Inception Mission

Inception Mission Report for CMVA Borno - Jere LGA

Health system strengthening remains the core mandate of the performance based financing system globally and the AF-NSHIP in North East state of Nigeria is geared towards rebuilding the weak health care system following the impact of the conflict.

This impact of conflict on health systems is known to weaken health service delivery and some instances, completely deprive the population of access to basic health care services. Rebuilding health systems in conflict affected areas have shown to be an emergency intervention, requiring adequate financing to restore infrastructure, human resources, equipment, medical supplies, promote hygiene, improved security access, motivation of health workers who will make extra effort to provide these much needed health services to the affected population etc.

Performance based financing seeks to create a platform to achieve all these goals through its best practices; especially providing autonomy to health institutions in providing essential services through transparent and accountable means.

Contract management and verification Agency; Bell Dome Consult Limited with a vast base of experience and human resources in management of health systems and rebuilding health systems in conflict affected areas, have carried out an initial assessment visit to Jere LGA of Borno state where it is contracted to manage the implementation of the PBF in seventeen (17) Health facilities including two (2) secondary health facilities.

An appraisal of the health supervisory institutions in Borno state such as the State primary health care Development Agency, the State Ministry of health and Jere LGA primary health care department showed some capacities acquired ahead of the PBF implementation in the state; An asset towards robust supervision and sustainable system strengthening.

Though Jere LGA is currently implementing the performance based financing program, huge gaps were identified at the level of the primary health care centres and the LGA department where implementation ought to be optimal. Health facilities and supervisors have limited knowledge of the PBF mode of action and has resulted in poor interpretations and implementation since pilot began in this area.

Bell Dome Consult Limited, through its initial assessment visit to the LGA, the state primary health care Development agency and the state Hospital services management board, have designed a coaching and mentoring system to improve on the capacities of the health facilities and the supervisors, as entrenched in the MPA and CPA domains for implementing health facilities and performance framework for supervisors. These training designs will be implemented daily, weekly, monthly and quarterly over the period of the contract entered with Bell Dome Consult Limited as shown in the quarterly work plan.

Recommendations and Conclusions

Health system strengthening in conflict affected areas have been an area of specialty for Bell Dome Consult Limited, especially through the Performance Based Financing for over half a decade ago.

A review of Borno state and Jere LGA in particular have shown a huge need for capacity building, coaching, mentoring, adherence to PBF financial standards and management of clinical data.

All these were mapped out to be achieved professionally and in good time. In line with improving access to health care and contributing to achieving universal health coverage, especially on high impact maternal and child health programs,

Bell Dome Consult Limited is most equipped to reestablish and rebuild health care services in all areas of its responsibilities.

To achieve its set tasks, Bell Dome Consult Limited recommends that the client ensures timely communication of matters, to the teams on the field, especially in cases of imminent change in mode of operation and tasks.