Health Systems Strengthening is often described as improving the healthcare system of a country. This invariably includes increasing funding of health infrastructure tied to budgetary allocation to health as a fraction of a country’s budget, in addition, improving health policy, working towards universal health coverage and all other health measures. The World Health Organization health systems building blocks are service delivery, health workforce, strategic information, commodities, health financing, leadership and governance.

Society for Family Health supports the government of Nigeria to focus on health systems strengthening in various ways. These include social marketing and behaviour change communication to improve access to essential health information, services and products to motivate the adoption of healthy behaviors, support of Primary Health Care delivery systems, and social franchising of hospitals, pharmacies and medicine shops in the private sector. SFH contributes to national strategies for the prevention of HIV & AIDS, promotion of child spacing, other maternal, neonatal and child health interventions and the prevention and control of malaria.

Social Franchising for Health

SFH operates a social franchise network comprising mainly private hospitals, maternity homes and faith based hospitals. A total of 365 facilities with spread across 25 states of the country providing a range of services that include family planning, post abortion care, integrated management of childhood illnesses, basic emergency obstetric and neonatal care and cervical cancer screening and cryotherapy services. Health providers’ skill and knowledge are enhanced in these service areas through formal trainings, use of service delivery protocols and job aids, supportive supervisory visits, internal and external quality audits.

Service Delivery, Commodities Distribution and Medical Credit

SFH plays a key role in service delivery on family planning (FP) and maternal, neonatal and child health (MNCH) intervention areas, in addition to widespread distribution of related commodities nationwide, with a focus on hard to reach areas. In recent years, SFH through her medical credit fund (MCF) program also commenced support to business activities in the private sector through business trainings, promotion of the uptake of medical credit loans for service quality improvement as a supply side intervention in the private health market in Nigeria. The focus for these supply side intervention is on the private sector, among the facilities in its franchise network and the larger private health facilities. So far, over NGN 200m has been disbursed to over 76 facilities that have benefited from the scheme while over 200 facilities have had access to business trainings.

Universal Health Coverage and Health Financing

In the public sector, SFH works mainly on supporting the roll out of state level health insurance schemes as well as improving primary health care. This aims at promoting of universal health coverage in Nigeria. SFH has played a major role in supporting the Ogun State government on their state wide health insurance scheme termed Araya scheme. SFH established franchise service in Ogun state and collaborated with other government partners to ensure the facilities franchised are empaneled under the scheme to be able to provide services to the poor and vulnerable.

Furthermore, SFH is a member of the quality unit set up by the state to coordinate all quality related matters and develop an accreditation standard for facilities both public and private to be empaneled in the scheme. In Lagos State, SFH plans to renovate, equip and manage 5 primary healthcare centers (PHCs) and make them model institutions for first level healthcare delivery in Nigeria providing services of optimum quality. SFH is strategically positioning itself to support the government in the roll out of the basic healthcare provision fund (BCHPF). SFH intends to provide support in areas of provision and quality of care, enrolment of the informal, poor and vulnerable population into the state supported health insurance scheme to ensure a wide coverage among the citizenry, generate demand for utilization of services, serve as intermediary for setting up protocols and actively carrying out the channeling of payments to facilities enrolled in the scheme and play an advisory role to the government in financing, service delivery and governance for the roll out.

HIV/AIDS Programming

In addition, SFH supports the government of Nigeria on HIV/AIDS control by assisting state agencies, civil society organizations network on AIDS and Police Action Committee on AIDS to strengthen the discrete and core functions of health systems in addition to managing the relationships among these core functions and link the health system with non-health system entities and actors. In addition, SFH has strengthened federal and state government stewardship for sustainable and effective multi-sectoral and evidence informed HIV prevention response. The Nigerian civil society organizations also had their capacities enhanced to engage in HIV and AIDS prevention, care and support interventions. SFH in collaboration with other Enhancing Nigeria’s Response to HIV/AIDS consortium member organizations facilitated an enabling environment for HIV/AIDS service delivery and pushed for an effective anti-stigma and discrimination legislation to be passed in seven of the eight ENR implementation states.