Assessment of health service delivery parameters in Kano and Zamfara States, Nigeria

Abstract

Background In 2013, the Nigeria Federal Ministry of Health established a Master Health Facility List (MHFL) as recommended by WHO. Since then, some health facilities (HFs) have ceased functioning and new facilities were established. We updated the MHFL and assessed service delivery parameters in the Malaria Frontline Project implementing areas in Kano and Zamfara States. Methods We assessed all HFs in each of the 34 project local government areas (LGAs) between July and September 2017. Project staff administered a semi-structured questionnaire developed for this assessment to heads of HFs about the type of facility, category and number of staff working at the facility and to record geo-coordinates of facility. Results In the Kano State project area, 726 HFs were identified and geo-located: 31 were new facilities, 608 (84%), 116 (16%) and two (0.3%) were Primary Health Care (PHC), secondary and tertiary facilities respectively. Using the national definition, there were 710 (98%) functional facilities and 644 (91%) of these reported to the national health information platform, District Health Information System, version 2 (DHIS2). The Zamfara project area had 739 HFs: eight were new, 715 (97%), 22 (3.0%) and two (0.2%) PHCs, secondary and tertiary facilities respectively. There were 695 (94%) functional facilities with 656 (94%) of these reporting to DHIS2. Using national criteria for primary health care designation, only 95 (9%) of all PHCs in the two States met the minimum human resource requirements. Conclusion Most HFs were functional and reported to DHIS2. A comprehensive MHFL having all the important parameters that should be established and updated regularly by authorities to make it more useful for health services administration and management. Most functional facilities are understaffed.

Improving health information system for malaria program management: malaria frontline project lessons learned from Kano and Zamfara States, Nigeria, 2016-2019

“…The performance of the health facility is tracked based on the selected key malaria indicators on the monitoring wall chart and use of the analyzed data for decision making. The MFP printed and distributed malaria monitoring wall charts across 726 and 739 supported health facilities in Kano and Zamfara States, respectively, from 2017 [ 5 ]. Since 2020, Kano State government took ownership of the printing and distribution of the malaria monitoring wall charts across Kano State health facilities.…”

“…This provided an accurate number of facilities expected to submit a monthly report, and therefore, the catchment area denominator needed to calculate rates. Recording the staff numbers and categories at facility showed that less than 10% of PHCs in Zamfara and 20% of PHCs in Kano State had the required minimum staff established by the Ministry of Health to deliver the expected service [ 5 ].…”

“…The project has strengthened malaria surveillance activities and addressed challenges by having accurate number of facilities as it relates to reporting rate of completeness and timeliness [ 5 ]. The MFP health facility service assessment provided updated information on health facilities in both project states and helped to assess each facility´s functionality, services provided, and data reported into the DHIS2 platform and human resource database.…”