MAKING ACCOUNTABILITY REAL

1. MAKING ACCOUNTABILITY REAL Presentation at the 23rd ERC Meeting by Dr. John Onyeokoro, NPHCDA

2. Vision, Goal, Objectives of PresTOPE Vision: A polio-free Nigeria, Africa and world Goal : To provide leadership support in Nigeria’s effort to accelerate the interruption of polio transmission in 2012 and achieve zero new indigenous cases in 2013 and every year thereafter. Objectives • To set and enforce national targets and milestones for polio’s eradication within 24 months • To report to Mr. President monthly on the progress, challenges and corrective actions being taken to stop polio in Nigeria and request the President’s direct engagement as necessary • To focus attention and action in the most vulnerable and highest risk wards, LGAs and states and monitor their progress monthly through an LGA and State accountability framework • To lead monthly reviews on polio eradication, direct and take corrective actions • To ensure the required leadership of LGA Chairmen and state Governors in the polio eradication effort • To mobilize specific States, LGAs, partners, traditional and religious leaders, international partners, civil society, the media and the general public as required to ensure high quality, funded polio eradication activities

3. PresTOPE Mandate • To provide leadership support in Nigeria’s effort to accelerate the interruption of polio transmission in 2012 and achieve zero new indigenous cases in 2013 and every year thereafter. • Provide the leadership, oversight, directions and follow-up required to ensure the realization of Mr. President’s commitment to polio eradication within 24 months • Monitor progress based on monthly reports against an Accountability Framework • To focus particularly on the HR LGAs within polio-affected states • Task Force to report monthly to Mr. President • To take and direct rapid specific actions

5. Accountability Framework Background: The 22nd ERC (Oct 2011) recommended that stopping transmission of polio required an accountability framework, captured in major recommendation #3 “As part of implementing the re-affirmed Abuja Commitments a framework of accountability for LGA Chairmen and Ward Heads should be established, monitored by the special Task Force established by His Excellency the President.” Guiding Philosophy:Collective responsibility with individual consequences ( rewards & Sanctions)

6. Objective • The Accountability Framework is a tool to help raise population immunity to >3 OPV doses per child in infected, high-risk and vulnerable LGAs, by identifying the critical barriers and solutions; and holding individuals responsible for delivering rapid improvement so that polio transmission can be stopped in 2012 in Nigeria.

7. Principles • Promoting individual accountability at every level • Rewards for strong performance • Consequences for weak performance • Evidence based decision making • Random Independent assessments every month • Feedback to all levels • Implementation level(States & LGAS) programmatic responsibility

8. TORS and Accountability Presidential Task Force Core Group

9. Process Presidential Task Force to review Polio Accountability Report; make recommendations, take action Core Group: 1 Compile/ summarize State reports & verify 2. Integrate report of state, national and Task Force indicators; 3. Submit Report States verify & compile LGA assessments; add state responsibilities; report on progress monthly to Core Group (cc. to Gov, H. Commissioner) Independent random verification LGA Assessments to identify 3-4 critical impediments, solutions, individuals responsible, timelines

10. Roles and Responsibilities

11. Roles and Responsibilities

12. Roles and Responsibilities

13. Schedule & tiers of Stakeholder Accountability

14. ….Schedule & tiers of Stakeholder Accountability

15. Domesticating the Accountability Framework • Tools • Schedule and tiers of Stakeholder Responsibility • National Polio Accountability Report • State Reports • LGA Assessment Reports • Structure • LGA Level: Technical Committee of the Task Force and: PHC Coordinator, LIO,WFP,&Traditional Leader and LG Health Educator • STATE Level: Technical Committee of Task Force and the following: PS-SMOH, PS MOLGCA, DPH, Traditional Leader

16. National Polio Accountability Report • The Core Group will deliver a monthly Polio Accountability Report to the Presidential Task Force • To integrate LGA, state and national monitoring indicators. • The Core Group will also use other evidence (eg. IPDs LQAs) to verify standard indicators • The Task Force use the Report to identify underperforming states, LGAs and individuals, and recommend/take appropriate action every month.

17. LGA focus while keeping states, national in view • Focus on infected, high-risk and vulnerable LGAs • LGAs will assess 3-4 most critical barriers to raising population immunity, identifiy solutions, name individuals responsible for implementation and timelines for completion • State will compile these assessments into a report, send to Core Group monthly • States will monitor progress of LGAs, recommend rewards or sanctions; will reassess every 4 months • Core Group will summarize these reports along with state, national and Task Force indicators into one National Polio Accountability Report

18. LGA Assessment - Example LGA: _______________ Date: __________________

19. LGA Reports Prepared by State

20. LG Task Force Indicators: Examples LG Chairman: • Abuja Commitments • Actions taken upon confirmation of poliovirus State Task Force Chairman: • Funds release • Timely investigation of polioviruses • Community Mobilization LIO: • Preparation of monthly reports • Implementation of LG responsibilities

21. State Task Force Indicators: Examples Executive Governor: • Abuja Commitments • Actions taken upon confirmation of poliovirus State Task Force Chairman • Funds release • Timely investigation of polioviruses • SIOs • Preparation of monthly reports • Implementation of state responsibilities

22. Keys for Success • Training of States, LGAs (April) • Verification of LGA assessments – by states (systematically), and through independent assessments (eg. supervisors) randomly • National Rewards Program with standardized criteria, rewards to be tailored at local level • Consequences for non performance including within government; partner agencies • Systematic monthly collection, reporting, reviews and feedback loops from Wards - LGAs – State – Core Group - Task Force and back

23. Next steps Accountability Framework • State & LG Level trainings of Task Force on Programme Accountability& domestication • Activation of Technical Committee of State & LG Task Forces to have oversight over Emergency Plan (Emergency Plan Contact Team) • In-between Immunization Round Activities. • Let the work intensify; the viruses are actively working even as we speak……..

24. Finally…… • How do we engage the weakest link in the chain at the LGAs (PHC Coordinators, Word Focal Persons, LIOs) to make them more productive in plan implementation, monitoring and accountability? • Should we not consider having the 8 critical high risk states set up Polio Situation/operations room in tandem with partners as is done at the National Level? • Can we improve ownership of plans at State and LGA levels by making the State & LG Emergency Plan Contact teams the fulcrum of programme implementation at both levels? • Can Accountability work without clear lines of responsibility at the Local Government Level???

25. THANK YOU