The polio legacy process in Nigeria. Abuja, NPHCDA 15-Apr-16

Transcription

1 The polio legacy process in Nigeria Abuja, NPHCDA 15-Apr-16

2 Outline Background Mapping the polio Assets Legacy in action Way forward

3 Background

4 POLIO ENDGAME STRATEGIC PLAN OBJECTIVE 1 Polio virus detection and interruption OBJECTIVE 2 Immunization systems strengthening and OPV withdrawal OBJECTIVE 3 OBJECTIVE 4 Containment and certification Legacy (Transition) planning

5 The PL Status The Nigerian polio legacy secretariat is made of 3 man by NPHCDA, UNICEF and WHO The budget of the polio legacy planning process has been approved by the ICC. The technical working group has been expanded to include relvant MDAs and partners The PL process vision has to be going toward health system strengthening beyond 2020 taking into account the national policy and priorities as mentioned by the 30 th ERC.

6 Roles and responsibilities THREE KEY STAGES FOR LEGACY ROLLOUT BY 2018 Phase of Transition Planning & Decision Preparation Execution Activities Structure definition Selection of transition opportunities, cost assessment Formation of project oversight team MoUs with recipient institutions Revision of contracts Implementation of revised contracts Transfer of assets / capabilities Monitoring & Evaluation Creation of operation and communication strategies Capacity building Donor engagement Ongoing monitoring of transitioned assets / capabilities Leadership Transition Assistance Process management Technical assistance Professional Legacy Management Team Agencies and other stakeholders Donor Consortium Asset recipients Recipients

7 TRANSITION PLANNING TIMELINES Phase of Transition Planning & Decision Preparation Execution Outcome Country transition plan finalized and agreed upon Assets ready for transition (e.g., funding available, initial trainings conducted) Transition process initiated Assets fully operational in new roles (depending on nature of transition) Estimated Timeline 12 MONTHS Within 6 MONTHS Within 12 MONTHS 2-5 YEARS of decision of plan in place after plan in place Timeline contingent upon eradication status 7

8 Legacy transition phase Nigeria actual plan POST GPEI PHASE COUNTRY EXAMPLES WHA RCMs Stakeholder engagement needed to raise awareness of need for country-level planning Transition planning underway DRC Nepal India Planning & Decision Preparation & Execution All other polio-free and recent outbreak Sudan Ethiopia Somalia S. Sudan Angola Bangladesh Indonesia Myanmar Egypt Chad Planning & Decision Preparation & Execution Timeline contingent upon eradication status Recently endemic Nigeria Planning & Decision Preparation & Execution Timeline contingent upon eradication status

9 Legacy planning timeline NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY THE POLIO LEGACY PLANNING LEGACY SECRETARIAT From the assets lessons learned, translate hope to commitments, commitments to action for the Nigerian population LEGACY PLANNING PHASE STARTING ENDING PHASE 1: ASSETS MAPPING: HUMAN RESOURCES, PHYSICAL ASSETS, INFRASTRUCTURE & NON TANGIBLE ASSETS PHASE 2: CONSULTATIONS, MEETINGS, PLANNING, REPORT CONSOLIDATION PHASE 3: IMPLEMENTATION PHASE 4: FULL COUNTRY CONTROL / OWNERSHIP

10 Legacy planning objectives Maintain a polio free world Share knowledge generated and lessons learned Transfer capabilities, assets and processes

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12 Assets mapping update

13 FGON STATES LGAs WHO UNICEF CGPP CDC-NSTOP FOMWAN JAP NTLC CDC ROTARY LABS ehealth EOCs Nigeria PEI donors and implementing agencies I m p l e m e n t e r D o n o r FGON STATES LGAs AUSTRALIAN AID BMGF CDC CORE GROUP DANGOTE DFID EU GLOBAL AFFAIRS CANADA GOJ - JICA KfW NORWAY ROTARY SIR EMEKA FOUNDATION UNICEF USAID WHO WORLD BANK

14 Mainly for EOCs running costs and the 54 M&A distributed between the national EOC and the other norther high risk States. The Foundation MoU for the EOCs ends by December 2016

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16 OPV not included

17 Funding mainly channelized through WHO and CGPP

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19 2015 PEI operations cost Polio Programme Main Functions Total Yearly Expenditure US$ BMGF US$ CDC US$ USAID US$ WHO US$ UNICEF US$ CGPP US$ Implementation and service delivery 59,249,284 29,971,464 6,282,200 20,154,000 18,171,860 4,823,760 Monitoring and data management 7,711,411 2,787, ,000 3,422,419 1,015,597 Diseases surveillance 16,784,405 3,000,000 16,784,405 Planning 2,804,731 2,804,731 Communication and community engagement 20,398, ,849 3,744,050 15,737,065 Capacity building 7,478,326 3,892,208 3,408, ,840 Resource mobilization and advocacy 875, , ,710 Policy and strategy 1,518, ,610 1,094,462 Partnership and coordination 1,132,960 1,132,960 Management and operation 18,381,335 3,995,963 1,212,000 11,387,219 1,786,153 Total 136,334,982 41,564,879 7,980,200 23,154,000 61,724,316 25,065,587

20 Human resources

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23 Total Adamawa Bauchi Borno Gombe Taraba Yobe Kaduna Kano Katsina Jigawa Kebbi Sokoto Zamfara Benue FCT Abuja Kogi Kwara Nassarawa Niger Plateau Abia Anambra Ebonyi Enugu Imo Akwa Ibom Bayelsa Cross River Delta Edo Rivers Lagos Ekiti Ogun Ondo Osun Oyo PEI HUMAN RESOURCES Main Functions Implementation and service delivery 2, Monitoring and data management Diseases surveillance Planning 9 9 Communication and community engagement 16, , ,310 4,971 2, , Capacity building 1 1 Resource mobilization and advocacy Policy and strategy 3 3 Partnership and coordination Management and operation Total 19, , ,001 2,538 5,293 2, , CDC-NSTOP Core Group BMGF_M&A WHO UNICEF

24 Physical Assets

25 WHO PEI PHYSICAL ASSETS INVENTORY State Vehicles Generator Laptops Photocopier Sat Phones Scanner Total Value USD Abia ,150 Adamawa ,100 Akwa Ibom ,850 Anambra ,200 Bauchi ,011 Bayelsa ,800 Benue ,450 Borno ,350 Cross River ,150 Delta ,150 Ebonyi ,850 Edo ,400 Ekiti ,150 Enugu ,413 Gombe ,383 Imo ,850 Jigawa ,608 Kaduna ,138 Kano ,164 Katsina ,482 Kebbi ,950 Kogi ,900 Kwara ,900 Lagos ,016 Nassarawa ,083 Niger ,179 Ogun ,383 Ondo ,500 Osun ,150 Oyo ,538 Plateau ,800 Rivers ,900 Sokoto ,526 Taraba ,150 Fct, Abuja ,474 Yobe ,700 Zamfara ,650 By end of 2017, only 10 Toyota Vehicles will be functional using the lifespan of five year for a 4x4 vehicle All laptop computers also must be renewed at that time

26 Assets distribution Infrastructure: National and State EOCs (Abuja, Sokoto, Kaduna, Katsina, Kano, Bauchi, Yobe and Borno Lab equipment: Maiduguri and Ibadan It equipment: All States Transport : In all States

27 A three-year running cost of the EOCs is about USD 14mo including the 54 M&As Yearly, the national EOC runs with USD 660k while the State EOC run on average for about USD 420k

28 Risks

29 Core risks seen for the legacy in Nigeria Funding meltdown from the GPEI partners EOCs operate under an MoU which expires by end of 2016 Frontline staff are uncertain about their contracts

30 Opportunities

31 Opportunities for the legacy planning in Nigeria FMOH vision on PHCUOR Mainstreaming the two first legacy planning objectives aiming at maintaining a polio free world (surveillance) and strengthening routine immunization Phasing the roll-out plan

32 Legacy in action

33 In between round PEI activities Over 16,000 Community Mobilizers contributing to broader health activities Routine Immunization New Vaccines introduction (Penta, IPV, PCV) Nutrition (CMAM) SIAs (Measles, MenA campaigns) Community Mobilizer Birth Registration Health Education (WASH) Surveillance

34 North East Zone: Proportion of AFP reported by various cadre of personnel Jan - Dec 2015

35 NWZ: Proportion of AFP reported by various cadre of personnel Jan Dec 2015

36 Reaching underserved population in security compromised areas

37 Transition planning proposed scenarios Scenario 1: Nationwide integrated disease surveillance support Scenario 2: Transitioning to Routine Immunization program Scenario 3: Transitioning to Maternal, Neonatal and Child Health Program Scenario 4: Transitioning to the Primary Health Care (PHCUOR)

38 How are we getting where we are going? Phase by phase transitioning Polio agenda overcoming the State strikes

39 Mainstreaming other programmes and direction of transitioning Surveillance Routine immunization as a lead of the PHC under one roof Nutrition Birth registration WASH HIV/AIDS

40 Needs Maintaining all staff for the surveillance Maintaining best performing community mobilizers for RI, birth registration, WASH, surveillance HRH from the FMH to be integrated

41 Actual benchmarks Finalization of mapping by end March 2016 Consultation with Stakeholders for decision making April - September Take of the legacy implementation October > Follow up of the implementation Oct 2016 Dec 2017

42 Final update on the mapping Finalization of mapping by end March 2016 Consultation with Stakeholders for decision making April - September Take of the legacy implementation October > Follow up of the implementation Oct 2016 Dec 2017

43 Way forward and prayer to the ED/NPHCDA Negotiate with donors to extend their contract until the country is declared polio free. EOC model to be maintained and proffered to all States which will help the application of the IHR in line with the Integrated Disease Surveillance and Response Incorporation of the polio assets into the PHC restructuring (PHCUOR: 10,000 HF for 109 in each senatorial zone by end of March 2016 => 5,000 by end 2016 and 5,000 in 2017) Polio human resources critical mass to be retained and integrated into the National HRH FMoH policy and framework

44 Thank you

45 FMOH concept of 1 PHC per Ward

46 The added value of 1 PHC per ward

47 The added value of 1 PHC per ward