The Executive Director/Chief Executive Officer, National Primary Health Care Development Agency, (NPHCDA), Dr. Faisal Shuaibu has described the newly introduced Nigeria State Health Investment Project (NSHIP) through the Perform-Based Financing Approach as one that has not only strengthened quality health care service delivery to the people but has also helped in bringing affordable healthcare to the door steps of Nigerians at the grass roots level.
He made this known in Abuja at a one-day midterm review meeting to access the impact of the project on the lives of Nigerians since its introduction in 2013.
According to him, NSHIP has helped to provide managerial autonomy to health facilities, whilst strengthening accountability mechanisms at the Local Government Area Primary Healthcare Authority and State Primary Healthcare Development agencies through a collective package of institutional and operational level results based on financing approaches.
“With this approach, there has been a paradigm shift from the traditional input-base to result based financing, fragmented and unclear accountability to accountability with well-defined indicators that are monitored; top-level bottom health investment (by the national, state, LGS) to bottom-up invest (by health facilities)- health facility autonomy.
“The health facilities now run as an autonomous institution by the officers-in-charge, who are also called facility managers.
“They are empowered to make appropriate decisions concerning the health needs of their people at the area as well as the management of the health facility and ensure they are executed accordingly because the future date that the health facilities earn is tied to the services rendered in terms of quantity and quality, resources distribution is more effective and efficient.
Again, this is different from input financing, in which health facility budgetary allocations are not dependent on their productivity. He also added, the earnings by the facilities are used for the improvement of the health facility while up to 50% may be shared by the health workers as performance bonus according to their performance.
With these earnings, health facility management does not have to wait for the drug revolving fund (DVR) and essential drug management are re-activated and institutionalised in the primary health care facility, medical supplies are acquired by the health facility management as needed from competitive accredited drug pharmacies.
This ensures constant availability of these consumable. This is a paradigm shift from the usual practice of getting drugs and medical supplies only from a state central store which is associated with stocking the health facility pharmacies with non-essential drugs.