Site Improvement through Monitoring Systems Assessment: Feedback Report for the Society for Family Health’s Integrated Child Health and Social Services Award 3 Project in Nigeria

The assessment aimed to review whether processes for HIV service provision were in adherence with USAID standards. The assessment was conducted on December 16, 2022, and the results provided information to support strengthening structures and processes for quality service delivery to U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) beneficiaries. All required and relevant elective core essential elements were assessed, and the strengths and weaknesses observed at the site were highlighted. Copies of the dashboards containing the summary of the assessment findings were provided to the site and the implementing partner’s representatives. The site team was engaged on the importance of addressing all identified gaps in stipulated timelines. The assessment revealed that there was availability of written procedures for stakeholder engagement, evidence of routine activities to support data quality, availability of a child safeguarding policy, and adequate documentation for gender norms and post-violence care services. However, the availability of policies on patient rights posted in plain view and the timely documentation of family care plans needed improvement. The Green Pasture and Home Initiatives site was assessed, and the following strengths were observed: the availability of a written procedure and evidence of training on stakeholder engagement, the availability of child safeguarding policies with documented evidence of annual staff training, the availability of a documented process or set of standard operating procedures (SOPs) to ensure that data collected at the site and reports to stakeholders accurately reflect the services provided, the availability of evidence that the site meets and reviews key programmatic/performance indicators at least quarterly, the availability of a documented site-level plan for program improvement or quality improvement initiatives outlining roles, responsibilities, activities implemented, and quantifiable projected outcomes, the availability of SOPs for the management of orphans and vulnerable children, the availability of post-gender-based violence services, and the availability of SOPs and supervisory mechanisms for gender norms interventions. However, the following weaknesses were observed: lack of policies on patient rights, stigma, and discrimination posted in plain view, and inadequate documentation of family care plans in the client charts reviewed. The assessment team made the following recommendations to the ICHSSA 3 project for health system strengthening: policies on patient rights and responsibilities should be printed and posted in plain view at Green Pasture and Home Initiative, and a routine audit of folders should be conducted at the site to update documentation for the family care plan. The SIMS assessment is a critical component of the ICHSSA 3 project, which aims to strengthen the health system in Nigeria. The assessment provides valuable information to support the project's goal of improving the quality of HIV services provided to PEPFAR beneficiaries. The recommendations made by the assessment team will help to address the identified gaps and improve the overall performance of the Green Pasture and Home Initiatives site.