National strategic health development plan nshdp
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National Strategic Health Development Plan (NSHDP) (Routine Immunisation Platform) Dr Muhammed Lecky Director - Dept of HPRS, FMOH Section I: Brief background Background: Previous efforts

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National strategic health development plan nshdp l.jpg

National Strategic Health Development Plan (NSHDP)

(Routine Immunisation Platform)

Dr Muhammed Lecky

Director - Dept of HPRS, FMOH

Expert Review Meeting, March 22-24, 2010


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Section I: Brief background

Expert Review Meeting, March 22-24, 2010


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Background: Previous efforts

Health Sector Reform Programme (HSRP) 2004-2007 was the first major initiative at reforming the health system in Nigeria.

Succeeded in laying down the policy basis for developing longer term strategies – National Health Policy, National Health Bill, reform in MDAs, etc

Development of a draft 10 year Strategic Health Plan

Signatory to the Call by African Ministers to increase funding to health sector to 15% of national budget

Signatory to the Call by African ministers of Health to use Ouagadougou Declaration and its implementation Framework to revise, update or develop national strategic health plans towards strengthen health systems based on the PHC approach

Expert Review Meeting, March 22-24, 2010


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Post HSRP

Wide consultations on the way forward post HSRP

NCH 2007 (Lagos): Adopted a resolution to develop a National Strategic Health Investment Plan.

Review of HSRP (2004 – 2007)

Re-focus from NSHIP - NSHDP

Expert Review Meeting, March 22-24, 2010


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Section II - Developing the NSHD Framework and Plan

…….a bottom-up approach

Expert Review Meeting, March 22-24, 2010


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Rationale for the NSHDP

  • To meet the challenge of improving health outcomes against country targets and the health-related Millennium Development Goals (MDGs), particularly for the poorest and most vulnerable population:

    • health services must be scaled-up

    • health systems must be strengthened

    • and hard-fought gains in health must be sustained and expanded.

  • This was seen to be possible within the context of a costed National Strategic Health Development Plan.

  • The NSHDP will serve as the basis for ONE health plan framework towards achieving:

    • Collective Ownership;

    • Harmonization;

    • Alignment;

    • Mutual Accountability

    • M&E for Results within the national health systems

    • Wide stakeholder participation at Federal, States and LGA levels, inclusive of CSOs, Development Partners & Non-State actors, etc.

  • Expert Review Meeting, March 22-24, 2010


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    Rationale for the NSHDP Framework

    • Consequent on the above, it was necessary to:

    • … provide a generic framework to guide Federal, States and LGA health planning processes

    • … build on country priority areas as well as other policies and goals related to health development in at federal, States and LGA levels to indicate what should be done for greater consistency, synergy,quality and efficiency in strengthening health systems using the PHC approach

    • The federal and States were to adapt and use the framework in their specific situation taking into account the progress made and the efforts that needed to be undertaken for better health outcomes

    Expert Review Meeting, March 22-24, 2010


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    Conceptual Framework for NSHDP

    National Development Agenda

    National Health Bill

    National Health Policy

    National Strategic Health Dev. Plan drawn from

    The Framework

    FedSHDP

    SSHDP

    LSHDP

    Medium Term Sector Strategy

    Fed, State and LGA Ops Plans

    Sector Annual Plans

    Operational Plans

    Expert Review Meeting, March 22-24, 2010



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    NSHDP Process Update (12/03/10)

    Background Studies (Done)

    HSRP I Review (Done)

    Expert Review Meeting, March 22-24, 2010

    10


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    Section III: NSHDP – An Overview

    Expert Review Meeting, March 22-24, 2010


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    NSHDP Content

    • Preface

    • Acknowledgement

    • Acronyms and Abbreviations

    • Presidential Health Summit Declaration

    • Executive Summary

    • Chapter 1: Background

    • Chapter 2: Situation Analysis

    • Chapter 3: NSHDP Priority Areas

    • Chapter 4: Results Matrix and M&E

    • Chapter 5: Resource Requirements

    • Chapter 6: Financing the NSHDP

    • Chapter 7: Implementation modalities

    • Annexure – M&E Results Matrix & Systems; Cost Sheets; and Methodology & processes of plan development

    Expert Review Meeting, March 22-24, 2010


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    NSHDP Priority Areas: A Snapshot

    Expert Review Meeting, March 22-24, 2010


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    Costs of National SHDP

    National = State + Federal SHDPs

    Exchange rate: N150 = $1

    Pls note, the Federal costs do not include scaling up of tertiary health care services.

    Expert Review Meeting, March 22-24, 2010


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    Cost distribution by priority area

    The total costs by priority area revealed majority of the costs were in health service delivery (49%) and human resources for health (42%) in the MBB based and selected state costed plans.

    Expert Review Meeting, March 22-24, 2010


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    Cost distribution by National Chart of Accounts

    The National Chart of Accounts was dominated by costs associated with salary and wages (44%), materials and supplies (22%) and capital investments (9%)

    Expert Review Meeting, March 22-24, 2010


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    Section IV: NSHDP – Monitoring for Results

    Expert Review Meeting, March 22-24, 2010


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    Structure of the Results matrix

    • Indicators, sources of data, baselines and targets,

    • …to track the achievement of the overarching goal of the NSHDP and SHDPs,

    • ….to also track progress under each of the 8 priority areas

    Expert Review Meeting, March 22-24, 2010





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    Recall

    • NSHDP has 8 priority areas namely:

      • Leadership And Governance For Health

      • Health Service Delivery

      • Human Resources For Health

      • Financing For Health

      • National Health Information System

      • Community Participation And Ownership

      • Partnerships For Health

      • Research For Health


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    Health Service Delivery and PHC

    • Goal : To revitalize integrated service delivery towards a quality, equitable and sustainable healthcare

    • 5 objectives:


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    Key interventions to be supported

    • Interventions to be supported are defined in the minimum package of care;

    • The Federal will continue to provide support for PHC, RI and IPDs, emergency preparedness and response, MCH commodities, NCDs and NTDs




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    RI Interventions

    • Support for States to improve outreach and population schedulable services for RI and other interventions

    • Targetted support to NPHCDA and MCH division (FMoH) to help states strengthen EPI in an integrated manner

    • List of vaccines to be supported

    • Measles immunization

    • BCG immunization

    • OPV immunization

    • DPT immunization

    • Pentavalent (DPT-HiB-Hepatitis b) immunization

    • Hib immunization

    • Hepatitis B immunization

    • Yellow fever immunization

    • Meningitis immunization

    Expert Review Meeting, March 22-24, 2010


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    Health Service Delivery and PHC

    • The Federal Plan and by extension the NSHDP is focused on delivering on the Ouagadougou Declaration on PHC

    • Seeks to strengthen PHC by:

      • Accelerating towards universal coverage for essential care package for all Nigerians; - this emphasises scale up of routine immunisation

      • Increasing physical access to health care facilities;

      • Strengthening the drugs and health commodities procurement and distribution system;

      • Strengthening referral care; and

      • Support for the institutionalisation of a QA system


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    Section VI: Presidential Summit and Declaration for the National Partnership for Health

    Expert Review Meeting, March 22-24, 2010


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    The Summit: Structure National Partnership for Health

    • Theme of the Summit : “ACCEPTING COLLECTIVE RESPONSIBILITY FOR IMPROVING OUR HEALTH IN NIGERIA”.

    • Presidential Summit: Took place on the 10th of Nov, 2009 as an agenda item on the National Economic Council (NEC).

    • It was preceded by the following prep-summit technical sessions at the ICC:

      • A one day pre-summit technical session called:– “High Level Forum on Health MDGs and Related Initiatives” on 5th of Nov, 2009.

      • A one day Special Pre-Summit Plenary on 6th, Nov, 2009

    Expert Review Meeting, March 22-24, 2010


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    The Summit: Objectives National Partnership for Health

    • To engage the Governors and obtain their commitment in on-going efforts to meet the health needs of Nigerians

    • To fast track the health sector response for the achievement of the 7-Point Agenda through the implementation of the Health Sector Component of Vision 20: 2020

    • To agree on critical issues that would further strengthen the collaboration between the States and the Federal Government.

    • To position the States and by extension the Local governments to actively participate in the delivery of quality healthcare services.

    Expert Review Meeting, March 22-24, 2010


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    The Summit Outcome National Partnership for Health

    • A consensus and road map on the active collaboration and participation of the Federal and State governments in health care delivery was reached and agreed upon.

    • A Partnership Agreement known as “NATIONAL PARTNERSHIP ON HEALTH: DECLARATION ON MUTUAL ACCOUNTABILITY FOR IMPROVED AND MEASURABLE HEALTH RESULTS IN NIGERIA” which reflects key and measurable deliverables within the Health sector was agreed upon.

    • The Declaration is currently being signed by all the State Governors.

    Expert Review Meeting, March 22-24, 2010


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    Summit’s Commitment to Results & Targets National Partnership for Health

    • Reducing infant and under-five mortality from present levels (75/1,000 Live-Births and 157/1,000 Live-Births respectively) by half by 2015;

    • To have decreased prevalence of underweight children under 5 (U 5) years of age to 18% by 2015;

    • Interrupt wild polio virus transmission by 2010

    • Increase percentage of Children aged 12-23 months who are fully immunized by at least 25% annually and to have attained 80% by 2015

    • Achieve 80% of 1 year olds immunized against measles by 2015

    • Reducing Maternal mortality ratio by a third from present level (545/100,000 Live-Births) by 2015;

    • Increase by at least 10% annually (from present level of 37%), the proportion of births attended by skilled health personnel and to have achieved at least 80% Nationally by 2015;

    Expert Review Meeting, March 22-24, 2010


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    Summit’s Commitment to Results & Targets/2 National Partnership for Health

    • Increase by at least 10% annually the percentage of pregnant women with four antenatal care visits by 2015;

    • Achieve universal access to reproductive health by 2015;

    • To have halted by 2015 and begun to reverse the spread of HIV/AIDS,

    • To have halted by 2015 and begun to reverse incidence of malaria and other diseases;

    • To have reduced the prevalence of Malaria in children under the age of five (5) years by at least 25% annually from present level (198/10,000) and to achieve 75% reduction by 2015 using an integrated approach;

    • Increased budget allocations to health at the Federal, State and LGAs from the present level by at least 25% each year towards achieving the Abuja Declaration target of 15%; committing to at least 90% budget release and 100% utilization by the end of the year;

    Expert Review Meeting, March 22-24, 2010


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    Thank You National Partnership for Health

    Expert Review Meeting, March 22-24, 2010


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