Communicating the Millenium Development Goals (MDG)

 

Dr. Annika Sweetland Jonathan in the last one year, Nigeria’s rating has lives, they were less likely to be engaged in the and Dr. Ishiyaku M. Mohammed of Huffington Post said under the visionary leadership of Hajiya Amina M. Az-Zubair, Senior Special Assistant to the President on the MDGs — now advising her third consecutive president — Nigeria has made bold strides.

“Nigeria make history in late April with its first ever widely adjudged free and fair presidential election, but it just launched what has been described as the largest scale-up of MDG investment in the world, targeting nearly 25 million of its poorest residents. Perhaps even more remarkable, the initiative will befinanced exclusively by the Nigerian government.”

Once one of Africa’s most indebted nations, successful negotiation of debt relief with the Paris Club in 2005 facilitated an annual savings of $1 billion that was to be earmarked for development purposes. Amazingly, that’s actually how it’s being used.

Senior Special Assistant to the President on MDGs, straddles civil society, private sector and government and has accumulated considerable experience in leading people and managing resources.

MDGs Score Card

While commending the appreciable effort of Nigeria on MDGs the UN boss said through quality leadership by President Goodluck significantly improved.

“This is very important initiative and leadership. With such a strong political leadership by President Jonathan and supported by international community and full participation of the civil societies the MDG target by 2015 can be met.

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The Chair, Committee on MDGs Federal House of Representatives, Saudatu Sani has under her chairmanship and leadership, she collaborated with the Office of the Senior Special Assistant to the President on MDGs

Introduction

For decades people working in the development world have struggled to communicate to the main beneficiaries of their efforts the work that has been done by them on their behalf.

There was a realization that if people did not know what was being done to improve their lives, they were less likely to be engaged in the process, and thus less likely to h0ld the government accountable.

The resultant effects mean that people remain apathetic to the process of change while governments and development agencies continue to struggle to inform and educate the people to engage in the process.

Research has shown that the most successful projects involve change agents working closely with recipients of change, this ensures long term sustainability.

In order to facilitate a greater understanding and involvement between change agents in most cases, government and their beneficiaries, there was a change in thinking towards evolving a more comprehensive way to communicate the message of social development reform. People in the development world began to meet and talk about various means to get their message across.

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Opportunities for synergizing between CSO, Parliament and Institutions of the Executive such as MDGs office are fundamental and such joint strategizing must continue. The Legislature should ensure that benchmarks and targets that are clear and unambiguous are developed for all public projects and programs in order to ensure an effectiveness of its oversight function. Oversight role of the Legislature is very important; particularly the House Committee on MDGs must develop its capacity in a technical and institutional sense, through among other things, training and exchange visits, to be able to do its job effectively and efficiently.

The near eradication of polio in Nigeria has been one of the great development success stories of recent years and a major step forwards in the use of MDG-related Debt Relief Gains to achieve MDG 4. Some experts have called it “historic gain against the disease”, a view endorsed by a World Health Organization (Who) report in March 2010.

There were 333 confirmed cases of polio across 26 states in the first half of 2009 (the full-year total was 388). But by half way through 2010 (week 28), just three cases of wild polio virus 1 (WPV1) and three cases of WPV3 has been confirmed in four states. That’s a year-on-year fall of 98 per cent.

Civil society

The Center for Democracy and Development organized events and examined the position of Nigeria on the implementation of the Millennium Development Goals (MDGs) and what needs to be done for the country to meet the goals in 2015.

Nigeria can meet the eight MDGs in 2015 if the federal, state and local governments are committed to the full implementation of NEEDS, SEEDS and LEEDS respectively. The National Assembly must step up its oversight roles on policies and programmes that will make Nigeria to meet the MDGs.

For Nigeria to accelerate the achievement of the MDGs there is urgent need for co-operation and collaboration among the federal, state and local governments in the design, harmonization and implementation of pro poor policies. President of the Federal Republic of Nigeria, commended for his commitment and affirmation to the achievement of the MDGs through the appointment of a Senior Special Assistant on MDGs.

There is the need for a national perspective plan (not a Federal plan) that links the PRSP (NEEDS-II) and 20-2020 targets to the 7-Point Agenda and integrates the MDGs into the perspective plan. This should be done through strategic partnerships and collaboration among the relevant stakeholders.

Eradicating Polio

Historic declaration

This dramatic progress has been achieved since the Federal Ministry of Health, the Bill & Melinda Gates Foundation and the Chairman of the Nigerian Governor’s Forum signed the historic Abuja Declaration on Polio Eradication in Nigeria in February 2009. The declaration is a public pledge to mobilise state and local government area (LGA) administrations to achieve a vaccination coverage target of 90 per cent.

At about the same time, traditional leaders throughout the country pledged to support immunisation campaigns and started pushing parents to have their children vaccinated.

How immunisation is carried out

Nigeria calculated that, if it could reach all children under five with the multi-dose vaccine, it could stop transmission of the wild polio virus. To do that, it instituted two immunisation programmes: routine and supplemental.

Routine immunisation

To validate administrative coverage, a data quality self-assessment was conducted during 2009 at 222 health facilities in 111 LGAs.
The assessment showed there had been an improvement in cumulative DPT3 coverage (DPT3 is an indicator of how well routine immunisation is performing), with coverage of 79 per cent in 2009, compared with 71 per cent in 2008 and 70 per cent in 2007. In May 2010, cumulative DPT3 coverage was 73 per cent – a figure which illustrates the challenges involved in routine immunisation.

Supplemental immunisation

Supplemental immunisation takes place through immunization Plus Days (IPDs), which have been held both nationally and at state level during 2010. They have high-level support from state governors and other senior members of government. For example, Mrs Abimbola Fashola, the wife of the Governor of Lagos State, urged “all our mothers, fathers and caregivers to ensure that their children and wards within the age of 0-5 years are immunised …The vaccine is free, safe and effective”.

Vaccine security

Two important activities have been completed. First, all routine vaccines in the national
Polio Eradication Initiative (PEI) schedule were procured, distributed and used. Second, the national cold-storage chain was assessed to understand its status and gaps in storage capacity, as well as to prepare for the planned introduction of new vaccines: Global Alliance for Vaccines (GAVI) had granted conditional approval to introduce Hib pentavalent and pneumo vaccines.

“Supplemental immunisation takes place through Immunization plus Days (IPDs)”

Challenges encountered

The first challenge is to overcome continued resistance from some community leaders, as their buy-in is key to sustained success. Successes to date should be a powerful tool that campaign leaders can use to persuade and convince.

Sustainability is also a major challenge because, if routine immunisation in the remaining high-risk states, such as Kano, is not stepped up, widespread re-infection may reverse the progress made so far.

Lastly, as noted by WHO, management issues at all levels of the polio eradication campaign are critical barriers to success in Nigeria. A full commitment to the eradication programme is sometimes lacking at LGA level, while immunisation campaign are sometimes not well implemented and there are, as ever, resource constraints.

Moving forward

As well as being “historic”, Nigeria’s achievement in almost eradicating polio is also a demonstration of the Government’s ability to partner and invest in public health. Polio immunisation is one of the more difficult immunisations to carry out, so there is good potential to use the polio campaign as a springboard for routine immunisation against other major diseases, such as the planned 2011 measles campaign.

A major lesson learned is that the involvement of state governors and LGA chairpersons is crucial for success. The active involvement of religious, traditional and community leaders in the eradication campaign and the excellent collaboration between the Nigerian Government and international development partners (including international philanthropic foundations and bodies) were also key success factors.

Sufficient funding is always likely to be a problem, but successes so far should make it easier not only to obtain funds from partners and key stakeholders, but also to secure their release in a timely fashion.

Key points on polio:

  • Most recent statistics show that Polio has almost been eradicated in Nigeria.
  • Six confirmed cases january – july 2010, compared with 388 cases in the whole of 2009.
  • Two immunisation programmes routine and supplemental.
  • Vaccines have been delivered and cold storage chain strengthened.
  • Involvement of state govreners, LGA chairpersons and traditional rulers is crucial to success.
  • Polio programmes can be a springboard for tackling other diseases.

Midwives Service Scheme

Poor material and child health continue to be one of the most serious development challenges facing Nigeria. With better health care the deaths of over 50,000 mothers and 250,000 babies a year could be prevented. Targeting this challenge, in 2009 the Government launched a new Midwives Service Scheme with funds from debt relief gains. This initiative recruits unemployed and retired midwives for deployment to primary health centres in rural communities. Midwives are crucial in bringing down maternal, newborn and child mortality rates.

The National Primary Health Care Development Agency (NPHCDA) leads the initiative. Although progress to date has been remarkable, challenges need to be addressed to revitalise primary health care centres, increase the number of skilled midwives, and speed progress towards MDG health goals 4 and 5.

Cluster model for obstetric services

The scheme is organised on a cluster model. A group of four primary health care centres and a general hospital form a cluster. The primary health care centres provide basic obstetric care and, if necessary, refer patients to the general hospital for comprehensive emergency obstetric care.

To date, the midwives scheme operates in 163clusters covering 652 primary health care centres nationwide. The scheme gives maternal and newborn child health a much-needed impetus by offering babies a good start in life and improving the wellbeing of mothers.

Training

Midwives recruited to the scheme undergo refresher training at midwifery schools and clinics. Training focuses on life-saving skills and managing childhood illnesses.

Collaborative effort Importantly, the initiative involves

the three tiers of government and brings in strategic partners. The Federal Government and states have formalised their collaboration in a memorandum of understanding. In addition the Federal Ministry of Women’s Affairs has provided ambulances to serve the clusters. This was a clear commitment by government to better interagency coordination. The National Primary Health Care Development Agency takes the lead and pays the salary of each midwife as well as providing complete midwifery kits.

For their part, state and local governments provide accommodation for the midwives in the local community and a monthly allowance.

Strategic partners include the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), Partnership for Reviving Routine Immunization in Northern Nigeria-Maternal and New-born Child Health (PRR In N-MCH), Pathfinder International, ACCESS/JEPHIGO and the Planned Parenthood Federation of Nigeria (PPFN). Partners provide technical support and help monitor the scheme.

A connected system

The thrust to connect midwives, other health workers and administrative units to a national support system through a dedicated communications system is an important part of the initiative. The system will host a dedicated website, transmit data, and provide voice communication and video conferencing. It also takes advantage of the potential for technologies such as GSM to improve management and reporting of maternal and child health care nationwide.

More midwives for rural communities recruited community-based maternal, newborn and child health services clustered around 163 hospitals

  • 2,488 unemployed and retired midwives recruited.
  • Tranied to save lives and provide community-based maternal, newborn and child health services
  • Deployed to 652 frontline facilities clustered around 163 hospitala
  • Community engagement through Ward Development Committees

The current initiative connects the NPHCDA headquarters, six regional offices, the central health supplies store and 40 clusters. The dedicated voice communication system is already up and running, allowing midwives to consult with other health workers. The website and system for uploading reports and data are also operational.

Development Committees

The current initiative connects the NPHCDA headquarters, six regional offices, the central health supplies store and 40 clusters. The dedicated voice communication system is already up and running, allowing midwives to consult with other health workers. The website and system for uploading reports and data are also operational.

Ward development committees

Another significant aspect of the scheme is encouraging community support. Reactivated or newly established ward development committees play an important role in advocacy and communication. They also help track the improvements midwives are making to maternal and child health.

Overcoming challenges

Despite remarkable progress, there are still challenges to be overcome. Advocacy and communication campaigns will play an important role in helping state and local governments play their part effectively, and in making sure they continue to support the scheme.

For example, some states have not yet fulfilled their promise to provide accommodation and allowances. Young, single or newly married midwives are particularly mobile and states need to pay incentives promptly to retain them.

Another challenge is that the target of recruiting four midwives for each primary health care centre hasn’t yet been met.

The shortfall particularly affects the northwest and northeast of the country. Recruiting the 1,000 midwives needed in 2010 is a significant hurdle that is currently receiving attention.

To provide more comprehensive maternal and child health care it will also be important to build on the training midwives have already received in life saving skills and child health care. This means professional development in, for example, preventing mother-to-child transmission of HIV/AIDS, care of newborn babies and family planning, as well as basic computer and internet skills.

Scaling up

In a recent boost to the scheme, the Nursing and Midwifery Council put forward an additional 486 recently graduated midwives for deployment. The launch of a drive to recruit additional midwives is also boosting recruitment.

The NPHCDA is also examining the proposal for an extensive outreach programme. This will complement the facility-based midwives with community health extension workers.

In addition, a checklist for monitoring maternal and child health care is being developed. This, along with an impact evaluation by the World Bank, will keep the programme on track and ensure lessons continue to be learnt from experiences in the field.

Connecting midwives nationwide

  • Nationwide voice, data, internet, video and conferencing system
  • Voice communication, website already in place

Improving basic education in Nigeria

In the last five years, Nigeria has tackled two major problems in basic education: chronic shortage of qualified teachers, especially in rural areas, and the dire quality of education children receive in primary school. With gains provided by debt relief the Government launched initiatives that have put 74,000 new qualified teachers in primary schools and boosted the skills of more than 400,000 serving teachers. Class overcrowding in urban primary schools is gradually reducing towards the national norm of 35 pupils per teacher. This will improve the quality of teaching, which has declined over the years. Importantly, progress towards MDGs 2 and 3 education targets and educating Nigerians to play their part in achieving Nigeria Vision 20:20 are on course.

Shortage of teachers, poor quality education

In 2005, there were not enough teachers to staff all primary schools, particularly in rural areas and slums. And, more than half the teachers were unqualified. Adding to the problem, most serving teachers had not updated their skills in years. In 2006, the Federal Teachers’ Scheme and Nationwide Capacity building were introduced. These programmes work in tandem to put more teachers into schools and improve the quality of teaching.

Federal Teachers’ Scheme boosts supply of teachers

The Federal Teachers’ Scheme tackles the chronic shortage of qualified teachers in primary schools.

Every two years this initiative places 45,000 unemployed Nigeria Certificate in Education graduates into schools across the country as teaching interns. The Federal Government provides each intern with a monthly stipend while States supplement the basic stipend either by providing accommodation or by an incentive payment.

Interns attend a short induction course before deployment. On successful completion of the two-year internship, States offer them fulltime teaching posts.

To date this initiative has boosted the teaching force with 74,000 new teachers. The student- to-teacher ratio, especially in rural schools, is improving. Marking this progress, some States no longer participate in the scheme because they now have enough teachers to fully staff primary schools.

The scheme also tackles the need to equip children with the basic knowledge and skills
in the sciences that are necessary for national development. To this end, 10,000 of the interns with backgrounds in science, maths, English and technical subjects are deployed to teach junior secondary students.

In-service professional development raises teacher performance

The nationwide capacity building scheme for serving public primary school teachers is an in-service professional development programme. It exposes teachers to new approaches to coping with large classes and gives them an opportunity to exchange experiences with other teachers.

Every year during the long vacation, this initiative provides 145,000 teachers, 400,000 in all to date, with professional development to aid student learning. The focus is on teaching English, maths, social studies and science – the fundamental skills students need.

More teachers for primary schools

74,000 more qualified teachers in primary schools:

  • 40,00 National certificates Education graduate interns placed in primary schools  in 2006, 34,000 in 2009
  •  5,000 focusing on junior secretary sciences in 2007, and a further 5,000 in 2009
  • 36,868 graduates completed their two years teaching intership sucessfully in 2008
  • 25,686 now have permanet teaching posts in the Federal Capital Territory and the States

In addition, teachers can make use of education resource centres equipped with reference materials. By using these centres they can continue to improve the skills they learn during the short in-service training.

Links with other key strategies

Boosting the supply of qualified teachers and improving the quality of education are critical
to fulfilling the aims of the National Policy on Education and the Universal Basic Education Act 2004. These entitle all children aged 6-14 years to free education.

Quality teaching

Professional development for 400,000 teachers to date:

143,140 serviing primary teachers recieved professional development training in 2006, 158,600 in 2008, and 115,415 in 2009.

“The student-to-teacher ratio, especially in rural schools, is improving”.

The professional development programme also witnessed challenges, largely because State agencies nominated people who weren’t teachers. This was overcome by involving the teachers’ union and other stakeholders in selecting participants, and getting accurate information about those selected to make sure that they were indeed teachers.

 

 

Author: nmmin

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