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RMNCAEH+N: FG seeks effective coordination, implementation

by Haruna Gimba
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By Haruna Gimba

The Federal Government of Nigeria said it consistently increased its effort to improve maternal and new-born health outcomes.

This was contained in a communique issued at the end of a five-day national RMNCAEH+N quality of care technical working group meeting with federal, state ministries of health, department and agencies and implementing partners.

The communique stated that, since 2017 when Nigeria joined the World Health Organization (WHO) led Quality, Equity and Dignity (QED) global network to improve quality of care (QoC) to mothers and newborns, health Ministries Departments and Agencies (MDAs) both at the national and sub-national level are striving to ensure effective QoC implementation to reduce maternal and newborn mortality by half and improve the experience of care by 2030. 

The Reproductive Maternal Newborn Child Adolescent Elderly Health plus Nutrition (RMNCAEH+N) QoC National Technical Working Group (TWG) in country, is responsible for the effective coordination, implementation and monitoring of QoC, ensure states implementations and interventions. 

The meeting had in attendance 124 participants from the Federal Ministry of Health (FMOH), National Primary Health Care Development Agency (NPHCDA), State Ministries of Health, State Primary Health Care Development Agencies/Boards, Development Partners (including donors and Implementing Partners), Research institutions, Academia, Professional Associations and Civil Society Organizations (CSOs).

Health Reporters gathered that key deliberations at the meeting among other issues deliberated are; “That most of the RMNCAEH+N QoC sub-committees could not meet from the time the last TWG was held in December 2022. One subcommittee did not meet at all, while some only met a few days to the TWG without much impact or reporting the activities of the TWG hence not achieving the said goals/objectives of the last TWG resolutions.

“The group agreed that the TWG sub-committees should meet at least twice before the next TWG.  The involvement of the secondary and tertiary institutions as part of the TWG and also data collection points was also discussed, and it is expected that data tools from tertiary (MPD4QED Database) be extended to secondary level of care and should be incorporated into the HMIS data tools as well, as this will help to sustain effective reporting at all levels which is essential in QoC implementation.”

Also, issues surrounding scale-up and training/retraining of health workers were brought to the front burner during the presentation of the RMNCAEH+N QoC update.

In presenting the overview of the National RMNCAEH+N QoC Implementation Guide, deliberations were made on the structure, role and composition of the TWG vis-à-vis the RMNCAEH+N Multi Stakeholders Coordination Platform (MSPCP) and the National Steering Committee. Participants discussed the need to streamline/integrate structures to provide seamless flow of QoC implementation, reporting and approvals.

There were also extensive deliberations on the need to integrate QoC and Maternal Perinatal Child Death Surveillance Response (MPCDSR) TWG and Steering Committee.”

It added that during the States updates, discussions were mostly on how to improve States data reporting and dissemination – aggregate data and not proportions should

be reported and also the use of uterotonics should be tracked and reported.

“BHCPF facilities should be synchronized in all states and States should take advantage of this funding to implement QoC effectively; there is need to calculate still birth rate correctly as this should be calculated over the total birth rate.

“Training of Trainers on child component of the MPCDSR should be in the revised MPCDSR Trainers Manual; and there is need for state to take the lead in coordinating and harmonizing partner participation/implementation in the various state.”

There was also a deliberation on the presentation of the RMNCAEH+N QoC state scorecard. The presentation showed sub-optimal collaboration between the QoC Focal persons and HMIS officers in some States.

There was a presentation on the Assessment visit conducted in six states: Gombe, Ebonyi, Kano, Taraba, Yobe and Sokoto.

According to the statement, some of these resolutions were made during the TWG; “That the name of the RMNCAEH+N QoC learning platform should be called “Nigeria QoC Learning Platform” and should be linked to other platforms and structured like OnTIME Consutium and Facility Registry to be able to linked as one.

“It is expected that the platform will be launched by the Minister of Health by September/October 2023. Data tools at all three levels of care (primary, secondary and tertiary) should be integrated and MPD4QED data which is largely from the tertiary sites to be integrated into the DHIS2 also and equally extended for use at secondary level of care.

“NPHCDA should make access to the newly revised ODK dashboard easy to all relevant stakeholders. The formalities for getting access should be clear to everyone to reduce any bureaucratic bottlenecks.

“Each BHCPF facility to organize quarterly business/costedplan meeting. Efforts should be made at all levels to digitize data in all health facilities. The Nigeria MNH Acceleration plan was presented and agreed on by the TWG, for implementation with a suggestion that there should be frequent reporting to the TWG on on-going activities in the plan.”

Others are; “The need to advocate to States by the TWG members for the immediate establishment of the Department of Family Health with lead by WHO State Officers and support of Partners working in the state as approved by the last

NCH in December 2022.

“On RMNCAEH + N QoC National Conference /Knowledge Sharing –It was agreed that leads of all sub-committees should be members of the coordinating team.

“TWG agreed on the nomination of Dr. Ejike Oji as the Chair of the Planning Committee; WHO Representatives and Barrister Oris Ikiddeh of USAID MCGL-QoC as Co-Chairs. FMOH/NPHCDA will serve as the Secretariat for the planning. So far, 30 members were identified including other MDAs, Professional Associations, Regulatory bodies.”

Also, all newly scaled up learning sites were accepted and adopted, it was agreed

that subsequent intention to scale up must be approved by the TWG having met the criteria for scaleup; and every Basic Health Care Provision Fund (BHCPF) facility that meets the criteria can scale-up.

In presenting the State Assessment Visits on RMNCAEH+N QoC, the TWG adopted the motion that all the indicators should be used to track for the facility visits and assessments. It was also agreed that State Assessment should continue to go on as this will strengthen the system.

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