The impact of an NGO on strengthening the Nigerian Health System

Rotary International in Nigeria

The Rotarian Action Group for Population & Development (RFPD), is a resource for the Rotary International – Area of Focus ‘Maternal and Child Health’ (MCH) for 20 years. For the newest project, Rotary has been mandated by the Nigerian Federal Minister of Health, highlighting the success achieved by Rotary in improving the Nigerian Health System with Obstetric Quality Assurance (OQA).

After being successfully scaled up twice, RFPDs newest project was commenced in June 2016 – June 2018. Total Budget of this project amounts to 1 million US $ co-funded by The Rotary Foundation and the Federal Ministry for Economic Cooperation and Development (BMZ).

The projects objective is to support and accelerate the implementation of the Nigerian MPDSR (Maternal and Perinatal Death Surveillance and Response) guidelines with Quality Assurance in Obstetrics (OQA). To achieve this, the project promotes and supports the use and implementation of MPDSR/OQA and particularly supports family planning in 65 secondary and teaching hospitals. The hospitals were selected in cooperation with the FMOH and are distributed between 8 countries (Kano, Kaduna, FCT Abuja, Enugu, Anambra, Ebonyi, Ondo and Osun) from North to South.

During the past project implementations RFPD developed a comprehensive and holistic model to saving mothers and children. With the model, Rotary is substantially contributing with the project to improve the Nigerian Health System by:

  • initiating since November 2016 the conversion from manual to digital data collection (MPDSR/OQA) according to the national guidelines
  • implementing and introducing since February 2017 an innovative web-based e-platform ( for reliable data collection and analysis
  • systematically analysing since April 2017 digital data on three levels (national, per state, per hospital), analysed, and recommendations for action based therefrom can be analysed
  • training doctors and midwives in management and analysis of digital data
  • instructing hospitals and their staff to introduce Quality Assurance in Obstetrics (Structure, Process and Outcome)
  • improving the access to family planning services and modern contraceptives
  • starting a “Door-To-Door” family planning pilot project in Ondo and Enugu to improve the provision of FP services in rural areas
  • providing Birth Kits, modern Contraceptives and Mosquito Nets

Since starting the project more than 17.000 Birth Kits from a generous donation, were provided to health professionals by Rotary Clubs during Community Dialogues. With the help of the kits child birth related deaths, especially during risky home deliveries, can be prevented. Additionally, women and families are provided with information about – and access to – contraceptives, significantly reducing the numbers of maternal deaths. Within half a year 476 patients received a long-acting reversible contraceptive (LARC), donated by the International Contraceptive Access (ICA) Foundation. Furthermore, good nutrition for mothers and babies is being promoted during Community Dialogues and Vitamin Sachets are being distributed where necessary. To ensure the effectiveness, the distribution is being monitored and scientifically accompanied by the Godfrey Okyoe University in Enugu.

With the activities, the projects main impact is:

  • Directly Strengthening and being part of the Nigerian Health System
  • Capacity building by knowledge transfer to Ministries of Health, Hospitals and Communities
  • Extending the access to professional Family Planning services in partnership with NGOs
  • Initiating the transition towards innovative electronic and reliable data collection and analysis
  • Web based MPDSR program puts FMoH into position for expanding quality assurance system to further hospitals, communities and the remaining states
  • The entire Health System of recipient countries can be strengthened in near future

This program proves that an NGO like Rotary can have an impact on Health Systems by implementing Quality Assurance in Obstetrics. Usually the necessary improvement of Quality of Care in Hospitals starts in the Obstetrics department. RFPD is initiating replications of the project in Tamil Nadu, India and Rwanda.

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