Niger State

Niger State (The Power State)

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Where We Are

Niger State, formed in February 1976 from the defunct Northwestern State, has a population of 4,082,558 according to the 2006 census. Positioned in the Middle West Central of Nigeria, it shares boundaries with Kaduna State in the Northeast, Kebbi State in the Northwest, Kwara State in the Southwest, Kogi in the South, Zamfara in the North, and the Republic of Benin in the West, with the Federal Capital Territory, Abuja, located at its southeastern border. The state comprises 25 Local Government Areas and 17 development areas, housing 275 political wards across three senatorial districts and six health zones.

In the Health Sector, primary, secondary, and tertiary healthcare services are provided, with a focus on prevention, promotion, protection, restoration, and rehabilitation at the primary level, while secondary and tertiary levels cater to curative services, including specialized care. The state faces health challenges, including a maternal mortality rate of 130/100,000 live births, under-five maternal mortality of 103/100 live births, and an infant mortality rate of 260/100 live births. The primary challenge lies in inadequate manpower, both in quantity and quality, with some General Hospitals lacking sufficient Medical Officers and many Local Government Areas lacking Midwives.

In 2017, the Quality of Care (QoC) initiative was introduced in Niger State, focusing on enhancing Reproductive, Maternal, Newborn, Child, Adolescent, and Elderly Health plus Nutrition (RMNCAEH+N) standards. Since its launch, the initiative has extended its influence to cover 249 healthcare facilities, comprising 247 BHCPF (Basic Health Care Provision Fund) and two non-BHCPF facilities, fostering a more extensive impact on QoC in the state.

NIGER Map

Health Facilities in Niger State

1565

Health Facilities *

1368

Public 
Facilities

197

Private 
Facilities

1498

Primary 
Facilities

64

Secondary 
Facilities

3

Tertiary 
Facilities

QoC Facilities

12

Learning Sites
(initial)

279

QoC
Sites

Others

274

BHCPF Sites **

25

LGAs *

274

Wards **

Data Sources: 

Nigerian Health Facility Registry

** National Primary Health Care Development Agency (NPHCDA)

Facts and Achievements

  • In 2017, the Quality of Care (QoC) initiative was launched in Niger State with the aim of improving RMNCAEH+N healthcare standards.
  •  A thorough baseline assessment was conducted, revealing that the skilled birth attendant (SBA) indicator stood at 37.5% (DHIS 2017), thus, indicating need for improvement.
  • Since its inception, the initiative has expanded its reach to encompass 249 healthcare facilities (Comprising of 247 BHCPF & 2 non BHCPF facilities) enabling a broader impact of QoC In the state.
  •  The governance structure of QoC operates at the state level, with State ministry of health overseeing the coordination of entities such as Agencies, LGAs and facilities.
  • QoC has received invaluable support from the State and partners such as UNICEFand WRAN who share the vision of advancing quality of care in the state through capacity building for health care providers, supportive supervision, community involvement /engagement among others.
  • The state commenced operationalization of  the Basic Health Care provision under (BHCPF) in 2020.
  • All  274 BHCPF facilities receive quarterly funds disbursed as Direct Facility Financing, through the BHCPF.
  • Quality Assessments (QA) of 50% of BHCPF HFs was conducted in the previous quarter to track progress across 10 priority areas , ensuring judicious use of the health facility funds.
  • A score card is generated following each quarterly QA.
  • The progress of QoC is closely monitored through the tracking of 30 different indicators, ensuring continuous improvement in healthcare outcomes. 
  • To distill the essence of QoC’s impact into a concise format, a score card has been developed, focusing on three critical indicators: Deliveries conducted by skilled birth attendants (SBA), deliveries monitored using partograph, pregnant women who received anti malaria.
  •  Since 2021, the Quality Improvement (QI) teams has played a vital role in implementing strategic goals and driving positive change within the QoC framework.

Success Stories

PPH Case Reduction

The implementation of quality care for improvement in Niger State has been highly successful, with significant achievements observed through the provision of quality care services in the 29 designated Quality of Care (QoC) facilities utilized as learning sites in the state. Notably, the use of the Partograph and Uterotonics (Oxytocin, Misoprostol) in monitoring labor and managing the third stage of labor has seen substantial improvement, as reflected in the reported data in DHIS2.

Additionally, the establishment of quarterly Peer-to-Peer learning sessions at both facility and Local Government Area (LGA) levels has been institutionalized. This approach facilitates the sharing of knowledge and experiences, communication of best practices, and cross-fertilization of ideas among facilities. As a result, there has been a noticeable increase in service uptake and an overall enhancement in the quality of service delivery within the learning sites.

~ Individual/Group Narrator

PPH Case Reduction

Across all Quality of Care (QoC) sites, there has been a successful adoption and application of quality improvement processes identified by the Quality Improvement (QI) team to address identified gaps in the facilities. In these facilities, healthcare providers have undergone capacity-building through training sessions covering Basic Emergency Obstetric and Newborn Care (BEmONC), Essential Newborn Care Course (ENCC), respectful maternity care (RMC), among other essential topics.

Each of the 29 learning sites has developed specific QoC aim statements, process indicators, outcome indicators, and set targets for the facility, guided by the State QoC strategic objectives.

Furthermore, there has been a noticeable enhancement in data quality within these focal facilities, with the State and Local Government Area (LGA) teams taking advantage of all opportunities to mentor the facilities on the use of tools, proper documentation, and timely reporting.

~ Individual/Group Narrator

Voices from the Field

Score Cards

INDICATORS

DEFINITION

Q3 2022

Q4 2022

Q1 2023

Q2 2023

Total number of maternal deaths across learning sites in the State

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Total number of neonatal deaths in learning sites in the State

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Total number of U5 deaths in learning sites in the State

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Total number of stillbirths at learning sites (disaggregated – fresh/macerated)

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Total number of facility reporting experience of care

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Niger State Specific Data And Information

Lessons Learnt From Niger State QI Implementation

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Title Of The Report Will Appear Here

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Niger State Related Events

Gallery

Take A Tour On Happenings And Events Carried Out For Quality Of Care In Niger State

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