Chigari Foundation began active operation in February 2016 in Routine Immunization (RI) and Primary Health Care (PHC) in six Northern Nigerian states of Bauchi, Borno, Kaduna, Kano, Sokoto and Yobe that have tripartite Memorandum of Understanding (MOU) with Bill and Melinda Gates Foundation (BMGF) and Dangote Foundation (DF) to improve RI and PHC in these states. The overall deliverables of Chigari Foundation on RI/PHC demand creation are:
The overall programme goal is to create an interface between communities and the health system through the traditional institution for improved demand and accountability for RI and PHC system.
The engagement model takes a “bottom-up’’ approach to build the capacity and strengthen the role of the traditional institution in driving demand of PHC services. So far, Chigari Foundation has engaged all Emirates/Chiefdom councils in 6 states namely Borno, Yobe, Bauchi, Kano, Kaduna and Sokoto states. The Foundation also supported the establishment and strengthening of the Emirates Councils Committee on Health (ECCOH) and the traditional leaders through these committees to develop annual operational work plans incorporated into the State Social Mobilization Working Group (SSMWG) plans in the respective states.
Our strategy was developed in an iterative process with different groups for effective partnership in creating demand for routine immunization and other primary health care services. Our major partners are:
A group of field experts in the 6 tripartite MOU states collecting data and mobilising key community members to support Chigari Foundation achieve its objectives.
To enhance our understanding of the multi-layered structure of the traditional institution and the influence mechanism within their communities, ‘Landscape Mapping (LM)’ was conducted in the 6 states.
The objectives of the LM are as follows:
1. Described demographic and socio-economic characteristics of traditional leaders across 6 MOU States –Bauchi, Borno, Kaduna, Kano, Sokoto and Yobe.
2. Described the structure of the traditional institution in each of the State.
3. Generate geospatial map of the jurisdictions of the traditional leaders.
The Social Network survey and analysis was also conducted to evaluate the the influence mechanism of the traditional leaders and network of contacts within their communities. The following objectives were achieved from the SNA:
1. Identified and described influential decision makers and the decision-making processes within the traditional institutions and communities
2. Described how the social network of traditional institution influences positive health seeking decision making by individuals and improved accountability in the immunization program at the community level
Additionally, from this activities, a comprehensive directory of the traditional institution was also created for the Emirates and Chiefdoms in the states.
In June 2017, the name-based community engagement strategy was piloted in Bodinga LGA of Sokoto state. The result of this pilot indicated significant improvement in uptake of RI services in communities thus the approach was recommended for adoption by all states. The strategy entails the traditional leaders (Ward Heads) line listing all the under one children in their communities using simple exercise books and subsequently reconciling the list with the RI registers in the nearby health facilities. The named-based strategy has now been rolled out across all the six MoU States.