NSHIP- Enhancing Qualitative Health Care Delivery

By Kehinde Adeleye
|
The health sector in Nigeria has been a source of serious concern to all and sundry. This is especially because virtually everything has gone topsy-turvy in this supposedly humanitarian sector. The rate at which our leaders jet out of the country to seek medical assistance is not only worrisome, It has continued to make people lose confidence in government’s medical facilities. As it stands today, one can argue that, quality healthcare can only be assessed by the rich while the poor drop dead daily due to egocentric attitude of our leaders. Some years ago, in Ondo state, the health sector was almost in shambles with the state having the worst indices in the maternal and child health in the south western geopolitical zone of Nigeria. Expectedly, the numerous unhealthy practices in medical facilities and other related ones have negative implications on the health sector of the state.

However, things began to take a new dimension with the birth of the Nigeria state health investment project (NSHIP). The project, aimed at reviving the health sector from its sorry state, is funded by the World Bank. The project which was first piloted in Ondo, Nasarawa and Adamawa states in December, 2011 is expected to end in 2020.It is necessary to bring to the fore the major reason for the introduction of NSHIP-it is to strengthen the health facilities in the selected states, considering that ever before now, there had been stagnant health outcomes with little or no progress coupled with limited physical and financial access to health services among others.

Interestingly too, Result based financing (RBF) is the approach used in executing NSHIP which comprises of performance based financing (PBF) and Decentralized facility financing(DFF).in other words, health facilities are given bonus based on their performance in terms of quality and quantity. The number of patients, particularly mothers and children that visit such facilities will determine the bonus. The essence of this is to motivate and encourage the health personnel discharge their duties with the aim of encouraging indigenes and people to assess the health facilities around them.

It is also fundamental to know that such cash bonus is not for merry making, rather it is expected to be used to upgrade and strengthen such facilities. The Federal Ministries of Health and Finance, the National Primary Health Care Development Agency, the State Ministry of Health as well as the State Primary Health Care Development Board work in collaboration and support of the World Bank to achieve a common goal. Now, 532 health facilities across the length and breadth of Ondo state have benefited from this gesture. One good thing about NSHIP which was  first piloted in Ondo State is that it gives opportunities to every member of the communities and representatives of health facilities to express any challenge Or difficulties they face in the course of implementing the programme. They are allowed to deploy their own strategies when it becomes imperative. The community have a say in what happens to their health.

The emphasis on community participation at the same time given people the zeal to take full ownership of the project. Community leaders, Religion leaders, Traditional Rulers, Market women and other stakeholders gather together to discuss the areas where they need NSHIP intervention in the health facilities within their immediate environment. No doubt, this new idea has brought tremendous development to the 532 health facilities across the state such as infrastructure, development of human capacities, purchase of medical and non-medical equipment among others. Without mincing words, this project has increased the quality of care in health facilities and that of health care services utilization. Asides this, it has also reduced out of pocket spending, removed catastrophe health expenditure and created employment for the people.

It is worthy of note that apart from the fact that NSHIP has improved monitoring and supervision of Health Facilities, it has also improved inter-agency and inter-stakeholder collaboration among the ministry of health, Hospitals Management Board and State Primary Health Care Development Board to work towards achieving a common goal. These have, no doubt, strengthened the health care delivery system in Ondo state and put in place efficient and responsible processes that can address the health care needs of individuals.

With a timely step in the direction of giving a new lease of life to the people, one will agree that NSHIP has sufficiently captured the health needs of the people of Ondo state. However, a source of worry to many is what becomes of the NSHIP assisted health facilities after the 2020 expiration date of the project in Ondo state. To foretell any major setback, it is high time government started to take full ownership of the project by making budgetary provision for it. This will go along way in sustaining the legacy of the state and the World Bank. Undoubtedly, the health revolution in the state is unprecedented and the only way to sustain this huge gains is through the collective efforts and cooperation of all.

    Kehinde Adeleye Communication  officer,  NSHIP