The strategic aim of European Union-Support for Immunisation Governance in Nigeria (EU-SIGN) is to strengthen health sector governance through the entry point of Routine Immunisation (RI). To this end, EU-SIGN works to extend the policy of Primary Health Care Under One Roof (PHCUOR) from the Federal to the State and Local Governance Area (LGA) levels while strengthening Routine Immunisation (RI) and reducing maternal and under five’s burden of disease.
Because Primary Health Care (PHC) in Nigeria is fragmented, with key functions overlapping among the Federal, State and LGA levels of government, many States and LGAs lack a coherent framework for policy and programme, with cooperating partners all too often working in isolation rather than in concert toward Nigerian policy aims. With its premise that a clarification of function across the nine themes will contribute to aligning responsibility with accountability and health sector stewardship, EU-SIGN aims to create a supportive environment for strengthening health systems and services while improving RI health coverage and outcomes at scale.
EU-SIGN therefore works to strengthen the National Primary Health Care Development Authority (NPHCDA) at the Federal level, assisting it to support to the State Primary Health Care Development Authorities/State Health Boards in 23 priority States and FCT Abuja –Abia, Akwa Ibom, Anambra, Bauchi, Cross River, Ebonyi, Edo, FCT, Gombe, Jigawa, Kaduna, Kano, Katsina, Kebbi, Kogi, Kwara, Lagos, Ogun, Osun, Plateau, Rivers, Sokoto, Yobe, and Zamfara).
The work of EU-SIGN is comprised of four key output areas:
- Improved State and LGA management systems and stewardship of PHC geared towards routine immunisation including policies and practices/guidelines for PHC;
- Improved delivery of RI services via the PHC system including infrastructure for RI, transport and cold chain, and relevant equipment;
- Improved policy and programming based on evidence, information and communication grounded operational research and evidence uptake;
- Reduce and halt the transmission of polio infection with in support of the global aim of polio eradication and the Nigerian aim of its elimination.
As part and parcel of EU-SIGN’s work plan, the project is supporting key initiatives related to civil society CSO/NGO mapping to understand options for engagement in advocacy, accountability and delivery. It is also supporting an assessment cultural-linguistic area to update understanding of the major determinants of support for and resistance to RI to inform communication and social engagement efforts.
And, as part of its “evidence agenda”, EU-SIGN is supporting NPHCDA Research Technical Committee’s Operations Research Advisory Group (ORAG) to oversee operations research to help strengthen the evidence base for health sector decision making at the Federal, State and Local Government Area (LGA) and community levels. Informed experience at the Federal level and in the States and understanding of the weaknesses of current institutions and the resultant fragility of structures for stewardship and service delivery points call for targeted investment to test and validate key approaches that will strengthen capacities for governance and improving immunisation-related outputs and outcomes. This work includes support for priority operations research to fill critical gaps in evidence with the ORAG’s oversight of this work helping ensure maximal impact in terms of evidence uptake and improved policy and programming leading ultimately to better health outcomes at scalp.