RANA school health and safety pilot under the Reading and Numeracy Activity Project (RANA) in Katsina State.

IHC, under the UNICEF/Reading and Numeracy Activity (RANA) project in Katsina implemented a one-year pilot project in Katsina. Using the SafeZoneTM approach developed in collaboration with royal society for prevention of accident (ROSPA), IHC tested the effect of health and safety support in improving basic WASH, enrolment and incident reporting indicators in selected schools in Katsina State.

The main purpose was to improve the health and safety compliance of selected schools across 3 LGAs in Katsina State using SafeZoneTM. Schools were selected from the 40 non-treatment intervention schools based on population of settlement, infrastructure, proximity and population of pupils. Two schools were selected in each LGA (one for intervention and one for control) i.e. 6 schools across the 3 focus LGAs.

Some of the intervention supports include; school safety documentation such as safety policies, risk and fire assessment procedures, access control and security methodologies; procurement and use of safety devices such as fire extinguishers; and training of selected staff of the schools on life-saving skills and first aid administration.

The school health and safety re-assessment, which was conducted after these supports were implemented, reflected over 100% increase in the SafeZoneTM score of all the schools from the baseline assessment.

Repositioning Equitable Access to Comprehensive Health Services (REACH) project
Client: Shell Petroleum Development Company (SPDC)

Earlier before the implementation of the REACH Nembe project in Nembe, service delivery had been hampered by several challenges including infrastructure, staffing, implementation capacity, commodities and logistics.

Repositioning Equitable Access to Comprehensive Health Services (REACH) known as REACH Nembe Project was an initiative of Shell Petroleum Development Company (SPDC) in collaboration with Nembe Community Development Foundation (NCDF) and Bayelsa State Ministry of Health geared towards an easy access to health services by the people in Nembe community.

The REACH Nembe project was geared towards developing and implementing a viable Community Health Insurance Scheme (CHIS) for the indigenes of Nembe Kingdom, with the focus of refurbishing and reactivating the Nembe General Hospital, and engaging a project manager to oversee it towards being comprehensive.

The REACH Nembe project was launched on November 7, 2013. The Project partners include Bayelsa State Ministry of Health, Shell Petroleum Development Company (SPDC), Nembe City Development Foundation (NCDF), InSiGHt Health Consulting Limited (IHC), ProHealth HMO Limited and Marina Medical Services Limited.

The REACH Nembe project comprised 3 prongs: increasing financial access to health services through the implementation of a community health insurance scheme; improving comprehensive service delivery at the facility through required infrastructural and staffing support; and overall project management.

IHC was the project manager saddled with overseeing all the implementation activities which resulted to a strengthened health service delivery system – human resources, capacity building, quality improvement, and infrastructure; with over 10,000 enrollees.

Quality improvement of maternal and child health services in Lagos and Enugu States
Client: Partnership for Transforming Health Systems (PATHS2)

The Engagement for Quality Improvement and Performance or EQuIP strategy is a comprehensive approach to quality improvement that provides the means of generating a numeric index of quality for basic maternal and child health services. This is done using the quality estimation tool (QuEsT) to assess performance in core priority areas. This forms the basis of an objective measure for monitoring progress and developing quality improvement plans to address critical gaps in quality. The strategy also includes monthly supportive supervisions, constitution of quality improvement teams amongst the staff of the facilities and training. All this is within the context of also engaging the state stakeholders in improving an overall QI framework for the states.

The methodology involved three rounds of facility audits based on the assessments of 10 core priority areas of MNCH services, case studies involving the knowledge evaluation of consulting health workers on common maternal and new-born health conditions, and client satisfaction survey. These three processes were conducted/implemented using the Quality Estimation Tool or QuEsT – a combination of criteria and indicators from the Service Delivery Indicator (SDI)1, National Health Management Information System (NHMIS), the Integrated Supportive Supervision (ISS) tool and requirements of the National Quality Strategy Document, 2014.

Following computation of scores, each of the 68 intervention facility was debriefed on gaps identified through the analysis of baseline data and were given quality improvement plans or QIPs to execute through a constituted QI team solely comprising facility staff. Monthly supportive supervisions were conducted to monitor the implementation of the QIPs and give guidance as appropriate.

Stakeholder mapping guide was used to identify relevant stakeholders in both states who were actively engaged in every step of the QI approach. This QI approach was implemented for a period of 10 months, from June 2015 to April 2016, in 39 facilities in Lagos and 29 facilities in Enugu states across rural and urban LGAs–out of which there were 8 public hospitals, 35 private hospitals and 25 faith-based facilities.

At baseline, none of the intervention-facilities scored above the benchmark of 5 which was the set quality score standard. Following interventions, 10% of the facilities in each state were targeted to score above 5 after second assessment and 20% to score 5 after 3rd assessment.

Seventeen (17) and ten (10) facilities scored above 5 in Lagos and Enugu respectively showing that the target for the second round of assessments was exceeded by 33.6% and 24.5% in Lagos and Enugu respectively. Twenty two (22) and seventeen (17) facilities scored above 5 in Lagos and Enugu respectively showing that the target for the third round of assessments was exceeded by 36.4% and 38.6% in Lagos and Enugu respectively.

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