Watch NNNGO-PAS’s Barr. Ayo Adebusoye talks about “Nigeria’s Health Infrastructure -Need for State of Emergency ” on the Lagos Television (LTV) program ‘Talk Time on Morning Delight’.
The development Research and Projects Center (dRPC) is organising a “one day high level strategic dialogue” on advocacy and accountability on routine immunisation in Nigeria.
The dialogue is being organised in conjunction with the National Association of Community Health Practitioners of Nigeria (NACHPN).
The event will have in attendance the Executive Secretary, National Primary Healthcare Development Agency, Faisal Shuaib; Senior Technical Advisor, dRPC-PACFaH@Scale, Emmanuel Abanida; community health workers and other development partners working on routine immunisation in the health sector.
The aim of the dialogue is to strengthen the accountability framework for routine immunisation service delivery at national and state levels.
The meeting is part of the continuous efforts towards attaining the objectives of Nigeria’s Strategy for Immunisation and Primary Health care system strengthening, (NSIPSS) 2018 – 2028.
This is expected to address some of the challenges facing routine immunisation in the country. Effective routine immunisation is a key challenge facing the health sector. Many children under the age of five often miss some vital vaccines which is meant to immunise them against some deadly diseases such as polio, yellow fever, tetanus, measles among others.
This has been a major source of concern for health experts, development partners and the international community.
The dialogue, supported by the Bill and Melinda Gates Foundation, is set to to explore the mechanisms for civil society engagement and to examine and create an understanding of the new roles and expectations for states under the NSIPSS project.
PREMIUM TIMES will bring you live updates from the event.
9: 19 a.m. – Its a cloudy morning in Abuja metropolis, the temperature is about 22 degrees celsius.
The event is being held at the Blu Cabana restaurant in Mabushi area of the Nigerian capital.
9:26 am- Participants are just arriving the venue
The meeting is yet to begin, participants in the hall are still exchanging greetings.
One of the lead speakers and senior technical advisor at dRPC, Emmanuel Abanida, is already at the venue.
9:40 am- Arriving now is Judith-Ann Walker, the Executive Director, dRPC.
Currently in the hall are Ibrahim Yisa, European Union – Support to immunisation Governance to Nigeria (EUSIGN); Paul Bassi, John Snow International (a USAID group); and Femi Oyewole JSI.
9: 50 am – More participants are still entering the hall. Registration is ongoing for participants while some are seated in groups discussing.
The programme is divided into two sessions.
The MC apologised to the participants saying the event is yet to start because they are waiting for the representative of the ES, National Primary Healthcare Development Agency (NPHCDA) Faisal Shuaib.
Topics to be discussed include: Building dynamics in advocacy to support Routine Immunisation (RI) in Nigeria: dRPC-PAS Model; by Mr Abanida
The keynote address is expected to be delivered by Mr Shuaib of the NPHCDA
10: 02 am – Just entering the hall is the representative of the NPHCDA chief, Abdullahi Bulama, who is the Director, Planning Research Statistics.
The event has been declared open by the facilitator of the dialogue, Umar Kawu
On the high table is Ms Walker, Mr Bulama and Mr Abanida
10:10 am – The event commences with participants introducing themselves. In the hall are participants from Lagos, Niger, Abuja, Kaduna among other states .
10:26am
The welcome address is given by Ms Walker. She specially welcomed the delegates from Niger, Kano, Lagos and Kaduna.
She said the organisation would have loved to have participants from all over the country but unfortunately they can not.
She said the delegates and participants are repository of knowledge which will guide the Routine Immunisation (RI) discussion.
Ms Walker said they are here to address the gaps in RI in Nigeria.
She said though the gaps are not anyone’s making, there is much still to be done.
“These are to be done in terms of policy making, implementation and funding.”
Ms Walker said the government will be needing $3.6 billion in the next ten years for immunisation and the federal government will be contributing $2 billion.
She said state governments are meant to contribute the remaining fund.
“We are speaking of accountability, it is our mission, our mandate. To understand the accountability it is the responsibility of CSOs, media and civil servants.
The CAPs have a critical role to play and the framework is implemented in this document, she said.
She wished the participants a fruitful deliberation.
10:46 The representative of the ES, NPHCDA. Mr Balama declared the meeting open.
He apologised for coming late and said the ES could not come because he had to be in Kaduna.
There are over four million unimmunised children in Nigeria. NPCHDA has introduced mechanisms & innovations to improve coverage – Keynote speech by Abdullahi Garba, Director, Research & Planning
Mr Bulama said RI is very important for the country. He said the Director General of the WHO, Tedros Ghebreyesus, emphasised the importance of RI and the work to be done during the meeting in Geneva.
Mr Bulama said CSOs have the opportunity to talk because they do not work for the government and as such cannot be compared to civil servants who are gagged by their job.
He said the resources does not always maters but the rule of the game does. The MICS reports makes it clears that the resources do not match the result, he said.
He said part of the effort the agency has been taking in improving RI is that every department in NPHCDA conduct meetings every week
10: 50 am Bulama said the agency is also working on how the nation can start local vaccine production.
“We are looking at how we can be on our own feet. Tis we are doing by seeing how we can start local vaccine production. But with vaccine creation, the resources is limited. This is why GAVI has extented the date for vaccine funding in the country.”
GAVI has some concerns that is why they are giving us additional support at the this time till the next ten years, hopefully our economy and resources might have improved, he said.
He said the PHCs are also being given funds to run their facilities to make it more functional to attract more clients
He said the agency is doing everything to reduce the large noise of Nigeria having the largest number of unimmunised children.
“The agency is doing everything possible to reach all children with immunisation,” he said.
Mr Bulama said the emergency of RI is aimed at ensuring that we prioritise immunisation in our homes so that we can close the gaps.
“We will do everything to ensure that it reaches at least 80 per cent of children in the country.”
He also acknowledged the importance of accountability in the federal and state level saying it would ensure that RI goes a long way to reaching all Nigerians.
He said some of the problems facing RI is that some states do not know how many facilities they have.
He said states like Jigawa, Kebbi, FCT among others do not have an accurate record of the PHCs in the states. He said in the north-central, there is no facility that is five star, meaning having a doctor, nurses, CHEW, J-CHEW and working laboratories.
He said the agency is trying to correlate all these data and have a score card for every state governor on their facilties and how they fare.
The agency expects to have a geo-location of every PHC facility in the country, he said.
Mr Bulama said his agency admits that there is a problem.
He said a recent report by the agency that shows routine immunisation was not effectively covered across Nigeria was an example of them admitting a lot still needed to be done.
11:00 am Mr Abanida in his presentation titled ‘Building dynamics in advocacy to support RI in Nigeria; dRPC-PAS Model’ gave an insight into what dRPC has been doing in the health sector especially in routine immunisation and capacity building
Mr Abanida said said the organsation is a non-governmental organisation and as such what they do is advocacy especially in RI, family planning and capacity development.
He said RI is very important and needs revival. He said dRPC is not working in vacuum. We are an organisation that has gotten a grant and are working in the country, he said.
Mr Abanida said one of the problems facing the PHCs is the lack of manpower.
He said there are 86 training institutions in the country for community health workers and so far over 200,000 workers have been trained between 1997 and 2017, while only 122,000 are engaged either in private or public facilities.
“The question now is why are the rest not engaged? Is it that the government does not have enough money to do so?”
11:20 am – We are now at the question and answer session.
A delegate from Kaduna State asked the NPHCDA who monitors the PHCs in the states. She cited a case of a newly renovated PHC in Jere, Kaduna State which she said is very small. Yet there is a bigger and empty facility belonging to the federal government around the area, she said.
Mr Bulama said state governments are in charge of most PHCs in their states. He said unfortunately, most states do not have an accurate record of facilities in their states. He said there are about 900 health facilities across Nigeria which are yet to be completed.
Mr Bulama said most of the health facilities that are not completed are part of the constituency projects by lawmakers. He said some are still at foundation level, some at construction level, while some have gotten to roofing stages but not completed or handed over to the agency.
He said the agency would need about N10 billion to complete these facilities.
“We have informed the president that we will be needing about N10 billion to complete these facilities. Most of the money allocated for the facilities were returned to the government after the end of the fiscal budget year when the facilities were budgeted because they did not finish building. We do not pay contractors for unfinished projects. Most of the scattered unfinished facilities are so because most of the lawmakers who proposed the project did not follow up or were not voted back to power.
Mr Bulama answering question of manpower from Kano State said he knows that manpower for the PHCs is still a challenge.
He said this remains difficult because most midwives and community health extension workers are not willing to be transferred to rural areas where their services are needed most.
He said the agency has been trying to solve the problem and they are expecting funding to do so, but they are yet to take off. This, he said is because they are still doing an understudy of the problem and how to address it
12: 00 pm A halt in the dialogue as participants go for tea break; to reconvene in 30 minutes.
Others on the panel are Ibrahim Yisa, European Union- Support to immunisation Governance in Nigeria; Paul Bassi, JSI; Muyi Aina, Solina Health
The first speaker, Ahmed Garb, speaks on the NSIPSS document saying the document is a road map of what the government intends to achieve in the next ten years as regards immunisation in Nigeria.
He said the document was drawn up by the federal government, state governments, GAVi and other developmental partners working in immunisation sector.
Mr Garba said for the agenda stated in the document to be achievable and fully implemented, state governments need to get involved and take it as their own.
He said the government would be needing at least $ 3.6 billion Nigeria for routine immunisation in the next ten years. About $2 billion of the fund will be provided by the federal government and $1 billion by GAVI.
He said what is delaying the take off is some issues the country had with GAVI in terms of misappropriation of funds and non-eligibility of some issues.
“We have that under control. Some of the issues such as misappropriation, the FG has assured that they will return the funds. But this is not the case, we need to be able to show visible progress during the implementation.”
Aside this, Nigeria is ready to implement the document. Nigeria is ready to work and in a short time this will be done and there will be a proper rollout. NPHCDA will be engaging all its partners soon, he said.
Mr Garba however emphasised that state governments will take ownership of routine immunisation to be able to have a sustainable outcome.
He said the states need to step up their games. We want to see them take full responsibility and ownership of the PHCs, he submitted.
1: 00 pm- The second panelist, Muyi Aina, a public health practitioner of 20 years and working with Solina Health is speaking on the possible advocacy “ASKS” in RI services.
Mr Aina, founder and managing partner with Solina Health, said there is a need for CSOs to help the government especially the states understand where the problem is; because most times the increase and release of funds are not the major problems in achieving effective routine immunisation.
Mr Aina said there is a need for advocacy to the federal, state and local governments in order to make them understand the importance of Immunisation.
He said the biggest elephant in the room is funding.
“The federal government is trying its best to provide vaccine procurement. Even if we have GAVI agreement to continue to fund routine immunization, we still need to put in more pressure to ensure that we can afford and fund vaccine procurement without external help.”
Mr Aina said there is a need for the government to put immunisation at the top of the agenda.
1:30 pm
The two panelists have finished presenting and the facilitator has opened the floor for questions and answers from the participants.
1: 35 pm
Some of the questions raised was on how to involve beneficiaries in the advocacy programme.
How can advocates get politicians to understand and imbibe some of the health projects knowing full well that most of them want to campaign with visible projects such as roads which can be seen and used for campaigning and win them a re-election?
Another question raised was how advocates can ensure funds are released for immunisation?
Why is it difficult to compel partners to buy into government project? a participant asked.
1: 40 pm _ In answering some of the questions, Mr Garba said there is no crime involving beneficiaries in advocacy of immunisation, but that is only if the people involve understand the issue at stake.
He said the release of funds at times is not often the problem of the state but executing the project for which the funds was budgeted.
Mr Garba gave an example of Bayelsa State where he said fund was released for immunisation. But three months after the fund was released, it was not utilised, he said.
He said further investigation revealed that the money had been released by the government but was kept in a private account of one of the officials in the state.
“So the release of funding might not necessarily be the issue; but monitoring how the money is being disbursed and used. This is where accountability comes in. Every Nigeria needs to be accountable and not just the politicians.”
Mr Aina while answering some of the questions said the advocates in the health sector need to learn the act of advocating because every other sector seems to understand the act more than the people in the health sector.
He said the advocates need to learn how to present their issues to the politicians in an appealing manner that they can also use for their campaign. This he said will make it appealing to them to key into the programme.
Mr Aina condemned the act of not being able to get donors or partners to key into the goals of the government.
This, he said, has been difficult because there is really no agreed leadership in intervention agenda.
1: 50 PM
He said because Nigeria loves “Awoof”, it does not say no to any intervention programme proposed by development partners.
Mr Aina said there is a need for the government to prioritise intervention agenda to be able to get maximum results and not just take on everything available without a direction.
“We have gotten to a stage in Nigeria where we tell people to hold their money. We also need to gather ourselves and elect smart people who know how to generate resources,” he added.
1:55 PM – The facilitator has closed the question and answer session
He starts the second session by introducing the next panelist/presenter, Ibrahim Yisa.
Mr Yisa, an health economist, is discussing fresh perspectived from stakeholder on governance/ accountability for RI.
Mr Yisa said Nigerians should not think about financing and funding health care in monetary terms alone, but should always try to analyse the implication of what the money will translate to within the country.
He said the funds should be interpreted in terms of the quality of care and what it would stand to change in the space at which it was released.
He said when advocating with the politicians, more appeal should be done to the conscience and this is a way of looking at accountability to the health sector. because this will be more effective than waiting for the outcome of the government’s non-releast of funds.
“When we talk about government we mean accountability, transparency and responsibility.”
He said there is a need to also educate the populace to know what their leaders promised and to make them know if they have delivered on it or not. He encouraged the CSOs to know how to focus their advocacy.
As stakeholders, there are new perspective we should look at when talking about accountability.
“RI is the fist opportunity for survival for a little born. Immunisation contributes significantly to the economic growth; as such we need to make sure the funds released for it are maximised fully. Before we talk about politicising issues, we need to think about the children.”
2:00 pm – Speaking now is Paul Bassi, a professor of public health, Bingham University and Director Child Health and Special Duties JSI . He said there is a need for CSOs to do more in the implementation stage of routine immunisation as this will help reduce the wastage of vaccines at community level.
“What i am advocating is to allow CSOs to be at every levels across the states and levels of implementation.”
Mr Bassi said CSOs need to also factor in local community based professionals in their advocacy and also listen to them and not always rely on the knowledge of foreign partners or donors to solve immunisation and other health issues.
Mr Bassi said CSOs are meant to agree on how to solve problems and how to contribute their quota and improve the quality of lives. Every child that is vaccinated is protected and becomes a better child, he said.
He tasked each participant from different states to think back to when they were formulating their programmes, look for their objectives and re-strategise. He said it is time to start thinking of the vulnerable population.
He said routine immunisation is an entry point of the primary health care. He said whatever is achieved at the immunization point will translate to the quality of the primary health care.
Giving an example, he said they were able to get cooperation from barbers in Bauchi State which assisted in identifying newborns for vaccine coverage. He said they had been having problems identifying them, but the barbers who were not considered to be CSOs came in to save the day.
Mr Bassi said for a long time, the voices of the CSOs in Nigeria have been neglected, but thanks to the polio disaster, it forced the Nigerian government to listen to the CSOs.
CSOs need to monitor what is being done, how policies evolve from creation to implementation. This will translate to how polices are formulated from the state and then translated to the LGA and the LGAs to the wards and the communities.
” There is a need to engage private organisations. We have religious bodies, education bodies to work to create a milestone,” he added.
Speaking now is the third panelist for this session, Abdul Garba, from Save the Children .
He is speaking on advocacy and roles of non-state actors in options for funding RI in Nigeria.
He said the CSOs should be seen as partners and should be allowed to contribute to whatever the government is doing. The NPHCDA needs to encourage and include CSOs, NGOs in their agenda, he said.
Mr Garba said there is a need to bring everyone together to make progress in the health sector.
He said this is the only way there can be an effective implementation of policies in the sector
2: 45 pm – we have come to the end of the panel.
The facilitator has opened the floor for questions from participants.
Some of the questions raised are on accountability for RI in practical terms.
How can we encourage adequate data collection? a participant said.
Responding to some of the question is Dorothy Nwodo, Director Disease Control and Immunisation, NPHCDA. She said she wants states to participate more in vaccine implementation and contribute to buying of vaccines.
Ms Nwodo who is one of the authors of the document, NSIPSS, said the states and some CSOs were engaged while drafting the document.
She explained that after the first draft which was done in September was submitted to GAVI, some CSOs complained that they were not engaged in the process and as such GAVI said they should go re-convene and engage them.
We had to engage them and the engagement was sponsored by GAVI and the federal government.
Explaining how they carried out the engagement, she said they engaged through the the governors forums, the 36 speakers of the states and the National Assembly before they submitted the document.
“We have submitted the final document and we have already gotten a provisional approval and we are waiting for GAVI on how to implement.”
Ms Nwodo said Nigeria had to beg GAVI not to pull out. because the nation only has 33 per cent immunisation coverage and this is very low.
“We need to get more children covered and the economy of Nigeria is still not buoyant to do it alone. I am happy that this session is taking place because we need to engage CSOs to know what to do and how to go about it.
“GAVI has a platform for CSOs. And they fund it because they said if you galvanise all the effort of the CSOs, we know where your strength lies. So that as the exit Nigeria, We can know how to work together to achieve our goal.
Immunisation financing is a big issue that we need to look into. We need to understand where is the private sector’s stand in this. The private sector has been doing a lot especially in the north were we have Dangote and Bill and Melinda Gates Foundation in collaboration with the state governments to set immunisation moving.
The document is all about how to use the vaccine to strengthen the primary health care and the health system
3: 30 pm – The session has gone on launch break.
It would be re-convened at 4:10 pm
4: 20 PM : The session has re-convened. There is a break-out session, the participants have been divided into four groups.
They are to discuss options for CSOs building in and support accountability in states’ immunisation within the context of the NSIPSS: Advocacy for leadership/governance,Funding and policy implementation.
The group will re-convene after 30 minutes of deliberation.
The groups are meant to report back and present to the house.
5:02 pm – The groups have been suspended and everyone has re-convened.
The facilitator has called on the first group to present what they deliberated – the group deliberated on leadership and governance
The presenter for group A said there is a need for the mapping out of CSOs and to develop terms of references.
CSOs were also suggested to be made members of local government health agencies and state primary health care development agencies.
They also proposed that CSOs should monitor budget performance and preparation
5 : 10 pm – Group one also advocated strong advocacy for the implementation of RI strategies to the state executive, house of assembly and local government executives.
Encourage traditional and religious debates to be strong advocates by giving them information on budgeting and implementation.
Help ensure TSA is deployed for the disbursement of funds.
They also asked for publicising erring government officials and reward impactful officials.
– Group Two while presenting on policy implementation said there is a need for the state to make its commitment towards the RI financing strategy.
They agreed that there is also need for a sharing formula for RI financing prior to the end of the transition plan to be divided among the federal government, state and local governments.
They said the deduction should be based on the sharing formula to be done from source.
The group also said there should be a legislation centred on RI financing to be captured in the National Health Act. This will improve awareness in the community and promote community participation.
This will also increase demand for policy implementation by CSOs for continuous advocacy.
CSOs should advocate for states to sign into “Open Government Partnership” .
CSOs should also engage their government through the open partnership state steering committee on RI accountability.
5: 20 pm – Groups three and four said there should be an RI strategy plan for five years and the government should provide a a robust disbursement, expenditure plan
5:20 pm- The presenters have finished presenting and Ms Walker has taken over the stage.
She thanked all the participant for coming.
She noted that the participants from Lagos seem to be distant in the discussion as much references were not made to Lagos as compared to the northern states.
She asked if it was because Lagos seems to be doing better in RI programmes than states in the north.
Ms Walker also said the Lagos State participants will be having a bi-lateral meeting with the NPHCDA so that they can have an in depth understanding of the issue.
Ms Walker noted that most of the participants seem not to have seen the document before coming to the meeting. This she observed because of their level of interaction with the panel while discussing.
She advised CSOs to make use of the opportunity and send in their proposals. She said dRPC is ready to support CSOs.
5:36pm – The meeting was brought to an end.
Oyebisi made the statement while delivering a keynote speech at the second Lagos State SDGs Summit with over 200 leading representatives of government, civil society, private sector and the media in Lagos.
Lagos, Nigeria, September 20, 2018/ — NNNGO-PACFAH@Scale Project Director, Oluseyi Oyebisi on Thursday urged governments at the State and Local Government level to seize opportunities for a healthy population by improving on the release of funding for family planning (FP) and routine immunization (RI) in Lagos State. Oyebisi made this statement while delivering a keynote speech at the second Lagos State Sustainable Development Goals (SDGs) Summit with over 200 leading representatives of government, civil society, private sector and the media in Lagos.
Speaking on the projects findings at the summit which had in attendance the Commissioner for Economic Planning and Budget, Honourable Sunday Olusegun Banjo, Oyebisi said: “from our work we have seen an increase in budget allocations to FP and RI in the 2018 budget and if we have more funds for our primary health care centers (PHC’s) to effectively deliver FP and RI services, we will see an increase to the uptake of family planning in the State”.
“Honourable Commissioner, as I prepare for my presentation at this summit, I reviewed the score card developed by NNNGO-PAS on FP financing at the 41 local government areas of Lagos State. We have seen commitment to family planning in the health budget for the State and I applaud you for that. Here you can see how funds are released to PHC’s and how little these funds are. We see between 3000 and 25,000 Naira given to PHC’s monthly to buy FP consumables albeit irregular.
An improved use of family planning services can help achieve our global goals objectives with results seen in the areas of unintended pregnancies, a cut in maternal and child deaths–giving women more control over their lives and the chance to work.
Honourable Sunday Olusegun Banjo, Commissioner for Economic Planning and Budget, Oluseyi Ojurongbe, Working Team Private Sector Advisory Group on SDGs Nigeria and Mories Atoki. – SM Sustainability, SDGs & Climate Change Pricewaterhousecoopers Inc were among panelists discussing multi-stakeholder approaches to attaining the SDGs at the event.
Oyebisi who is leading the Nigeria Network of NGOs /Partnership for Advocacy in Child and Family at Scale, PACFaH@Scale, (PAS) a social accountability project aimed at ensuring improved financial commitment to FP and RI in Lagos State also met with a section of nonprofits at the event to discuss the PAS project.
LAGOS, Nigeria, 29 March, 2018– The Civil Society Organizations (CSO) mapping meeting was organized by NNNGOPACFaH@Scale to address the Intermediate Outcome under the Result Tracker which states “Increased CSO coalition network to conduct technical reviews of the state’s new domestic funding schemes and to provide feasibility study updates in Niger, Kaduna, Kano and Lagos”.
The meeting which was held at the O.L.A. Conference Centre, Maryland, Lagos State was attended by 25 organisations working in the civil society space and was focused on:
To achieve these objectives, a study protocol was followed from which quantitative (Questionaire) and qualitative (Interview) data were collected to conduct the study. Part of what came up at the meeting was the need to reinforce the active role organisations play, especially in health advocacy. It is key to ensuring the sustainability of health development as it necessitates the establishment of partnerships among such organisations.
LAGOS, Nigeria– The overarching objective of the Lagos State Family Planning Costed Implementation is to increase the overall Contraceptive Prevalence Rate (CPR) from 48 per cent to 74 per cent by 2020. Achieving this target is not only an indication of Lagos State’s commitment to ensuring the achievement of the goal of the National Blueprint (36 per cent CPR), it is also a way of fore-grounding the role of Lagos State as one which sets the pace for innovation and development in the country.
In its bid to achieve this goal as well as provide universal coverage of quantitative and efficient primary health care centres, the Lagos state government resurrected the Primary Health Care Board, PHCB. PHCB is tasked with the responsibility of implementing health care services through community participation, intersectoral collaboration, utilize appropriate technology for health-integrated services as well as supply essential drugs and comprehensive monitoring and evaluation of the process. This is where the need to integrate healthcare providers at the local government level comes in.
All twenty local government areas in Lagos state have more than two-hundred and eighty-eight Primary Health Care Centres, including flagship centres which have as part of their core duties, provision of Reproductive Health and Family Planning (RH/FP) services. The idea is to take health care services into the communities in order to ease the pressure on secondary and tertiary healthcare facilities and ultimately and better serve the people at the grassroots.
In past months, the Lagos state PHCB has hosted RH/FP managers from the twenty LGAs in the state to meetings which aim at tackling the challenges experienced by these LGAs in the delivery of health care services especially in the area of reproductive health and family planning. These meetings which often comprise RH/FP officers from different LGAs in the state, directors and officials from the PHCB, also look into strategies on how to ensure the achievement of the state’s share of the National Blueprint goal.
The August edition of the monthly Family Planning (FP) Managers’ Meetings was hosted on Monday, 13th August 2018 by the Lagos State Primary Health Care Board (PHCB). In its usual fashion, it was attended by Reproductive Health/Family Planning Managers (RH/FP) and relevant Directors from the Lagos State PHCB along with the NNNGO-PAS team who provided support.
Data on RH/FP services carried out in PHCCs from all twenty LGAs of the state between June and July 2018 was presented and revealed that the number of women who registered with the PHCCs for antenatal care increased from 11,878 in June to 12,075 in July 2018. Of this number, there were 1, 511 deliveries in June and a decrease of 1, 328 in July. Statistics also showed that despite the gap between the number of registrations for antenatal services and delivery rate, a silver lining was the decrease in the occurrence of still-births at the PHCCs within Lagos State.
RH/FP managers noted the less than 10 per cent ratio of women registered for antenatal care with PHCCs to women who undergo delivery of their babies at PHCCs in the state is largely a function of the unideal health care system. They bemoaned the dearth of adequate facilities at the PHCCs, lack of adequate community involvement which breeds ineffectiveness.
These challenges which pose a threat to the lives of grassroots women and their unborn children have also resorted to lack of trust in the system; on the part of the patient and their families. RH/FP managers noted that many pregnant women tend to employ the services of trusted but unskilled health caregivers or religious centres which many noted have resulted in health complications over the years. They indicated that since many grassroots women live distances away from the closest PHCCs, therefore, they often resort to undergoing home deliveries due to inability to transport themselves to the centres especially during the night when many go into labour.
Health care officials who manage PHCCs said, a cause for concern is the attitude of relevant authorities towards funding and provision of RH/FP consumables. Many LGAs have not received steady funding for the running of the centres while almost none of them receive imprest on RH/FP care, in recent times.
Barr. Ayo Adebusoye, Project Officer for NNNGO-PAS identified that the duty of Civil Society Organisations is to put pressure on stakeholders and relevant authorities, through the collective efforts of the Lagos State Advocacy Working Group, NNNGO-PAS, Pathfinder and NURHI, in order to ensure that health becomes a priority to government and adequately funded. He noted that statistics from the FP budget tracking conducted in Lagos state from January 2018 to June 2018 revealed that the Ministry of Health released forty-eight million Naira and provided FP consumables to LGAs through the Saving One Million Lives Initiative. The next step is to make enquiries into how these resources are utilized in order to advocate for more in subsequent years. This, in his opinion, is a direction worth taking to achieve the common objective of a better health care system.
Oyebisi Oluseyi, Project Director of NNNGO-PAS commended the board and managers for their work while noting that it was refreshing to see such a level of commitment in the public sector. He encouraged that they be accurate in their data collection and recording in order to assist the government in identifying what requires attention and the measures to employ. This will aid the fight against maternal and infant mortality in the country while ensuring that the sustainability of resources for the coming generation is guaranteed.
ABUJA, Nigeria October 12, 2018 –The need to improve service delivery, availability and access to Family Planning (FP), for the majority of women across Nigeria, has once again been reiterated by public sector officials, Academics and Civil Society representatives working in the area of reproductive health and family planning in Nigeria.
This was the consensus at a One-day Leadership Training for Family Planning Focal Persons organised on October 12, 2018, by the development Research and Projects Center (dRPC), under the PACFAH@Scale program with the aim of strengthening the leadership skills and competencies of participants so that they could champion FP issues and needs within the state system.
Speaking at the event, Greg Izuwa, Deputy Director, Reproductive Division, Federal Ministry of Health noted that scores of Nigerian women of reproductive age clamour for access to family planning but the program’s capacity in the country is highly inadequate to meet their needs, therefore it is imperative for everyone concerned to work together with the government so that these challenges can be mitigated.
“The Nigerian Government has, through the Federal Ministry of Health put in place a policy of free family planning information, services and commodities to family planning clients at public health facilities across the country,” said Mr Izuwa. This will help to address inaccessibility owing to ignorance and poverty mostly experienced by underprivileged Nigerian women. He added that select private health facilities are equally being supported with government’s free commodities to enable them to provide family planning services at very subsidized fees to willing clients.
“There are no systematic studies to determine the policy advocacy inclusions and exclusions in the family planning documents that abound in the public health space in Nigeria,” said Dr Aderibigbe Adedeji, Associate Professor of Public Health, University of Ilorin. He surmised that in order to achieve 27% modern Contraceptive Prevalence Rate (CPR), there needs to be a thorough interrogation of existing policies in order to map how they can better address the needs of the people.
According to Joyce Ahmadu, a gender expert who spoke at the event, “there is need to propose policy actions to strengthen gender integration in future policy development processes” She identified that due to the gender specificity of family planning, government should explore gender-focused research and analysis of norms that affect health-seeking behaviours and health outcomes of women/girls and men/boys in order to arrive at effective interventions targeted at the specific issues. She said this is in response to the identification of gender gaps which came up during an assessment of policies and documents on child and family health in Nigeria.
She, therefore, recommended that policymakers should develop and include gender-sensitive results and indicators to guide the monitoring and evaluation of gender equality, disaggregate gender data at all levels and budget line for gender-related interventions as well as engage stakeholder from the government, CSO and INGOs with gender expertise in the policy development process.
NNNGO-PAS’s Program Officer, Ayo Adebusoye, one of the participants noted: “The conference helped to shape the thoughts and actions of CSO representatives who participated such that we now understand how best to leverage on our individual strengths while working together as a team in order to achieve optimal results”. He concluded that learning to work in synergy with other FP champions within the state and across the country is key to achieving family planning targets.
LAGOS, Nigeria–/On November 1, 2018, NNNGO-PAS hosted 19 CSOs for a second NNNGO-PACFaH@Scale / LASAM Advocacy Sub Committee Meeting to Review Routine Immunization 2018 Workplan. The meeting was organised to address issues that had been identified as important for health advocacy during the first NNNGO-PAS/LASAM meeting which was held on September 21, 2018.
The first meeting which was attended by 14 CSO representatives had been organised by the NNNGO-PAS Team in order to articulate more focused areas of advocacy that would improve RI funding and coverage in Lagos State in Y2019. At the second NNNGO-PAS/LASAM work plan review meeting held on November 1, therefore, issues specific to the Lagos state reality in relation to RI were strategically discussed and solutions proffered.
In highlighting the best strategies to employ in order to achieve desired results, a recurring theme at the meeting was the need to involve beneficiaries in the campaign for improved reproductive health services, especially for hard-to-reach communities. Participants noted that ordinary citizens who are the beneficiaries of the PACFaH@Scale program, when armed with the adequate and appropriate information, have the ability to hold their governments accountable and demand increased funding for RI in Lagos state and the country.
To ensure that citizens have the information they require, participants worked on identifying the target beneficiaries per senatorial districts and LGAs and created a plan on how to disseminate issues briefs which contain information on the RI realities and the budgetary status. Participants also identified the need to cultivate working relationships with policy-makers and influencers while noting the need to articulate specific briefs to these policy-makers.
At the first NNNGO-PAS/LASAM advocacy meeting, participants had identified the need to establish a Local Government Health Authority (LGHA) as essential for effective RI coverage in Lagos state as it is the implementing arm of the Primary Health Care Board (PHCB). They also noted the importance of the LGHA in ensuring that public and private resources are coordinated within the LG. At the second meeting, therefore, participants raised an advocacy sub-team from amongst those in attendance with a mandate of working with LGA chairmen to ensure the establishment of LGHA.
Participants also noted the need to cultivate as RI champions within the various community. As RI champions, these individuals who could be opinion leaders who would be at the forefront of discussions relating to RI issues at both community and policy-making levels.
Another highlight of the meeting was a presentation made by the Reproductive Health Coordinator, Dr. Okaga, in light of the need for intense advocacy to the State Treasury Office and other relevant stakeholders to ensure that remaining allocated funds for MNCH would be released. A delegate was set up immediately by the participating CSOs representatives and mandated to pay an advocacy visit to the State Treasury Officer and other relevant stakeholders as soon as the meeting ended.
LAGOS, Nigeria, 10 September 2018— A fully immunized child is one who has received the complete doses of the standard six antigens – BCG, Diphtheria Tetanus Pertussis (DTP) (3 doses), polio (3 doses), and measles vaccines. Globally, there are about 19.5million un/under-immunized children with 18% of them live in Nigeria.
A survey conducted in 2017 using a Multi Indicator Cluster Survey (MICS) showed that only about 23% of children in Nigeria were fully immunized in the last one year leaving 77% not fully immunized. In addition, statistics from the National Immunization Coverage Survey (NICS) 2017 for Lagos State showed that 68% of children aged 12-23 months received full immunization. This implies that although RI coverage in Lagos is impressive, there is still a lot more work to be done to achieve 100% coverage with the intention of leaving no child behind.
Understanding the critical role civil society organisations can play in attaining the 100% coverage goal for RI in Lagos State, NNNGO-PAS, following up on a civil society mapping exercise in March 2018, organised a strategy meeting with the Lagos State Accountability Mechanism (LASAM) on Friday 21, 2018 to review the costed implementation work plan for RI in Lagos State and to identify areas for advocacy. Organising a strategy meeting at this time was therefore not simply timely, but key to ensuring effective implementation of the RI costed implementation plan in Lagos state especially as governments begin preparations for 2019 RI year.
“We must begin to articulate more focused areas of advocacy that would improve RI funding and coverage in Lagos State now and in the coming year-2019” said Oyebisi, B. Oluseyi, NNNGO-PAS Program Director, who noted that part of the objectives of the meeting was to engage meaningfully with government and other critical stakeholders through a technical review of the costed implementation plan for RI in Lagos State, new domestic funding schemes and conduct feasibility updates on same.
Ayo Adebusoye, NNNGO-PAS Programs Officer further explained that the meeting also aimed at identifying capacity gaps amongst accountability mechanisms in the State, setting the foundation for addressing identified gaps with a view to strengthening and amplifying civil society’s voice on RI issues.
As with many other states in the country, issues of inadequate financing for routine immunization and untimely releases is playing out strongly in Lagos, a State that prides itself as a centre of excellence. History proves that these issues have plagued reproductive health for a long time. A report released by InfoGuide Nigeria in May 2018, noted that “vaccines have always been problematic for Nigeria primarily because funds are insufficient or were not released on time”.
The aforementioned roadblocks to RI service provision and delivery are compounded by inadequate cold chain infrastructure, weak preventive maintenance system of cold chain systems leading to rapid and continuous breakdown, inadequate supportive supervision, weak monitoring and lack of data for action as well as the slow integration of private providers in RI service delivery.
Needless to say, there is an urgent need to intensify advocacy for a sustained increase in allocation to RI and timely release of such funds. Specifically, critical stakeholders must begin to tackle these issues by ensuring that governments fulfil their commitments to RI with emphasis on adequate funding.
INTRODUCTION
The Nigeria Network of NGOs (NNNGO) is the first generic membership body for civil society organizations in Nigeria that facilitates effective advocacy on issues of poverty and other developmental issues.
For 25 years, we have worked to give non-profits in the country the needed support to keep their doors open and to serve millions of communities, families, individuals and variety of causes that critically need their intervention. As of June 2017, we have a membership of over 2,400 organisations. In 2016 alone, 442 of these organisations had a combined budget estimate of over 1billion Naira (N1, 033, 000,000)
This document concentrates on the amendments our membership is suggesting to the Part C of the Companies and Allied Matters Act (CAMA). These suggestions are informed by the NNNGO’s specialist knowledge of the non-profit sector as well as by non-state actors who deliver development outcomes to communities throughout the Federation.
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INTRODUCTION
Nonprofit governance has been in the spotlight in the last few years with increased interest in regulatory compliance. The Part F of the Companies and Allied Matters Act (CAMA) is the law guiding the formation and governance of nonprofits in Nigeria. This document is our attempt to provide a framework for improving nonprofit compliance with the Part F of CAMA. Our theory of change is centered on the assumption that good nonprofit governance serves as a strong foundation for an efficient nonprofit sector. In this document we have placed strong emphasis on how nonprofits can achieve each clause in the law, rationale for meeting them and key outcomes for the nonprofit sector.
This document is an important piece of guidance that nonprofit trustees and managers need to be familiar with. It draws on the legal requirements, established best practices and principles designed to challenge nonprofits to improve their governance and to ensure necessary systems and processes are in place in their various organisations to comply with regulations guiding the operations of nonprofits in the country, thereby helping them keep a focus on their purpose (objects).
We have developed this document as a tool to support continuous improvement in line with each organisations size, activities and circumstances. This is our first attempt at creating a tool that can help nonprofits in complying with regulatory requirements, we welcome your comments and suggestions in making the document better.
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