Borno State School Of Nursing Introduces Nship/pbf Curriculum

By Ahmed Abu, The Nigerian Voice, Maiduguri

Borno State Primary Health Care Development Agency (BOSPHCDA) under the leadership of the Executive Director, Dr. Sule Meleh and Nigeria State Health Investment projects Additional Financing (NSHIP-AF) under the Project Coordinator, Hajiya Habiba Saidu have been given a boost as the Management and Staff of College of Nursing and Midwifery, Maiduguri has agreed to introduce and inculcate Performance Based Financing (PBF) approach into its school curriculum to prepare students with knowledge as they face services in Health facilities after graduation.

The introduction of NSHIP/PBF to all manner of students of the institution according to the Provost is aimed at addressing laziness and non-challant attitude of health workers towards living up to their responsibilities and enhance better heath care service delivery in the state.

This is even as traditional rulers including the District Heads of Bolori, Alhaji Wadaima Abba Masta, Gwange, Alhaji Shettima Mattawali Bukar and the District Head of Old Maiduguri, who is the son to Shehu of Borno, Alhaji Abba Umar Shehu Abubakar Garbai have expressed happiness with NSHIP, a World Bank assisted Project for strengthening Primary Health Care Centres and secondary Health facilities in their domain, and pledged to give their maximum support for ownership and sustainability.

Recall that the Project Implementation Unit (PIU) team of NSHIP/PBF have continued with its Advocacy Visits/enlightenment and engagement of stakeholders on the impact of the project in the state which has been ravaged by insurgency in the last 10 years with attendant displacement of millions of Internally Displaced Persons (IDPs) who are in dare need of heath care.

Engaging Advocacy Team during visit to College of Nursing and Midwifery, the Provost, Hajiya Arkwaya, represented by her Deputy, Bukar Aji, said, "The coming of NSHIP in Borno is a life saving grace, and that is why even before you advocate, some of our staff including my humble self who had little knowledge of NSHIP have been teaching our students on what NSHIP/PBF is all about.

" The NSHIP/PBF is designed in such a way that would not only motivate staff through payment of bonuses at the end of each quarter, but has also equip most of the contracted facilities with standard laboratory and medical services expected of every patients and their relatives.

"As Health Educationists, we commend the present administration of Professor Babagana Umara Zulum, the World Bank and the National Primary Health Care Development Agency, BoSPHCDA and PIU Team who introduced NSHIP in the state. We in this College will partner with Borno State Primary Health Care Development Agency and Nigeria State Health Investment Project to ensure strict adherence to Performance Based Financing approach aimed at strengthening our health system in Borno State.

" It would be of value if everything is being put in place to ensure sustainability of the project. What NSHIP is doing is what is expected of every health worker to do, but this have since been eroded, and with the coming of PBF, it has really revived the old tradition and commitment to duty". Aji stated.

Earlier, the Human Resource Officer of PIU, Alhaji Kundili Bukar and Communication Officer, Inusa Ndahi among other Advocacy Team said, they were in the College to solicit support towards the implementation of NSHIP.

Kundili said, the project which started as a Pilot Scheme in two Local Government Areas of Jere and Maiduguri Metropolitan Council (MMC) in mid 2017, has been scaled up to 10 LGAs, with 101 contracted private and public Health Facilities and General Hospitals, while efforts have been completed to embark on 3rd scale up to Mafa and Konduga among other Council Areas based on the 2019 Work Plan.

He words: "Performance-Based Financing (PBF) is a health systems approach with an orientation on results defined as quantity and quality of service outputs.

"PBF started in Nigeria in 3 states namely Adamawa, Nasawara and Ondo and eventually scaled up in 2017 to Bauchi, Borno, Gombe, Taraba and Yobe States.

"The funding for this project is a loan by the Federal Government from the World Bank. At the national level, the implementing agency of PBF is the National Primary Health Care Development Agency (NPHCDA) as a project called Nigeria State Health Investment Project (NSHIP) while at the State level, it is implemented by the State Primary Health Care Development Agency.

"Through the Additional Financing-Nigeria State Health Investment Project, (AF-NSHIP), PBF was introduced in Borno and Yobe States in the 2nd quarter of 2017. It started in Borno as a pilot in Jere and MMC LGAs. In the 1st and 2nd scale-up, we now have 10 LGAs implementing this project in the State namely: MMC, Jere, Biu, Bayo, Kwayakusar, Hawul, Askira/Uba, Shani, Kaga and Magumeri.

"A total of 91 PHCs and 10 GHs are into the project across these 10 LGAs. The Rationale for the Project is that Borno state suffered from insurgency with most of the health facilities destroyed.

"Before the introduction of NSHIP, there was High maternal and infant mortality rates, very low immunization coverage, Dilapidated health facilities before PBF,

Lack of drugs in most health facilities, Lack and insufficient number of health personnel in facilities compared to the high number of internally displaced persons that need quality health care.

"The Approach of the Project is that; contracted Health facilities prepare business plans every quarter in the project and sign contracts with the BoSPHCDA based on a valid business plan.

" We also are called Contract Management Verification Agency (CMVAs) and LGA PHC staff who assist health facilities in developing business plans.

"Contract Management and Verification Agencies (CMVA) through its verifiers verify monthly quantity in health facilities with support from LGA PHC departments, conduct quarterly quality verification.

" Additionally, Counter verification of quantity and quality is done by the Independent Verification Agency (IVA) as well as Quantity counter verification by Community Based Organizations (CBOs) and quality counter by IVA certified assessors.

"The LGA Steering committee meets quarterly to validate invoices for payments and Payments are made by the Project Financial Management Unit directly into the account of the health facilities.

" The Health facilities therefore used the subsidies based on approved business plans to improve quality of services and motivate staff based on performance.

"Our Success Stories now is that 91 PHCs and 10 General Hospitals in 10 LGAs are benefiting from the project, with plans of expansion to other LGAs (Mafa and Kodunga LGAs).

" Presently, there are significant improvement in the infrastructure of all PBF health facilities if you pay visit, there are availability of essential drugs in all health facilities, Functional Laboratory services, improvement in the general state of equipment, Provision of health care services 24/7, Recruitment of staff and General improvement in the quality of services offered to the population.

"Others include; improvement in hygiene and sanitation, Free Antenatal Care (ANC) and delivery services, Proper management of Data and Significant improvement in the health indices for the State.

" We will be very happy and grateful if introduction of NSHIP/PBF would be actualized in no distant time into the curriculum for the training of nurses, midwives and other health personnel in this College.

"We have also engaged our Stakeholders such as Religious/traditional Leaders through Sensitization of the community on PBF and the visible changes this has caused in the health facilities.

" This is because, sensitization of the community to benefit from improved quality services at the health facility as a result of Performance-Based Financing is key through education of the community by the respective stakeholders so that at the end of the exercise, we expect the community to own the project towards sustainability." Kundili concluded.