1. NIGERIA STATE HEALTH INVESTMENT PROJECT IN NASARAWA STATE – Update on NSHIP activities
Presented: December, 2016

2. Objective of NSHIP
To increase the delivery and use of high impact maternal and child health interventions and to improve the quality of care at selected health facilities in the participating states.

3. NSHIP DEVELOPMENT INDICATORS
Proportion and number of month old children fully immunized;
Proportion and number of births attended by skilled health providers;
Average of Health Facility Quality of Care Score;
Number of outpatient visits by children under five; and
Direct Project Beneficiaries (2,469,175), of which 53% are female.

4. The project consists of two components :
PROJECT COMPONENTS
The project consists of two components :
Results Based Financing (RBF) – PBF and DFF.
Technical Assistance (TA) – State and National
The RBF component has two sections:
Strengthening Service Delivery mainly at the health facility level
Strengthening Institutional Performance at the Federal, State and LGA levels.
The TA component supports the implementation of the RBF at LGA, State and National levels

5. UPDATE ON NSHIP ACTIVITIES – July to September2016
Coaching and Mentoring of health facilities on Business Plan development – Recurrent
Monthly Quantity verification of PBF facilities – Recurrent
Quarterly LGAs Steering Committees meetings and Assessment of HMB and LGAs PHCDs – Recurrent
Quarterly Payment of Bonuses /subsidies to beneficiaries -Recurrent
Mentoring and coaching on financial and procurement managements – Recurrent
Technical Working Group and State Steering Committee Meetings – Recurrent
Advocacy visits to key stakeholders – Recurrent

6. UPDATE ON NSHIP ACTIVITIES – Cont ……….
Launch of DSF in Wamba in November, 2016
Capacity building of health workers on IMCI, Data validation, HCWM, TPM, and participation in National meetings
Financial management training in Kokona LGA
Participation in NSHIP 2016 Detailed Implementation Plan (DIP) development

7. Continuation of Household Numbering report by LGAs
UPDATE ON NSHIP ACTIVITIES – Cont ……….
Continuation of Household Numbering report by LGAs
Quantity counter verification (Community Client Satisfaction Survey)
Finalization for the engagement of communication consultant and M&E specialist for SMOH
Stakeholders meeting with LGA IMC Chairmen
NSHIP Mission to the state and performance review of project with focus on Hospitals
Radio programmes and TV sections in view

8. Activities Gallery

9. Challenges to Health system and RBF implementation in Nasarawa State
Weak supervision of health facilities by LGA PHCD, SPHCDA and HMB
Misapplication of funds at health facilities and poor of implementation of audit procedures by the state and LGAs and non enforcement by supervisors eg Nasarawa and Kokona LGA Audit report
Poor implementation of strategies in business plans by health facilities and no enforcement from supervisors.
Security challenges are still affecting some wards in the State especially in Doma and Nasarawa LGAs.

10. RECOMMENDATIONS
There is need for the PHC departments to continuously build the capacity of health facilities in the areas of data management and treatment protocols and service delivery guidelines.
Capacity building of the PHC department team and HMB teams and health facilities managers to improve their managerial and supervisory capacity.
PBF to stimulate demand for low performing services .
Health worker streamlining should be done in consultation with the project staff to minimise the effect of capacity gaps at contracted health facilities.
Health facilties to continuously improve the quality of care

25. LGA
NO OF HFS
AMOUNT BUDGETTTED
Quality Score
Amount Earned
Nasarawa 39
88%
Toto 31
61%
Doma 37
86%
Akwanga 30
60%
Karu 66
64%
Wamba 20
Kokona 29
keffi 17 5%
Awe 24
Lafia 57
Nasarawa Eggon 35
37%
Keana 21
Obi 6%
HMB
59%
TOTAL
453

31. NSHIP MSSIOM AIDR MEMOIRE
Poor Management of General Hospitals
Lack of logistics for supervision
Lack of support to HMB and SPHCDA for supervision from DLI fund
Poor service indicators and quality of General Hospitals
Commended the state for autonomy of DRF management by Hospitals
Poor performance in the area of Family planning uptake by the state
Negative effect of strike on health service delivery

32. ACTIVITIES NOT ACCOMPLISHED FOR 2016
Quarterly quality counter verification
Second PBF internship Programme
Training on emergency Gynaecological and obstetric care for PBF and DFF Health facilities
Essential drugs and clinical management training

33. THANK YOU!