Nigeria community case management

Community Health Systems:

  • The framework for community health system is still being developed and needs to be expanded. It is an effective system but with low reach (Global Fund Concept Note)
  • Community Based Organizations (CBOs) provide community based prevention, sensitization & mobilization, demand creation, care and support, refer and follow up on cases
  • Coordinated by the Lead NGOs at the zonal level, who are attached to private and secondary health facilities
  • Role Model Mothers used for increased access to commodities, increased active referrals and escorting clients to PHCs and secondary facilities.

Community Case Management

  • NMEP policy supports the use of pre-referral ARC at a community or peripheral health facility level.

Challenges:

  • Funding (often not costed and included in appropriations)
  • Interventions often not adjusted to fit peculiarities of communities (diverse cultural, social and religious set ups)
  • Cultural and operational barriers such as a lack of referral linkages to the formal health system, limited availability of rectal artesunate, and poor supervision and reporting have prevented implementation

Status:

  • The National Malaria Elimination Programme (NMEP) intends to expand access to malaria case management through iCCM (implemented in Nigeria since 2014)
  • This will be led by the Child Health Division
  • Delay in starting and the challenge of commodities

Implementers:

  • The Global Fund supports the rollout of the malaria component in 24 Local Government Areas (LGAs) in Niger State
  • Government of Nigeria through African Development Bank supports 2 LGA
  • Government of Nigeria through Islamic Development Bank supports 5 LGA
  • WHO funds the additional non-malaria commodities
  • ICF-International provides semi-annual data quality assessments to the project
  • PMI supports 11 states USAID-Nigeria, through maternal, neonatal and child health funding ; PMI supported another TWGs of NMEP and State Malaria Elimination Programs (SMEPs) with supply chain data to inform effective decision making.
  • PMI also provides technical assistance, assesses the performance of the drug revolving fund, and supports the routine distribution of ACTs, RDTs, and SP to 3666 health facilities.