Nigeria

With funding from the U.S. Agency for International Development (USAID), Jhpiego is working in select countries, including Nigeria, to address the COVID-19 pandemic. In Nigeria, RISE collaborates with the national and state primary health care development agency to contribute to COVID-19 vaccination uptake in the 16 local government areas of Taraba and 25 local government areas in Niger state and among HIV recipients of care in selected local government areas of Akwa Ibom, Cross River, Adamawa, Niger and Taraba. RISE priority activities include strengthening governance and leadership through advocacy, coordination and management of COVID-19 vaccine service delivery, and conducting training, capacity building, supportive supervision and logistics to ensure efficiency and accountability for mass vaccinations in communities and health facilities. RISE also contributes to improving social and behavior change technical assistance to address vaccine hesitancy, community demand generation and mobilization, identifying trends and defining adaptive messages across multiple platforms to increase vaccine uptake among priority populations, while contributing to COVID-19 data management and monitoring. The RISE COVID-19 vaccination initiative in Nigeria is implemented by lead partner Jhpiego and ICAP at Columbia University.

Funded by the U.S. Centers for Disease Control and Prevention (CDC), this five-year project builds upon activities funded by CDC to support Global Health Security through implementation of programs and activities that focus on protecting and improving health globally through partnerships with Ministries of Health and other institutions. With an initial emphasis on addressing the COVID-19 pandemic, the project is supporting countries—including Nigeria—and carrying out regional work in West Africa and South America to improve prevention of avoidable epidemics, including naturally occurring outbreaks and intentional or accidental releases of dangerous pathogens, and to improve ability to detect threats early and respond rapidly and effectively to public health threats of international concern. The project is being implemented by a Jhpiego-led consortium that includes the Johns Hopkins Center for Health Security, the Johns Hopkins University Applied Physics Laboratory, Global Scientific Solutions for Health, and Johns Hopkins University Center for Global Health.

In Nigeria, this project focuses on improving the country’s global health security through provision of technical assistance to the government of Nigeria, specifically the Nigeria Centre for Disease Control, National Agency for the Control of AIDS and National Malaria Elimination program to improve surveillance, laboratory services, data management capacity, and to contribute to technical competencies and delivery of the COVID-19 Response Mechanism grant and all other country priorities.

Funded by Unitaid, STAR Phase 3 is being implemented by a consortium of partners referred to as the STAR Core team, which includes consortium lead PSI, PATH and Jhpiego, as well as the International Labor Organisation with technical oversight by the World Health Organization. Implemented in seven countries (Cameroon, India, Indonesia, Mozambique, Nigeria, Tanzania and Uganda), STAR Phase 3 focused on addressing market barriers to HIV self-testing (HIVST) rollout and establishing the structures, systems and oversight mechanisms necessary for the long-term sustainability of HIVST.

In Nigeria, where Jhpiego was the lead partner, STAR Phase 3 activities include facilitating the distribution of more than 260,000 HIVST kits, in complement with Jhpiego’s work though the RISE initiative described above. Currently, Jhpiego is conducting implementation research to assess the acceptability, feasibility, cost and scalability of different Hepatitis C self-testing (HCVST) delivery models in Nigeria, and to leverage existing country-level relationships and the enabling environment created, the infrastructure and capacity built by the HIVST work. The HCVST delivery models target priority populations and people living with HIV. By using several delivery channels, the project is collecting valuable information, resulting in critical recommendations to manufacturers on the best way to expand product availability. Cost-effectiveness models and market research will allow stakeholders to compare cost-effectiveness and desirability of HCVST kits to existing program interventions.

Jhpiego serves as a core partner on the Palladium-led Integrated Health Program, the U.S. Agency for International Development’s main program for primary health care (PHC) in Nigeria. The overall objectives are to strengthen systems supporting PHC services, improve access to PHC services and increase the quality of PHC services. The program is expected to contribute to reductions in child and maternal morbidity and mortality in up to five target states, and to increase the capacity of health systems (public and private) to sustainably support high-quality PHC services. Jhpiego’s role is to support the program’s technical areas of reproductive health, family planning, and maternal and newborn health, including providing support for training and mentoring of providers, while also contributing to the quality assurance and quality improvement aspects of the program.

Moving Integrated, Quality Maternal, Newborn and Child Health and Family Planning and Reproductive Health Services to Scale (MOMENTUM) is a suite of projects, funded by the U.S. Agency for International Development, that aims to accelerate reductions in maternal, newborn and child mortality and morbidity in high-burden countries by increasing host country commitment and capacity to provide high-quality, integrated health care. Each of the projects has a specific focus area; together they provide a comprehensive, flexible package of support for countries as they overcome context-specific health challenges towards sustainable development. The five-year, Jhpiego-led MOMENTUM Country and Global Leadership project focuses on: 1) providing targeted technical and capacity development assistance to our missions, partner countries and local organizations; and 2) contributing to global technical leadership and policy dialogue for improved maternal, newborn and child health, voluntary family planning and reproductive health outcomes. Jhpiego’s 12 sub-partners under this project are: Save the Children, Johns Hopkins University International Vaccine Access Center, The Manoff Group, Quicksand, Matchboxology, BAO Systems, Avenir Health, McKinsey and Company, PACT, Institute for Healthcare Improvement, Christian Connections for International Health and Ubora Quality Institute.

In Nigeria, this project is focused on gender-based violence (including intimate partner violence and sexual violence), child early and forced marriage, and early adoption of family planning. Interventions are designed to deliver high-quality services that address gender-based violence and child early and forced marriage, as well as voluntary family planning and reproductive health care responsive to population needs. In addition, the project is supporting the strengthening of quality of care (QoC) of maternal, newborn and child health services through: national and state-level policy and strategy technical support, learning and research; strengthening of QoC data systems; and use of data for decision-making.

The Strategic Initiative for Service Delivery Innovation is a two-year strategic investment project, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, that aims to contribute to improve the quality of health care delivery in target areas in several African countries, including Nigeria. Jhpiego implements an innovative approach for integrated supportive supervision that includes collaborative improvement, training, a web-enabled supervision checklist and supervision of supervisors to improve integrated health services for underserved populations. Jhpiego also strengthens leadership and management skills among ministry of health staff for quality improvement and improved integrated service delivery in health facilities and communities.

In Nigeria, Jhpiego is responsible for supporting about 100 health facilities in collaboration with the Nigerian government in the use of four evidence-based approaches to improve the quality of HIV, TB,  malaria and COVID-19 care including other health priorities. These four approaches are: 1) collaborative improvement: 2) onsite training; 3) quality improvement tool to help supervisors provide useful support to providers; and 4) supervision for supervisors providing onsite support. Jhpiego also supports Nigeria State and the local government to strengthen individual and organizational capacity to implement the four approaches.

With funding from the U.S. Agency for International Development through Clinical Care and Clinical Research Nigeria, Jhpiego is providing support to the four-year ACE project. Implemented in Kwara and Niger States, the project aims to increase: 1) demand for HIV/AIDS and TB services within primary health care interventions; 2) quality of HIV/AIDS/TB services to provide client-centered, equitable and efficient treatment and to support continued viral suppression; 3) access to HIV/AIDS prevention and treatment services to all populations, especially the underserved and persons with special needs; and 4) resiliency, responsiveness and accountability of the health system to deliver sustainable HIV programs. Jhpiego is leading HIV-prevention activities focused on finding new cases of HIV; this includes implementing proven and innovative strategies for HIV testing and case finding, and scaling-up and integrating pre-exposure prophylaxis and gender-based violence services. Jhpiego is also responsible for strengthening evidence, implementation research and data science for HIV epidemic control including scaling-up of electronic medical records and virtual learning.

Under this two-year project, led by PharmaJet, Jhpiego is conducting a stratified-pair, cluster randomized study in two states of Nigeria. The study is designed to assess the programmatic feasibility, sustainability and scale-up plan for the introduction of the Tropis® injector for inactivated polio vaccine delivery into Nigeria’s Expanded Programme on Immunization. The PharmaJet Tropis injection system is a hand-held device, prequalified by the World Health Organization, that delivers precise intradermal injections without needles. If the evaluation results are positive, this new method for administering vaccines could accelerate uptake of polio and other vaccines, thereby bolstering the global health community’s ability to prevent disease and save more lives. This award is funded by the U.S. Agency for International Development’s Development Innovation Ventures.

With funding from the Patrick J. McGovern Foundation, and in partnership with Palindrome Data, Jhpiego is integrating an interruption in treatment (IIT) risk model into the existing electronic medical record system across 30-40 health facilities across two states in Nigeria for a period of 12 months. The model provides health workers with a score that refers to high, medium or low risk of an IIT at the next visit, enabling health workers to provide proactive care before an IIT occurs. The project seeks to meet the specific needs of clients by developing a package of preventive interventions for those most at risk. Conducting implementation research, the project evaluates the impact of the model and preventive interventions on HIV outcomes.