By Moses Emorinken, AbujaThe Federal Government Wednesday disclosed that at least 30 million Nigerians have been able to access qualitative and affordable healthcare services through its Nigeria State Health Investment Project/Additional Financing (NSHIP/AF).The NSHIP Project, which was co-financed by the World Bank, was implemented by over 2,000 health facilities across 113 Local Government Areas (LGAs) in the eight (8) states, namelyAdamawa, Nasarawa, Ondo, Bauchi, Borno, Gombe, Taraba and Yobe.Adopting experiences from countries like Rwanda, Haiti, Cambodia, etc., the Federal Government and the World Bank commitment the sums of $171.5 million and $145 million respectively to scale up the project with pre-pilots in LGAs in Adamawa, Nasarawa and Ondo States.Speaking during the NSHIP/AF Project Closure Workshop organised by the National Primary Health Care Development Agency (NPHCDA), in Abuja, the Executive Director of the Agency, Dr. Faisal Shuaib, noted that the project was borne out of the need to explore a different strategy to invest the limited available resources to achieve maximum results to attain the Sustainable Development Goals (SDGs) by 2030 and Universal Health Coverage (UHC) for all.Represented by the Director of Community Health Services of the NPHCDA, Dr. Nneka Onwu, he said: As part of the Federal Governments effort to improve access to quality health care for Nigerians, the National Primary Health Care Development Agency (NPHCDA) commenced the pre-pilot of output-based financing in 2011 under the Nigeria State Health Investment Project (NSHIP) using the experiences from Rwanda, Haiti, Cambodia etc in 3 LGAsFufore, Wamba and Ondo-East LGAs in Adamawa, Nasarawa and Ondo states respectively.The initial tremendous results are shown in the pre-pilot LGAs informed the governments commitment of $171.5 million and $145 million (credit/grant from the World Bank) for the scaled-up of result-based financing (RBF) to the remaining 49 LGAs across the three Adamawa, Nasarawa and Ondo States as well as an extension to 64 LGAs in the remaining five North East States of Bauchi, Borno, Gombe, Taraba, and Yobe. This was to rapidly rehabilitate and re-establish health care service delivery as a result of the devastating effect of the insurgency in the area.The implementation of NSHIP was also in line with Federal Governments Primary Health Care (PHC) revitalization agenda and the initiative of the provision of, at least, one functional PHC per ward across the country in order to attain Universal Health Coverage (UHC) under the President Muhammadu Buharis agenda for the health sector.The implementation of NSHIP brought about the paradigm shift from the traditional input-based financing, fragmented and unclear accountability, top-bottom investment approach, no verification and centralized medicine supply, to the result-based financing with well-defined and monitored performance indicators, accountability, bottom-up investment decisions, rigorous verification and decentralized medicine and health commodities supply within the PHC landscape. The result has been however unprecedented especially as it relates to the achievement of the Agencys mandates.The NSHIP was implemented by over 2,000 health facilities across 113 LGAs in the eight (8) States of Adamawa, Nasarawa, Ondo, Bauchi, Borno, Gombe, Taraba and Yobe which experienced total transformation and became functional with improved quality service delivery. This transformation has ensured that about 30 million Nigerians, including women and children, have access to quality basic health services and secondary services for continuum of care. The NSHIP was also implemented in the selected health facilities across the IDP Camps in Borno State which housed over 2 million internally displaced persons (IDPs).However, even as the NSHIP as a project that will officially come to a close with this workshop, I want to urge all stakeholders to use the best practices and lessons learnt from the project for implementation of subsequent projects and programmes in order to sustain the gains achieved.READ ALSO:Tackling medical tourism with healthcare investmentThe NSHIP/AF closed by 31st May and 31st October 2020 respectively. The NSHIP/AF made tremendous impacts in rebuilding the functionality of the health systems, particularly the primary health centre of the implementing states with in-country capacity built on Output-Based Financing across all levels.In his remarks, the Senior Health Specialist from the World Bank, Onoriode Ezire, said: This project was very consultative because people at the state and national were consulted and projects are on, both at the state and the National. The project is also very highly result-oriented. Unlike other projects that are processes driven, this is result-driven.Through this project, standard practices have been established. You cannot talk about the basic health care provision fund, national health sector development plan (part one), primary health care under one roof, system strengthening of health facilities today without talking about the NSHIP project.We are hoping that this project will be scaled, especially at the state level. I have been to Gombe, Bauchi and several other states, and my message remains the sameif we grow beyond paying for inputs in the health sector, and start paying for results, we will spend less on health and get more results for health. The NSHIP project is a very good model that we can replicate in spending and get better results.
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