In line with the National Primary Health Care Under One Roof (PHCUOR) policy, Niger State committed to revitalizing its Primary Health Care (PHC) system to address fragmented governance, inadequate financing, and gaps in human resources for health (HRH). Partnering with the Bill & Melinda Gates Foundation (BMGF) and TA Connect, the state sought technical assistance from Sydani Group to strengthen its PHC management capacity across seven key thematic areas: Data Management, HRH, Financial Management, Supply Chain and Inventory, Quality and Facility Management, Planning, and Community Relations.
Assessment:
Sydani conducted a comprehensive PHC management landscape assessment aimed at achieving three key objectives: determine the adequacy of PHC managers across all levels within the system; assess the support system and working environments to evaluate the ability of managers to perform their roles and; identify gaps in the competencies required by PHC managers to effectively carry out their job functions.
The assessment employed a mixed-method approach, gathering qualitative and quantitative data across 12 local government areas (LGAs) using a set of selection criteria, including security challenges and representation across senatorial districts. Respondents included 14 state-level focal persons, 12 LGA PHC directors and deputies, 256 Ward Development Committee (WDC) heads, and 256 officers-in-charge (OICs) from Apex Health Facilities. The assessment also involved key informant interviews, focus group discussions, and a desk review of relevant literature.
Result:
The assessment uncovered critical gaps across the seven thematic areas. Some key findings included a 46% absenteeism rate among health facility staff, with only 43% of health facilities tracking unexplained absenteeism. The functionality of WDCs for endorsing and submitting business plans was found to be poor. On the supply chain side, there were delays in requisition fulfillment and improper drug requisition documentation. While 98% of health facilities had adequate data tools, only 53% maintained proper records of unused or used data tools, and just 76% of facilities had focal persons responsible for data collation and review. The results informed the development of the Niger State Management Capacity Strengthening (MCS) plan, which provided targeted recommendations to address these challenges. The plan focuses on improving governance, capacity building, and operational efficiency across the state’s PHC system, setting the foundation for better service delivery and health outcomes.
Capacity building:
Sydani Group, contracted through TAConnect, provided technical assistance for this initiative, beginning with a comprehensive landscape assessment of the PHC management system. This assessment informed the creation of a targeted capacity-strengthening plan to address management challenges across the state’s PHC system.
To strengthen management capacity in the state, Sydani deployed a 70-20-10 learning model, which included structured on-site training, social learning, and on-the-job mentoring. Over a seven-month period, this plan targeted PHC managers, particularly Officers-in-Charge (OICs) in 128 apex health facilities across 12 selected LGAs. On-site training covered all thematic areas, equipping participants with essential managerial skills. Social learning opportunities enabled OICs to share insights and best practices, encouraging cross-pollination of ideas across facilities. In the on-the-job mentoring component, facility-level mentors and supervisors provided practical support, guiding OICs in implementing solutions to local challenges through capstone projects.
These projects allowed OICs to apply their training directly to facility management improvements, addressing issues like asset tagging, community mobilization for antenatal care, and facility repairs.
Result:
The capacity-building initiatives significantly enhanced PHC managers’ competencies in managing and improving facility-level operations across all seven thematic areas. Interactive on-site training sessions fostered core skills essential for delivering quality healthcare services. Social learning exchanges strengthened collaboration and problem-solving among managers, helping consolidate key lessons from training. Through the capstone projects, each of the 128 facilities successfully identified and began implementing tailored solutions, with all facilities actively reporting on their progress. These efforts have driven visible improvements across facilities, from enhanced community outreach to better management of facility assets, aligning facility-level functions with the broader PHC management strategy across Niger State.
