1. Measuring Health Policy Development Capacity in Nigeria
Allison Goldberg, Ph.D. Candidate
Columbia University

2. Outline of Presentation
The Purpose
Innovative Methodology
Baseline Results
What’s Next?

3. Purpose of the Assessment
Provide a baseline assessment of health policies developed at the Federal and State Government levels in Nigeria that can be measured against future policies developed with PATHS2 support
Output 1.1 and 2.1
Number of new and revised state and federal policies
developed with PATHS2 support that are consistent with the
National Strategic Health Development Plan (NSHDP)
and meet a minimum quality standard

4. What Are We Measuring and Why is this Important?
The Policy Cycle
Agenda
Setting
Policy
Formulation
Policy
Implementation
Policy
Evaluation of Effect
on Outcomes
Feedback
Political scientists devoted to public policy issues have used a fairly common heuristic framework to provide a conceptual grounding for public policy analysis. This framework consists of discrete phases associated with the policy process. Some political scientists have identified as many as seven stages, but the convention is 4.
Agenda setting: Stage where issues gain ascendancy as they compete for the limited attention of policy-makers.
Policy Formation: This is the stage where the the policy itself is defined.
Policy Implementation: this is where policy decided up is put into action Policy Evaluation of effect on outcome: this is where questions such as “has the policy worked?” “how can we improve policy implementation” are answered.
Anderson, James E. (1972). Public Policy-Making. New York: Praeger Publishing.

5. Methodological Underpinnings
Adaptation of the World Bank and partners’ Performance Measurement Framework (PMF)
An international standard for measuring National and State Government performance across a range of areas (e.g. financial, institutional oversight, service delivery)
SPARC and ESSPIN (Parallel Projects of DFID) also adapted the PMF to assess the institutional functionality of State bodies (e.g. QA, policy & planning, budgetary accountability)
Performance Measurement Framework (June 2005). PEFA Secretariat, World Bank, Washington DC, USA - PEFA includes World Bank, IMF, European Commission, UK, France, Norway, Switzerland and SPA Strategic Partnership with Africa.

6. Measurement Framework
Minimum Quality Standard
Clear goals and objectives
Clear and actionable implementation plan
Feasible budgets
Baseline information and research findings and/or national or international policies and guidelines are used to inform the policy development process
Consistent with National Strategic Health Development Plan (NSHDP)
The views and opinions of local government, civil society and non-governmental sector actors were taken into consideration
Policies address the needs of disadvantaged groups, such as women and children, the poor, those living with HIV/AIDS, and others
Policies include language that is consistent with the Millennium Development Goals
Domain 1
Domain 2

7. Scoring The Indicators
Scoring: Consistent with NSHDP (Domain 2)
Policies include language that is consistent with the Millennium Development Goals
Atleast six MDGs are explicitly referenced in the policy and some of the goals and/or objectives are aimed at meeting MDG indicators A
Atleast half of the MDGs are explicitly referenced in the policy and some of the goals and/or objectives are aimed at meeting MDG indicators B
Less than half of the MDGs are explicitly referenced in the policy, but none of the goals and objectives are aimed at meeting MDG indicators C
The MDGs are not explicitly referenced in the policy D

8. Scoring the Domains Scoring: Consistent with NSHDP (Domain 2) B C
Policies include language that is consistent with the Millennium Development Goals
The views and opinions of local government, civil society and non-governmental sector actors were taken into consideration B
Policies address the needs of disadvantaged groups, such as women and children, the poor, those living with HIV/AIDS, and others C
Domain II Score

9. Complete Scoring Matrix

10. The Policies National Policies (n=16)
Revised National Health Policy
National Anti-Malarial Treatment Policy
National Policy on Population and Sustainable Development
Nigeria National Medical Laboratory Services Policy
National Policy on Infant & Young Children Feeding in Nigeria
National Workplace Policy on HIV/AIDS
National Policy on Integrated Disease Surveillance & Response
National Policy on Food & Nutrition in Nigeria
National Blood Policy
National Human Resource Policy for Health
National Child Health Policy
National Health Financing Policy 2006
Health Promotion Policy for Nigeria
Maternal, Newborn, & Child Health in Nigeria
National Policy on HIV/AIDS
National Health Equipment Policy for Nigeria
State Policies (n=3): Enugu, Jigawa, & Kano State Health Policies

11. Overall Results A B C D
Half of the national policies scored a B while the other half scored a C+
Two out of three state policies* earned a score of a D+
Only the State Health Policies of Jigawa, Enugu, and Kano were included the baseline assessment. Few state specific health policies were reviewed since many states follow national policy guidelines

12. National Policies Disaggregated by Domain
The modal composite scores for the MQS and NSHPD domains were a C+ and an A
respectively
The policies performed much better in Domain 2: Consistency with the NSHPD

13. More Results on the National Policy Analyses
MQS (Domain 1)
All policies assessed were found to have clear goals and objectives
No policies included a feasible budget
Only two policies* contained a clear and actionable implementation plan
Consistency with the NSHPD (Domain 2)
The majority of policies (9) clearly described the process by which
opinions and views of local government, civil society, NGO, and others
were included
All but 2 policies explicitly referenced the need of disadvantaged groups
(e.g. women, children, people living with HIV/AIDS)
Benchmarks on the use of language consistent with achieving the MDGs
were less commonly met than the other indicators assessed
4 policies, including the Child Health Policy and the National Policy on
HIV/AIDS, referenced less than half of the MDGs and omitted MDG
indicators from the goals and objectives
*National Medical Laboratory Services Policy and the National Human Resource Policy for Health

14. State Policies Disaggregated by Domain
None of the include actionable implementation plans, budgets, and indications that
the policies were evidence-based. Only one policy specified clear objectives
2 policies referenced the need of disadvantage groups
None of the policies referenced the MDGs

15. What’s Next?
Applying same tool in the next 4 months to compare to baseline
Receiving HS 20/20 project funding to link the policy formulation,
policy implementation, and policy evaluation stages
Agenda
Setting
Policy
Formulation
Policy
Implementation
Policy
Evaluation of Effect
on Outcomes
Feedback
Anderson, James E. (1972). Public Policy-Making. New York: Praeger Publishing.

16.
Thank
you