available at the service points, guided by deliberate and focused plansMNCH is placed at the frontline in PBF design and its scale up is supported by EU-UNICEF
7 Background Information Implementation arrangements is aligned to the attainment of the NSHDP’s objectivesPre-Pilot evaluation revealed encouraging results and further clarified areas for immediate and long term adjustments for the scale up
9 Progress in Implementation Key Officers: SMOH, ADPHCDA trained on PBF In Mombasa-Kenya and Enugu-NigeriaPre-Pilot (Fufore LGA) was chosenRural LGA – Pop ~ 240,160Political Wards: 11A Cottage Hospital (Secondary HF)Baseline assessment of HFs and Communities done
10 Progress in Implementation 15 HFs selected: 14 HCs for MPA & 1 GH for CPAManagement structures at LG level constituted and inaugurated (2012)LG RBF Steering CommitteeWDCsHF RBF Committees (both HCs & Hospital)IMC (both HCs & Hospital)Bank Accounts for both HCs & Hospital opened
15 Increase coverage across the 3 PBF States Institutional DeliveryAdamawaNasarawaOndoAssumption: Estimated crude birth rate (per 1000 pop): Adamawa (51), Nasarawa (38), Ondo (32)
16 Quality scores are converging at high level but still have variations across states AdamawaNasarawaOndo
17 Significant improvement has been observed in many areas, with a few areas of consistently low scores From (2011)To (2013)AdamawaNasarawaOndo
18 What’s Responsible? Many factors but mainly Political will supporting change by the State GovernorHaving clear institutional arrangement with separation of functionsHaving PHC Under One Roof and empowering the PHC Agency with autonomyStrong mentoring (and WB TA support) and follow-up programme by the SPHCDA using the PBF ManualAutonomy given to the facilities to improve their staff strength, engage communities and utilize cash to solve immediate needs
19 Thank you PLEASE VISIT US @: http://nphcda.thenewtechs.com &
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