Niger PAS Partners Assessment Visit to Selected PHCs in Niger State

The Niger State PACFaH@ Scale partners, with the support from the development Research and Project Centre, Abuja undertook an assessment visit to some selected facilities (PHCs) in Niger State. The team which comprises of selected members from across the sub-grantee CSOs of the dRPC undertook an assessment visit to identify key issues and updates regarding service delivery, uptake of child and family health issue areas of the project as well as the PHCUOR policy implementation in Niger State
Activities of the Project 
Activities of the project revolve around the clusters:
  1. Developing the evidence base for the advocacy visits
  2. Disseminating information briefs to the stakeholders and media and educating them on the advocacy issue
  3. Training Civil Society Organizations in Nigeria and mobilizing them to participate in advocacy visits
  4. Advocacy convening and follow up activities
  5. Building support within government by creating champions within the beaureucracy by working in collaboration with NIPSS
  6. Monitoring, Evaluation and Learning
In the quest for the fulfillment of the objectives of the PAS project implementation in Niger State, as well as having a background information on government support, service provision and uptake to child and family health issue areas (FP, RI, CKD & PHCUOR Implementation) at the PHCs in Niger State,  some selected members of the PAS sub-grantees in Niger State carried out facility assessment visit to some PHC centres in Niger State to assesses information on PHC service support, provision and uptake across child and family health issue areas (RI, FP, CKD & PHCUOR Implementation) in Niger State by Niger State Government and PHC staffs
Objectives of the Visit
  1. To assess availability of services, commodities and human resources as it relates to child and family health issue areas (FP, RI, CKD & PHCUOR) in the selected PHCs in Niger State.
  2. To assess the availability funding to support  child and family health issue areas (FP, RI, CKD and PHCUOR implementation) in Niger State
  3. To examine the level of the implementation of  BHCPF as well as the integrated services in the PHCs in Niger State.
  4. To determine the extent of implementation of Primary health care under one roof (PHCUOR) in Niger State.
The Visit Targets
  • In-charge and other staffs working in PHCs
Niger PAS PartnersTeam
  • Shehu Ahmed Baba – Program Officer CCRHS-PAS
  • Mr. Oladele Matthew – Monitoring & Evaluation Officer, CCRHS – PAS
  • Mary Jalingo – Monitoring and Evaluation Officer SERDEC- PAS
  • Ahmed Abdulsalam – Programme Officer SERDEC-PAS
  • Comrade Haruna Shuaibu  Tanko– Project Directr, NAMMN-PAS
  • Ibrahim A. Mairiga – Programme Officer NAMMN-PAS
  • Ibrahim Aliyu – Monitoring and Evaluation Officer, FOMWAN-PAS
  • Mallama Kuluuwa Abdullahi – ProgramOfficerFOMWAN-PAS
The Meeting Deliberations
The facility assessment visit which was through visitation by the Niger State PAS partners was guided by a well structures questionnaires; the primary data collection instrument involved using a guided checklist to interact with the PHC staffs. Ten (10) facilities were sampled for assessment by the PAS team; about six members of PAS team. The facilities visited are as follows:
  1. Maternal and Child Health Clinic, Old Airport, Minna
  2. Maternal and Child Health Clinic Tunga, Minna
  3. Senator Dr. Idris Kuta Memorial Primary Healthcare Centre
  4. FSP Medical Out-fit Minna
  5. Dije Bala PHC Suleja
  6. Salihu Madalla PHC Madala
  7. Yanna PHC Centre Bida
  8. Doko PHC Centre Doko
  9. Ubandoma Primary Health Care Clinic, Kontagora
  10. Maternal and Child Health Clinic Kontagora
The visit to PHCs by selected Members of Niger State PAS Partners which took place from 17-18 May 2019 was in an interactive form, guided by a well structured check list with questions around Child and Family Health Service Provision and Support; availability of Services, support to services, availability of commodities, funding to PHCs and availability of human resources as it relates to child and family health issue areas (FP, RI & CKD) in Niger State PHCs. Questions were also asked around availability of integrated services under one roof, BHCPF, Basic minimum package, Implementation of PHCUOR policy as well as availability of water supply and cleanliness of the structure.
Summary of Findings from the Field
  1. Family Planning: Findings from the field on Family Planning reveals that across all the PHC facilities visited, FP services are available with mixed methods in practice. However, none of the facilities receives funding from state for FP services except commodities that are supplied through SPHCDA by donors / partners in the state. On human resource for health, inadequate human resource for health trails all the PHCs visited as majority of the respondents relayed that human resources are between the ranges of 2-4 staffs with and that they are often supported by volunteer staffs who are often not paid by government
  2. Routine Immunization: Routine Immunization (RI) services on the other hand are also available across all the PHCs visited. On storage facility for vaccines, majority of the PHCs do not have equitable storage facility for vaccines; they only uses refrigerators or cold boxes while few do not have any form of storage facilities and collect vaccines from central cold store. Also, no funding is received by PHCs from state on services and commodities except for the payment of adhoc staffs and commodities supply which is being done by partners/donors. Across the facilities visited, inadequate human resource for health trails all the PHCs visited; they relayed that the number of staffs do not always meet the upsurge of the clients visiting their respective facilities.
  3. Childhood Killer Diseases: All the PHCs visited are using the new treatment protocol or guideline which is Amoxycillin DT and Zn-Lo-ORS for childhood pneumonia and Diarrhea. Respondents reveals that the drugs on the other hand are not readily available across the facilities visited; majority of the respondents relayed that drugs are recommended for clients/patients purchase from outside the facilities. For human resource for health, respondents across all the PHCs visited reveals that human resources for CKD are not adequate.
  4. Primary Health Care Under One Roof: For the availability of the integrated services of PHCs under one roof, some respondents relayed that it is not yet integrated while some reveals that it is but not all components of the services are available under one roof. On the BHCPF, majority of the respondents reveals that they have not started benefiting from the services as the programme has been mentioned but not started. Majority of the facilities do not deliver basic minimum package as relayed by the respondents; the reason being that facilities do not have adequate manpower like Pharmacy Technicians, H/E etc. About 70% of the facilities visited have water supply systems like boreholes and the structures are neat while 30% of the facilities do not have water supply system and their structures needs total renovation.
Major Outcomes
  • All the PHCs (100%) were found to be rendering all the child and family health issue areas services
  • None of the PHCs visited receives funding from the state to support services and service uptake at the PHCs
  • All PHCs visited receives partners support through the SPHCDA for services like payment of adhoc staffs and purchase of commodities and consumables
  • In some facility, FP commodities are available while in some non availability of commodities  trails some other PHCs visited
  • All the PHCs have Inadequate human resource for health to support servie provision at the PHCs; PHCs cannot effectively run shift as result of lack of required number of staffs
  • Volunteer staffs are found to be supporting services across all the  PHCs visited
  • All the PHCs have and follow new treatment guideline/protocol for treatment of Amoxycillin DT, Zn-Lo-ORS for childhood pneumonia and Diarrhea in Niger State
  • Partners largely support provision of commodities and payment of adhoc staffs
  • Implementation BHCPF programmes have not commenced in all the facilities visited
  • Implementation of integrated services under one roof not fully in place
Key Recommendations
  • Niger PAS CSOs to support the upgrading of PHC and her services through advocating for funds supply, adequacy of human resource for health as well as supply of commodities and consumables
  • Push for immediate commencement of BHCPF programmes
  • Advocate for full implementation of PHCUOR policy and PHC strengthening in Niger State
  • Niger PAS Partners to Advocate for PHCs to be equipped to render the integrated services under one roof

Next Steps

  • Niger State PAS Partners to use the information generated during the meeting with consultants
  • Niger state Partner to also use the information generated during advocacy engagement with policy makers in Niger State