Process Monitoring Summary Results: Kebbi

The evaluation focused on the Integrated Health Project (IHP), Breakthrough ACTION-Nigeria (BA-N), and the Global Health Supply Chain Program – Procurement and Supply Management (GHSC-PSM, henceforth PSM). The Activities are known as the "tripartite USAID project" in the State. Monthly coordination meetings among the Activities are a key collaboration mechanism, facilitated by IHP. These meetings aim to share work done, plan for the upcoming month, harmonize workplans, and discuss challenges and brainstorm solutions. The Activities also invite each other to their specific coordination meetings to enhance coordination and effectiveness. For example, PSM invited IHP to its family planning coordination meeting, and IHP subsequently addressed some challenges with Local Government Authority (LGA) family planning coordinators. The Activities have a monthly briefing meeting with the State during which they present progress on their work. Activity respondents also mentioned several technical working groups (TWGs) and State and local officials with which they coordinate on varying schedules. BA-N and IHP provide technical assistance (TA) and coordinate with the State Ministry of Health (SMOH) and the Primary Health Care Development Agency (PHCDA) through two coordination units. Meetings were held daily, but with the emergence of COVID-19, are occasionally held every other week. They also use a WhatsApp platform to share information. The Activities reported that their monthly coordination meetings help facilitate collaboration and partnership, help avoid clashes of activities, and provide an opportunity to share cross-cutting issues and develop solutions. The meetings also provide a forum for capacity strengthening. The Activities reported that coordination meetings with the State allowed the State to see the individual contributions of each Activity and how their work is harmonized. Activity respondents said that coordination with the State through the various TWGs works well. Both Activity and State respondents stated that the co-location of offices helps with communication and coordination. Some State respondents noted that the PSM is temporarily co-located with BA-N and IHP due to a fire. Normally, PSM is co-located with the LMCU. State respondents appreciated PSM's co-location with the LMCU because the activity provides direct technical support. IHP also has offices embedded in three LGAs, which facilitates communication and coordination with the State at that level. State respondents reported good relationships with the Activities, but noted some challenges. One Activity respondent reported that, at times, the three Activities invited the State to the same meeting. The Activities also advised that there were months when they did not meet because of competing demands. The Activities' WhatsApp listserv was described as "not very active." One Activity respondent said that State satisfaction with coordination was about 70 percent, noting that the State is reluctant to fund activities. The State's reluctance to take ownership and to fund activities was echoed by respondents from the other Activities. One Activity respondent reported a need for high-level advocacy with top government officials to address issues around funding. Responses from IHP and State interviewees suggest that there was a difference in the State's versus IHP's interpretation of IHP's scope and role, and a tension around how IHP's funding procedures differ from those of other funders. These differences in expectations may be partly due to the way the State engages with other development partners. The differing expectations about IHP procedures was confirmed by two State respondents. One respondent elaborated, "They [IHP] are the ones coordinating, not the State, which is supposed to coordinate….The whole responsibility of coordination is under them; there is no ownership by the State." This respondent felt that IHP and the State need to develop a shared understanding similar to that with other partners.