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Effective Support from HHA Partners - A Case Study of Nigeria

Effective Support from HHA Partners - A Case Study of Nigeria . Why Nigeria makes a good case for successful HHA Process? What factors contributed to more effective HHA support? What are the key lessons from Nigeria for the HHA partners?.

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Effective Support from HHA Partners - A Case Study of Nigeria

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  1. Effective Support from HHA Partners - A Case Study of Nigeria

  2. Why Nigeria makes a good case for successful HHA Process? What factors contributed to more effective HHA support? What are the key lessons from Nigeria for the HHA partners?

  3. What makes Nigeria makes a good case for successful HHA Process? • High Maternal and Child Mortality Rates • IMR - 75 per 1,000 live births • U5MR - 157 per 1,000 live births • MMR of 545 per 100,000 live births • Low coverage for Basic Health Services • 10% Couple Protection Rate for modern methods • 6% of U5 and 5% of pregnant women slept under ITN • HIV prevalence of 4.6% • Huge out of Pocket Expenditure on Health • Over 70% • Source: 2008 NDHS

  4. Coverage for Routine Immunization Very Low Initial Reach : <20% Coverage for Routine Immunization Failure to sustain coverage after initial reach

  5. Under-five Mortality – Absolute Difference between low and high Nigeria has highest difference in the Region

  6. What makes Nigeria makes a good case for successful HHA Process? • CONTEXT: • Being the largest country in the SSA region, progress made by Nigeria is critical for achieving Global MDGs • Wide disparities in health outcomes across the states and income groups • Federal structure with strong role of states and local governments in delivery of health services • SPECTACULAR PROGRESS IN THE IHP+ PROCESS DESPITE MAJOR POLITICAL EVENTS IN THE COUNTRY • National Strategic Framework (mid 2009) • Evidence based and costed plans by all 36 states and Federal Capital Territory (late 2009) • Comprehensive National Strategic Health Development Plan (NSHDP) with a clearly defined Results Framework (early 2010) • Endorsement of the NSHDP by the 53 National Council of Health • Draft IHP compact by June 2010

  7. FACTORS CONTRIBUTING TO THE SUCCESSFUL HHA PROCESS IN NIGERIA • COUNTRY COMMITMENT : Appreciation of slow progress and strong political commitment at National and State levels to improve health outcomes • COUNTRY BASED HHA : Provided sustained advocacy and support leading to strong demand from Government for a harmonized approach and commitment to the IHP+ process • TA for proposal development to the IHP+ Global secretariat seeking financial and technical support • Eleven background studies to assess the Nigerian health system; • Technical Working Group to develop the National Strategic Health Development Framework (NSHDf); • Planning tool for operationalizing the NSHDPfat federal, state and LGA levels with training manual and guidelines for costing,; • 15 national consultants and seed funds to states to develop state health plans • Technical support to implement the NSHDP at all levels including Zonal Meetings to review the 2010 Operational Plans. • CONTINUED TECHNICAL ASSISTANCE: Additional Technical support from regional and global HHA partners- Evidence Based Planning, M&E, Innovations in Health Financing -RBF

  8. Factors that contributed to the successful HHA Process • The HHA partners through various technical sub-committees supported: • Advocacy and policy dialogue at high levels including with Ministry of Finance, National Planning Commission to foster national ownership • Technical assistance for implementation of plans at all levels and alignment under the platform of the UNH4 • Health care financing assessments including the 2006 – 2009 NHA and its sub-accounts, Public Expenditure Reviews, Study of National Health Insurance Scheme, Medium Term Expenditure Frameworks; • Monitoring and evaluation systems strengthening to update the Results framework of NHSDP by supporting development of methods and tools for annual health facility and household surveys; • Joint Annual Review institutionalization by providing support for the first Joint Annual Review in the health sector leading to a Joint Technical Assistance Plan.

  9. 2010 JAR Performance Score Card Making Progress On track Off track

  10. 2010 JAR Performance Score Card On track Making Progress Off track

  11. KEY LESSONS FROM NIGERIA TO HHA PARTNERS Country based HHA teams are critical for successful engagement and sustained advocacy Creating a core group of committed HHA staff to support IHP+ process immensely helps and it is important to empower this group Building evidence base will get better political buy-in especially from Ministries of Finance and Planning Engaging stakeholders and standardizing tools and processes helps planning and implementation process. Ensuring adequate financial and technical resources early on, especially support from Regional and Global IHP teams is important

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