Nigeria accounts for only two percent of the world’s population, but contributes about 10% of global infant, child, and maternal mortality. Every year, about one million children who are under five years old die and some 33,000 women die of pregnancyrelated conditions—most of which are preventable deaths. Nigeria has been grouped among the 68 countries that are unlikely to attain the Millennium Development Goals Four and Five (MDGs) on child and maternal survival by 2015. In nearly every area of primary healthcare, there is low coverage of high impact interventions. Coverage tends to be substantially lower in the North East and North West zones of the country where TSHIP is implemented.
TSHIP was a project which supported the integration of primary healthcare services to deliver maternal, newborn, and child health (MNCH) interventions and strengthen the health systems in Bauchi and Sokoto States. TSHIP supported USAID/Nigeria’s former Strategic Objective 13 (now Development Objective 4): Increased use of social sector services. TSHIP’s principle objective was to foster the use of high-impact interventions in the two focus states. TSHIP is an integrated package of health service improvement interventions, which helps state and local governments improve primary healthcare services by filling in capacity gaps, building on institutional strengths, and improving households’ ability to protect and promote their own health.
TSHIP supported USAID/Nigeria’s former Strategic Objective 13 (now Development Objective 4): Increased use of social sector services. Its principle objective was to foster the use of high-impact interventions in the two focus states. Program activities were organized under four sub-objectives.
TSHIP put maximum effort into training and capacity building. The scale of these efforts is impressive. Training CBHVs meant training ten CBHVs per ward across 323 wards, or 3,230 people. In the area of capacity building, TSHIP also created job aids; conducted extensive pre-service training; trained on and implemented StandardsBased Management and Recognition (SBMR); and provided on-the-job training, crossvisits, and workshops. TSHIP supported a wide range of policies, from simple standard operating procedures (SOPs) to legislation that created new agencies, such as the Drugs and Medical Consumables Management Agency (DMMA) in Bauchi State. All of these efforts were designed to strengthen and improve health systems or the context surrounding these systems.