BASICS-N PROJECT Community Partners for Health (CPH) Coalitions in Lagos, Nigeria 1994 – 1999 Sam A Orisasona Team Leader,...
Order of Presentation <ul><li>Project Mandate/Tiltle </li></ul><ul><li>The Critical Health Issues </li></ul><ul><li>Core P...
The Critical Health Issues <ul><li>In 1990 immunization coverage in Nigeria approached the African target of 80% </li></ul...
Project Mandate <ul><li>PROJECT :  USAID/BASICS-N Child Survival PROJECT </li></ul><ul><li>BASICS means Basic Support for ...
Core Processes <ul><li>Nigeria was decertified as a result of military perpetuation by the American Congress in mid 1990 <...
Management <ul><li>Needs assessment/Work plan development sessions </li></ul><ul><li>Training in Democracy and Governance ...
Logistical Support <ul><li>Provision of megaphones for awareness campaigns </li></ul><ul><li>Provision of cold chain equip...
Training <ul><li>Needs Assessment for carrying out child and community health programs </li></ul><ul><li>Operationalizing ...
Membership <ul><li>In Lagos: 700 partners identified (395 CBOs & 330 HFs of which 279 interviews were completed, only 90 o...
Characteristics of CPH <ul><li>Mushin CPH </li></ul><ul><li>Eligible groups  - 40 </li></ul><ul><li>Reached/Contacted - 33...
Networking <ul><li>Inter-CPH meetings, programs, and joint programs </li></ul><ul><li>LGA (supplied trucks for refuse coll...
Accomplishments <ul><li>Increased immunization </li></ul><ul><li>Cleaner environment </li></ul><ul><li>Making health care ...
Sustainability Issues <ul><li>Ability to: </li></ul><ul><li>Govern themselves including managing of resources and conflict...
Thank you
References <ul><li>William R. Brieger et al:  Community Partners for Health: Urban Health Coalitions in Lagos, Nigeria  In...
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BASICS-N PROJECT Community Partners for Health (CPH) Coalitions in Lagos, Nigeria

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Presentation given at the Future Health Systems Meeting in Nigeria January 2009 on innovations in health markets. www.futurehealthsystems.org

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BASICS-N PROJECT Community Partners for Health (CPH) Coalitions in Lagos, Nigeria

  1. 1. BASICS-N PROJECT Community Partners for Health (CPH) Coalitions in Lagos, Nigeria 1994 – 1999 Sam A Orisasona Team Leader, Lagos Field Office
  2. 2. Order of Presentation <ul><li>Project Mandate/Tiltle </li></ul><ul><li>The Critical Health Issues </li></ul><ul><li>Core Processes </li></ul><ul><li>Management </li></ul><ul><li>Logistical Support </li></ul><ul><li>Training </li></ul><ul><li>Membership </li></ul><ul><li>Characteristics of CPH </li></ul><ul><li>Networking </li></ul><ul><li>Accomplishments </li></ul><ul><li>Sustainability Issues </li></ul>
  3. 3. The Critical Health Issues <ul><li>In 1990 immunization coverage in Nigeria approached the African target of 80% </li></ul><ul><li>Since 1991, immunization efforts have slackened </li></ul><ul><li>In 993, only 37% of children received all antigens by first birthday </li></ul><ul><li>In 1992, USAID documented 29% children with valid full immunization coverage by 12 months </li></ul><ul><li>In 5 LGAs where BASICS was to serve, immunization coverage was pegged at between 20.5% and 40.9% </li></ul><ul><li>Physical accessibility was not much the problem, but, but lack of quality services by the public sector, </li></ul><ul><li>Hence, BASICS was mandated to redress the problem </li></ul>
  4. 4. Project Mandate <ul><li>PROJECT : USAID/BASICS-N Child Survival PROJECT </li></ul><ul><li>BASICS means Basic Support for Institutionalizing Child Survival, Arlington, USA </li></ul><ul><li>USAID MANDATE : Find innovative ways to meet the needs of poor Nigerian children in urban communities of Lagos </li></ul>
  5. 5. Core Processes <ul><li>Nigeria was decertified as a result of military perpetuation by the American Congress in mid 1990 </li></ul><ul><li>UPSI – Urban Private Sector Inventory of CBOs and HFs in late 1994 (in 13 communities, 6 selected) in 1995 </li></ul><ul><li>Selected communities where CPH were formed: Ajegunle, Mushin, Surulere, Makoko, Amukoko and Lagos Island </li></ul><ul><li>Community Fora/meetings: 2 meetings held in each cluster area (concept of coalition for improved child care introduced for debate and acceptance as alternative to increasing childhood morbidity and mortality) </li></ul><ul><li>Formation of 6 CPH by interested partners (by end 1995) and development of MOU (structure, leadership and responsibilities, reduced cost of treatment/CBO default prevention/management arrangement) </li></ul><ul><li>Constitution development </li></ul><ul><li>CPH NGO Community-based Registration by CAC (6 CPH) </li></ul><ul><li>Setting up of 6 CPH Secretariat. Documentation by 1997 (provided lessons for Kano, Abia States) – a total of 16 CPH set up </li></ul>
  6. 6. Management <ul><li>Needs assessment/Work plan development sessions </li></ul><ul><li>Training in Democracy and Governance </li></ul><ul><li>Establishment of women’s empowerment committees </li></ul><ul><li>Establishment of youth wings </li></ul><ul><li>Establishment of savings and loans cooperatives </li></ul><ul><li>Establishment of micro-credit scheme </li></ul><ul><li>Design, printing of letterheads, brochure for identity </li></ul><ul><li>Promotion of inter CPH collaboration/competition </li></ul><ul><li>Capacity building on M & E skills </li></ul>
  7. 7. Logistical Support <ul><li>Provision of megaphones for awareness campaigns </li></ul><ul><li>Provision of cold chain equipment and materials for immunization </li></ul><ul><li>Provision of environmental sanitation tools for sanitation activities </li></ul><ul><li>Provision of start-up stock of office supplies </li></ul><ul><li>Gifts of used vehicles, office furniture and computers by USAID (some were sold – e.g. Surulere – ($3,100) </li></ul><ul><li>Registration of partners (HF & CBOs) </li></ul><ul><li>Raffle ticket & appeal funds </li></ul><ul><li>Support for external audit of CPH accounts </li></ul>
  8. 8. Training <ul><li>Needs Assessment for carrying out child and community health programs </li></ul><ul><li>Operationalizing the cost of reduced health care cost on credit/building CBO Capacity to support failed individuals </li></ul><ul><li>Technical training on childhood target diseases: Malaria, Diarrhea & 6 immunizable childhood diseases </li></ul><ul><li>Training of TBAs </li></ul><ul><li>H/Education materials development </li></ul>
  9. 9. Membership <ul><li>In Lagos: 700 partners identified (395 CBOs & 330 HFs of which 279 interviews were completed, only 90 out of CBOs reported involvement in any health activities-71 specifically mentioned immunization) </li></ul><ul><li>Community fora were organized around potential HF and CBOs that were likely to form dyadic partnership- minimum of one HF and one CBO within a larger CPH </li></ul><ul><li>Community fora was held in (community halls, HF and clinics, schools, religious buildings) </li></ul><ul><li>CPH Board Formation </li></ul><ul><li>Formation of fund raising committee </li></ul><ul><li>Formation of finance & Budget committee etc </li></ul>
  10. 10. Characteristics of CPH <ul><li>Mushin CPH </li></ul><ul><li>Eligible groups - 40 </li></ul><ul><li>Reached/Contacted - 33 </li></ul><ul><li>Attended Fora - 23 </li></ul><ul><li>Joined CPH - 8 </li></ul><ul><li>Joined (not identified) - 6 </li></ul><ul><li>ENTIRE CPH </li></ul><ul><li>6 CPH initially comprised of 72 groups (80%) CBOs </li></ul><ul><li>Drop out – 2 CBOs, relocation of a dyad AJCPH to </li></ul><ul><li>AMCPH </li></ul><ul><li>2 years later, membership increased to 137 groups </li></ul>
  11. 11. Networking <ul><li>Inter-CPH meetings, programs, and joint programs </li></ul><ul><li>LGA (supplied trucks for refuse collection) </li></ul><ul><li>State MOH (annual immunization campaign) and Women Affairs (women empowerment-Mock Democracy Parliament Program) </li></ul><ul><li>Local schools </li></ul><ul><li>International donors/Agencies </li></ul><ul><li>UNICEF (All registered, collected 36,000 ORS for cholera emergency response) </li></ul><ul><li>Ability to response to emergency situations in all the communities by 1997 </li></ul><ul><li>Full program implementation by 1997 </li></ul><ul><li>Youth networking on week-long HIV/AIDS campaign, and “I am pregnant” - AJCPH </li></ul>
  12. 12. Accomplishments <ul><li>Increased immunization </li></ul><ul><li>Cleaner environment </li></ul><ul><li>Making health care accessible and affordable to members </li></ul><ul><li>Community coalition was extended to address other issues </li></ul><ul><li>e.g. elections, politics, education etc </li></ul><ul><li>CPH model was an innovative way to involve the private sector in reaching the poor with quality health and preventive services </li></ul><ul><li>CPH model actually dispelled rumors that community health coalitions are impossible in urban areas </li></ul><ul><li>CPH was replicated in Kano and Abia States </li></ul><ul><li>Lessons learned from CPH was transferred to the design of another model (CAPA) that works with government and the people opon transition to democracy </li></ul>
  13. 13. Sustainability Issues <ul><li>Ability to: </li></ul><ul><li>Govern themselves including managing of resources and conflict resolutions </li></ul><ul><li>Generate resources to maintain programs on a continuous basis </li></ul><ul><li>Plan and implement programs independently </li></ul><ul><li>Link with other development agencies and donors </li></ul>
  14. 14. Thank you
  15. 15. References <ul><li>William R. Brieger et al: Community Partners for Health: Urban Health Coalitions in Lagos, Nigeria International Quarterly of Community Health Education </li></ul><ul><li>2000-01;20(1):59-81 </li></ul><ul><li>Silimperi DR et al: Lagos Community Partners for Health: Innovative Private Sector Partnership Promote Child Survival . Arlington BASICS (USAID), 1997 </li></ul>

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