Enhancing frontline health workers\u27 abilities to improve MNCH services in Bauchi State through task shifting/sharing

Frontline health workers (FLHWs), including nurses, midwives, community health extension workers, and community health officers, are healthcare providers with the greatest access to clients and patients, and provide initial care to persons in need of health services. In 2014, Nigeria’s 57th National Council on Health approved a task-shifting and sharing (TSS) policy for essential healthcare services as a promising strategy for improving access and efficiency in Nigeria’s health system. Subsequently, FLHWs in Nigeria have been trained for new roles and functions traditionally reserved for mid- or high-level cadres, to optimize available providers and their capacities. This brief reviews the strategy undertaken in Nigeria’s Bauchi state and concludes that optimizing the roles of FLHWs through TSS is a good solution for improving maternal, newborn, and child health (MNCH) services and for addressing health system challenges. Other opportunities include widespread support for improving MNCH care and addressing the unmet need for care and uneven distribution of health professionals

Strengthening Bauchi State College of Nursing and Midwifery by updating its training curricula, procedure manuals and student handbooks

Many of Nigeria’s Nursing and Midwifery schools and colleges encounter challenges that include outdated training curricula, which can lead, in some cases, to loss of accreditation. In Bauchi state, a state College of Nursing and Midwifery was formally established in 2013. The Population Council engaged a curriculum expert who had worked with the Nursing and Midwifery Council of Nigeria (which stipulates minimum standards of compliance for accreditation) to assess the school’s training documents, including its training curriculum, procedure manual, and student handbook. The school is expected to secure full accreditation in 2019. The Population Council also supported the strengthening of the curriculum review committee, which now meets regularly to discuss both tutor and student recommendations on use of the new materials

Willingness to pay for community-based health insurance in Nigeria: do economic status and place of residence matter?

OBJECTIVE: We examine socio-economic status (SES) and geographic differences in willingness of respondents to pay for community-based health insurance (CBHI). METHODS: The study took place in Anambra and Enugu states, south-east Nigeria. It involved a rural, an urban and a semi-urban community in each of the two states. A pre-tested interviewer-administered questionnaire was used to collect information from a total of 3070 households selected by simple random sampling. Contingent valuation was used to elicit willingness to pay (WTP) using the bidding game format. Data were examined for correlation between SES and geographic locations with WTP. Log ordinary least squares (OLS) was used to examine the construct validity of elicited WTP. RESULTS: Generally, less than 40% of the respondents were willing to pay for CBHI membership for themselves or other household members. The proportions of people who were willing to pay were much lower in the rural communities, at less than 7%. The average that respondents were willing to pay as a monthly premium for themselves ranged from 250 Naira (US$1.7) in a rural community to 343 Naira (US$2.9) in an urban community. The higher the SES group, the higher the stated WTP amount. Similarly, the urbanites stated higher WTP compared with peri-urban and rural dwellers. Males and people with more education stated higher WTP values than females and those with less education. Log OLS also showed that previously paying out-of-pocket for health care was negatively related to WTP. Previously paying for health care using any health insurance mechanism was positively related to WTP. CONCLUSION: Economic status and place of residence amongst other factors matter in peoples' WTP for CBHI membership. Consumer awareness has to be created about the benefits of CBHI, especially in rural areas, and the amount to be paid has to be augmented with other means of financing (e.g. government and/or donor subsidies) to ensure success and sustainability of CBHI schemes

Collaboration with the University of Calabar for human resources for health management training for Bauchi and Cross River states

A pool of knowledgeable staff is required within middle and senior management for long-term human resources for health (HRH) planning and effective management at all levels of the health system—federal, state, and local. This brief reports on the training by the Population Council, in partnership with the World Health Organization in Nigeria, of 105 key personnel on HRH planning, management, policy dialogue, advocacy, and resourcing for the HRH project “Enhancing the Ability of Frontline Health Workers to Improve Health in Nigeria.” Critical HRH-related capacities were built among key Nigerian health system personnel and managers, most significantly in the states of Bauchi and Cross River and within their local government areas. These efforts should facilitate better long-term HRH planning and management in these areas, hopefully leading to improved health outcomes in these states. In addition, the institutional strengthening of a national center for HRH Training and Education, through the sustainability efforts of the HRH project, will continue to build the capacities of healthcare managers and workers throughout Nigeria

Strengthening in-service training and continuing education (IST/CE) for frontline health workers for Bauchi and Cross River states

This brief details Council efforts to develop effective, and costed, in-service training and continuing education modules for frontline health workers in Bauchi and Cross River states in Nigeria. This project was funded by WHO to aid the training and development of Nigeria\u27s public health worker sector

Population Council\u27s support for Nigeria\u27s third national Human Resources for Health conference and efforts to institutionalize HRH conferences in Nigeria

This project brief describes the Population Council\u27s partnership efforts with public health stakeholders in Nigeria to plan and host a third national conference for provision of necessary and relevant information on critical health issues to health staff and stakeholders throughout Nigeria

Evaluating Health Workers’ Knowledge Following the Introduction of Clinical Mentoring in Jigawa State, Northern Nigeria.

Clinical mentoring is work-based training for the capacity building of health care workers. This study determined if there were benefits and increases in knowledge levels for 33 selected health workers across 5 health facilities in Jigawa State following the introduction of clinical mentoring. Questionnaires were used to determine biodata and knowledge scores of mentored health workers and also key departmental activities before and after a 6 months period of introduction of clinical mentoring. Data was analyzed with SPSS version 20. Over 90% of the 33 mentored health workers showed an increase in their knowledge scores. The mean percentage score of the health workers increased significantly from 56.3 ± 2.1 before the start of clinical mentoring to 74.7 ± 1.7 (p<0.001) six months later. Mortality review meetings were also introduced. This study has shown that clinical mentoring is beneficial for improving the clinical knowledge of mentored health workers. (Afr J Reprod Health 2015; 19[3]: 118-125). Keywords: Health workers, clinical mentoring, capacity building, northern Nigeria Le mentorat clinique est la formation en milieu de travail pour le renforcement des capacités du personnel de la santé. Cette étude a déterminé s’il y avait des avantages et des augmentations dans les niveaux de connaissances pour les 33 membres du personnel de la santé sélectionnés à travers 5 Centres de santé de l'Etat de Jigawa suite à l'introduction de mentorat clinique. Des questionnaires ont été utilisés pour déterminer un curriculum vitae et des notes de connaissances du personnel de la santé qui sont passés par le mentorat et aussi des activités clés du ministère avant et après une période de six mois de l'introduction du mentorat clinique. Les données ont été analysées avec la version SPSS 20. Plus de 90% des 33 des membres du personnel de la santé qui ont subi le mentorat ont montré une augmentation dans leurs scores de connaissance. Le score moyen de pourcentage du personnel de la santé a augmenté considérablement de 56,3 ± 2,1 avant le début de mentorat clinique à 74,7 ± 1,7 (p <0,001) six mois plus tard. Les réunions pour l’examen de la mortalité ont été également introduites. Cette étude a montré que le mentorat clinique est bénéfique pour améliorer la connaissance clinique du personnel de la santé qui a subi le mentorat. (Afr J Reprod Health 2015; 19[3]: 118-125). Mots-clés: personnel de la santé, mentorat clinique, renforcement des capacités, nord du Nigeri

The rationale and relevance of existing cadres of frontline health workers and potential for new mid-level cadres

Front-line health workers (FLHWs) are expected to perform necessary maternal, newborn, and child (MNCH) services appropriately and effectively; however, few studies have investigated the extent to which FLHWs perform requisite primary health care (PHC) services. This study seeks to better understand not only FLHWs’ knowledge and performance of MNCH services, but the factors promoting and inhibiting their services in selected rural local government areas of Nigeria’s Bauchi and Cross River states. It also investigates the potential for a new PHC worker cadre, soliciting stakeholders’ perceptions about its feasibility for addressing maternal and newborn disease burdens in rural communities. The study’s findings show a shortage of all FLHW cadres—and for nurses and midwives, this shortage is critical—as well as insufficient equipment and materials required for FLHWs’ quality MNCH services, inadequate knowledge of critical MNCH issues, and poor staff welfare. The report details the urgent actions needed to strengthen human resources for health in rural communities in Nigeria

Enhancing frontline health workers\u27 abilities to improve MNCH services in Cross River State through task shifting/sharing

There is a shortage of qualified and skilled health professionals providing cost-effective maternal, newborn, and child health (MNCH) services in Cross River State, Nigeria. Frontline health workers (FLHWs) have the potential to learn new skills as part of a task-shifting and sharing (TSS) policy. This brief highlights the results of the TSS policy in Cross River state: village health workers identify and refer pregnant women in their communities to antenatal clinics and provide oral medications; community health workers perform initial case management and ensure quick referrals to secondary facilities for specialized care; nurses and midwives deliver MNCH interventions that are accessible and affordable to all; only medical officers can repair cervical lacerations, manage pre-eclampsia and eclampsia, and continue management of newborn complications. The brief offers recommendations so that governments can achieve adequate and timely access to high-quality health care through appropriate MNCH interventions, as well as enhancing the abilities of FLHWs to improve MNCH care services through TSS

Strengthening Cross River state schools of nursing and midwifery by updating their training curricula, procedure manuals and student handbooks

Many of Nigeria’s Nursing and Midwifery schools and colleges encounter challenges that include outdated training curricula, which can lead, in some cases, to loss of accreditation. In Cross River state, in 2014 only one health training institution was accredited—provisionally. Five other institutions had lost their accreditations from the Nursing and Midwifery Council of Nigeria (NMCN) which stipulates minimum standards of compliance for accreditation. An assessment team led by the Director of Nursing of Calabar’s Ministry of Health visited the Cross River schools to determine the best ways of addressing the gaps in the accreditation team’s report. Through the HRH project efforts led by the Population Council, all of Cross River’s schools of Nursing and Midwifery are now accredited by NMCN