Nigeria family health services : volume I

The project, which will be implemented by U.S. and Nigerian intermediaries (e.g., PVOs/NGOs, grantees, contractors, etc.), will: (1-2) increase demand for and the availability of modern contraceptives; (3) enhance the quality of FP services; and (4) improve planning and management by public and private health systems. The first component will increase demand for FP services by conducting information, education, and communication (IEC) and advocacy activities at the community, local government area (LGA), state, zonal, and national levels. Efforts will focus in the north on increasing awareness of and support for FP, and in the south on enhancing method-specific knowledge and available sources. Activities will include training for service providers in interpersonal communication and community motivation and outreach, radio drama and community-based traditional media, special videos for rural audiences, and print materials. Advocacy orientation will be a key means of increasing demand, especially at the LGA level. The second component will increase the availability of modern contraceptives. In both the private and public sectors, NFHS will: (1) expand the number of FP services providing long-term methods by technically competent providers; (2) strengthen management and supervision systems; (3) ensure a stable supply of FP commodities to service delivery sites on a timely basis; and (4) utilize cost-recovery schemes. In addition, in the private sector, NFHS will: expand the network of facilities offering FP services, with a focus on long-term methods; employ alternative delivery mechanisms; and segment the market to meet the needs of different socioeconomic classes. In the public sector, NFHS will upgrade service delivery sites and foster integration of FP within the primary health care system, such as antenatal clinics. NFHS will also support human resource and organizational development by providing TA from cooperating agencies and, on a selective basis, funds to match local investments. NGO institutional development under NFHS will include training in clinical services, management and supervision, IEC, cost-recovery, and commodity supply. NFHS will also strengthen public and private capacity to forecast and distribute contraceptives. The costs of FP commodities and services will be shared with the private commercial sector and other donors. The Government of Nigeria will contribute $10 million to public sector commodity purchases over the life of the project. NFHS will also undertake a national social marketing campaign to market condoms, low dose oral contraceptives, injectables, and possibly IUDs. Under the third component, NFHS will enhance FP service quality by upgrading facilities, training staff, and equipping sites. Training will include a national program of competency-based assessments of clinical and counseling staff skills for both the public and private sectors. National- and state-level activities that contribute to quality FP service delivery, such as the development and institutionalization of pre-service curricula, will be supported. To eliminate inequities between public and private sector facilities in terms of standards of practice, quality of care, training requirements, and reporting protocols, NFHS will periodically monitor the private sector facilities and employ quality assurance tools. Findings will be shared with private sector organizations. Finally, the project will improve planning and management of public and private health systems. Policy activities will be directed towards building support for the National Population Policy and the National Population Program and towards effective planning and implementation in the public and private sectors. To ensure sustainability, the capacity of the health system to design, implement, and assess specific activities in maternal child health/FP will be enhanced. Efforts will focus on: strengthening functional components of the health system at the federal, state, and LGA levels, as well as in the private sector; strategic planning and budgeting; health information systems; IEC; operations research; logistics; and training.