Bridging the policy-implementation gap in federal health systems: Lessons from the Nigerian Experience

Authors: Andrew McKenzie, Emmanuel Sokpo, Alastair Ager
Journal Title: Journal of Public Health in Africa
Journal Reference: 5:381
Document Type: Journal articles
Publication Date: 2014

The Partnership for Reviving Routine Immunization in Northern Nigeria – Maternal, Newborn and Child Health initiative (PRRINN-MNCH) supported efforts by the government of Nigeria to bridge Primary Health Care (PHC) policies and the provision of services at three levels of government: federal, state and local.

The paper suggests that understanding, informed by complexity theory and complex adaptive systems, have been helpful in shaping policy and programme design across these levels. To illustrate this, three initiatives are explored: Bringing PHC under one roof (PHCUOR), enhancing access to funding provided by the Global Alliance for Vaccines and Immunization (GAVI), and strengthening the midwives service scheme (MSS). These initiatives have demonstrated how concepts and experience developed at subnational level can influence national policy and practice, and how work at sub-national levels can add value to nationally conceived and nationally driven plans for PHC.

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Tags: Nigeria, Health policy, Federal health systems, Immunisation, Immunization, Primary health care, Routine immunisation, Routine immunization, Service delivery, Scaling up, Newborn health, Multi-stakeholder engagement, Maternal health, PRRINN-MNCH, PHCUOR, GAVI, Midwives service scheme, MNCH, Health systems strengthening, PRRINN, PHC, Adaptive programming, Bringing PHC Under One Roof, Financial management strengthening, state level health systems,