Nigeria

Nigeria accounts for almost 10% of the global burden of HIV, with over 1.5 million individuals in need of ARV treatment. Progress in addressing the country’s HIV/AIDS epidemic and other public health challenges is constrained by health systems weaknesses, shortage of skilled health workers and social workers, and limited accessibility of services. Complementing USAID’s service delivery implementing partners in the country, CapacityPlus focused on strengthening human resources for health and social services through support in preservice education, human resources information systems (HRIS), human resources management (HRM), retention, and orphans and vulnerable children (OVC). The majority of this work under CapacityPlus continues under a CapacityPlus Associate Award led by IntraHealth.

Highlights

Preservice education: Drawing on assessments conducted using the Bottlenecks and Best Buys approach, CapacityPlus supplied equipment and textbooks to 22 schools educating midwives and community health extension workers (CHEWs); trained tutors to integrate competencies formerly offered only in-service; and provided scholarships to 2,065 students at risk of dropping out of school. An evaluation indicated that more than 560 additional health workers (at least 450 added midwives and 114 added CHEWs) qualified to practice in Nigeria due to this support. Over 1,000 students received training in targeted competencies, leading to increased exam pass rates for midwives and community health officers. Midwifery and CHEW scholarship recipients were more likely to graduate and qualify on certification exams than students in the same schools in previous years. CHEW scholarship recipients are twice as likely to be posted in a rural facility as non-recipients.

HRIS: CapacityPlus supported the Nursing and Midwifery Council of Nigeria and the Community Health Practitioners Registration Board of Nigeria to deploy iHRIS Qualify for registration, certification, and licensing. Up-to-date records are now available for more than 250,000 nurses and midwives and an estimated 90,000 community health workers. The councils use the data to generate monthly reports about the cadres they are supporting and to compile requested reports for the Federal Ministry of Health, which is using the data to inform deployment decisions to provide care in the most underserved areas, identify duplicate health workers, provide and track educational training, and for budget planning. The project also supported deployment of State Health Workforce Registries for three USAID priority states: Akwa Ibom, Cross Rivers, and Rivers, and iHRIS Manage in Benue and Nasarawa. These functional HRIS feed into the National Health Workforce Registry, for which the project developed standard operating procedures.

HRM: The project supported development of HRH strategic plans at the national level and in eight states through participatory approaches using stakeholder leadership groups.

Retention: CapacityPlus collaborated with the National Primary Health Care Development Agency to conduct a study in six states to explore attrition, availability, and retention of midwives under the Midwife Service Scheme. Findings showed an overall mean rate of attrition of 16.4%. The project assisted stakeholders to use their state’s respective findings to advocate for improved deployment and retention of newly trained midwives and other health workers. The findings also aided the Federal Ministry of Health in Cross Rivers state to inform development of cost-effective strategies to increase recruitment and retention of nurses and midwives in rural areas. The project built the capacity of the State Ministry of Health to apply the Rapid Retention Survey Toolkit to identify health workers’ motivational preferences and use the findings to advocate for provision of related incentives to attract more health workers to rural job postings.

OVC: CapacityPlus worked closely with UNICEF/Nigeria and Maestral International to conduct a mapping of the child protection systems in six states. The State Ministry of Women’s Affairs and Social Development hosted the official launch of the reports, presenting them widely to representatives across state government sectors and other child protection stakeholder agencies. The launches were followed by the inauguration of high-powered state committees (comprising stakeholders drawn from the state judiciary, police, and child protection networks, Ministry of Women’s Affairs and other related agencies and departments) to guide implementation of the recommendations of the reports. Three states have started implementing recommendations.

Photo by Uko Gabriel Chukwudi