For better health, target policy

In a room in Abuja, 12 civil society groups huddle to plot and review strategies to win the battle for health. The target: people behind policies that impact reproductive health and future of mother, women, child and adolescents. Since September last year, they have used the weapon of advocacy, and it doesn’t come cheap. Project […]

In a room in Abuja, 12 civil society groups huddle to plot and review strategies to win the battle for health. The target: people behind policies that impact reproductive health and future of mother, women, child and adolescents.

Since September last year, they have used the weapon of advocacy, and it doesn’t come cheap. Project Rise Up, under its Champions for Change (C4C) initiative, doled out money to each of the 12 groups.

“We did a landscape to see how effective CSOs [civil society organisations] are. We found a lot of them were weak in capacity to undertake evidence-based advocacy, not able to participate in policy decisions or influence government,” said Theresa Effa, country representative for C4C.

“For you to improve service delivery, you need to have a policy that addresses it, and then move from just looking at the policy to engaging policy makers in such a way they will translate their policy into action.”

C4C targeted visionary CSOs and their leaders, put them through executive coaching in a series of workshop that taught storytelling to build their skills and gave out grants “to translate the skills they have learnt into action,” Effa explained.

Twelve different projects sprung up in the last 12 months in 12 locations across the country.

In Niger State, Amana Rural People’s Health trained 30 women living with AIDS on legislation prohibiting stigma against them.

Only 34 women living with HIV/AIDS visited primary health centre in the council areas of Kontagora and Rijau for services a month. When the project was done, their numbers increased to 104 a month.

Kano State, working with Youth Society for the Prevention of Infectious Diseases and Social Vices, pushed up its budget for reproductive, maternal and new born child health by 25% this year.

The increase will mean free services to some 3.9 million women and children. It also put up a service charter in August to show Kano residents can hold the government accountable for reducing maternal mortality.

Gombe State started task shifting, freeing up health workers by allowing lower-cadre staff take on some responsibility. That alone could impact reproductive health for some 527,000 women, according to Civil Society for Family Planning in Nigeria (CISFP), which joined in push for 25% increase in family planning budget.

“Now that we have been able to get more funding, the next step is to press for the release,” said Wale Adeleye, national coordinator for CISFP, a network of over 200 CSOs working in family planning.

“The government came with a ‘change’ mantra, which means they want to do things different. We are optimistic things will happen.”

Working with Women Friendly Initiative, 49 heads of religion and community in Kuje council area of Abuja committed to implement adolescent health policy, expected to benefit some 27,000 adolescents there.

In the last 12 months, the number of adolescents seeking reproductive health services in 10 primary health centres rose by 53%.

Action Health Incorporated pushed Lagos to integrate youth-friendly reproductive health service in a primary health centre in Apapa Iganmu, and set up a watch group to monitor service quality.

Girl Child Concern got Kaduna State government to allocate land to construct a health centre to provide reproductive and child health services to some 5,000 women and children.

In Delta State, Girl Power Initiative secured a helpline and got the government to designate three health centres to provide psychosocial support for girls and women who have suffered sexual violence. The service is estimated to benefit some 173,000 girls and women.

Earthspring International took its services to women behind bars, establishing health centres in three prisons. “Three thousand women and children in prison will now have access to health services, including immunisation, for the first time,” it said.

A total 141 news stories about maternal and child health were published or aired in Lagos in the last 12 months, according to Development Communications, impacting an audience 5 million strong.

The group said increased coverage could build demand for child and maternal health services for more than 20 million people in and out of Lagos.

The Women’s Health and Action Research Centre resorted to media campaign and public engagement to raise awareness about a law prohibiting female genital mutilation in Edo State.

“Since 1999, not one case has been investigated, prosecuted, judgement passed,” said Dr Wilson Imogan, who works with the centre which also trained police officers to be able to handle reported cases.

“The law is there. Police wasn’t even aware of the existence of the law. But no case has gone to court because somebody has to complain before you can prosecute.”

The $40,000-project to raise awareness of anti-mutilation law in Edo is an “inroad into maternal health care and reproductive health rights,” probably better than tablets and injections, according to Imogan.

“Young girls are mutilated across the world. People must stop infringing on the bodily integrity of these young people who didn’t give consent. Many have been known to die, get infections or develop sexuality problems later in life. Health is not just clinical services but your bodily integrity.”

Community Health Research (CHR) took budget transparency to a new height, producing a scorecard detailing funding for immunisation and the Midwives Service Scheme by the National Primary Health Care Development Agency.

A major step was getting the agency to open up its budgeting and meetings to local CSOs and media, apart from international nongovernment groups with the money to spend.