Online Program

Governance Capacity strengthening of Front Line Public Health Institutions: A Critical Reflection

Monday, November 2, 2015

Audu Liman, PhD, Pact Nigeria, Abuja, Nigeria
Alison Koler, MPH, Pact, Washington DC, Washington, DC
Kolo Yakubu, M.Sc Health Econs., Pact Nigeria, Gombe, Nigeria
While significant progress has been made worldwide in reducing maternal and neonatal mortality over the past two and a half decades, preventable maternal and infant deaths remain unacceptably high, particularly in sub-Saharan Africa. Nigeria has one of the highest maternal mortality ratios in the world, estimated in 2013 at 560 deaths per 100,000 live births. Through the Strengthening MNCH Frontline Organizations (FLO) project, Pact aims to improve the performance of frontline organizations, including Gombe and Adamawa states primary healthcare development agency (SPHCDA) and their Local Government primary healthcare departments (LGA PHCDs)

The project evaluated capacity growth among the SPHCDA and LGA PHCDs. In 2013, the Enabling Conditions Barometer (ECB) assessment tool was administered to 20 participants per state for the two states (Adamawa and Gombe). The participants were organized into 4 stakeholder groups, with 4 to 5 participants per group: 1) managers from the SPHCDA and SMOH, 2) staff representatives from the health facilities (frontline service providers) 3) members of the legislative bodies and the legislature, and 4) representatives from CSOs working on the MNCH issues in the two states. Two SPHCDA departments and 17 LGA PHCDs were administered rapid organizational capacity assessment (ROCA) in 2012 as baseline, 2014 for midline and end line will be in 2015.

ECB Index score for managers of public health institutions in Adamawa shows Effectiveness and Efficiency score was 54/100, For Gombe Effectiveness and Efficiency score was 65/100. A comparison of midline with the baseline ROCA for select LGA PHCDs shows increased ROCA assessment scores in Planning (Baseline 0.2, Midline 0.6). A further comparison will be made at end line.

Enhancing key health system governance areas including transparency, strengthening social accountability and internal/external supervision as well as consolidating the participation of all are among the critical priorities that front line institutions require capacity enhancement.

Learning Areas:

Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Evaluate program interventions which set out to enhance good governance capacity within the health sector targeted at both state and non state front line health organizations.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am result and measurement Advisor at Pact washington supporting a number of country programs with Measurement Evaluation Reporting and Learning
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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