This policy brief focuses on Improved Management through Participatory Appraisal and Continuous Transformation (IMPACT) in Nigeria. IMPACT is an approach that systematically appraises health facilities, supports improved service delivery, encourages community participation and recognises and promotes service quality. This is achieved through the implementation of four iterative components which work in synergy to contribute to better health services for communities. The components include:
- Peer and Participatory Rapid Health Appraisal for Action (PPRHAA), a simple but comprehensive process for appraising and collecting information on all the major aspects of a health facility with a focus on service delivery and facility management, as well as the views of clients and other members of a health facility’s catchment population.
- Strengthening Systems and Capacity Building involves developing and implementing models for key systems (e.g. Financial Management and Health Management Information systems) and strengthening management capacity.
- Integrated Supportive Supervision (ISS) is a unitary supervisory system which uses a common checklist and reporting format based on harmonised indicators from as many initiatives/ programmes as possible. It is driven by a common supervisory team.
- Quality Assessment and Recognition (QAR) is an approach to assess, recognise and promote quality improvements within health facilities. It involves benchmarking facilities against agreed standards and publicly recognising and promoting the outstanding facilities.
IMPACT is a model that is based on a pro-active but firmly non-prescriptive step-by-step methodology that responds to where partners are and moves at a pace that keeps them involved. It increasingly empowers them to take leadership and assume ownership of reform activities. It requires a deep level of participation, shared vision, joint development of strategies and local determination of priorities from all participants. PATHS used IMPACT throughout the six years (2002 to 2008) as its leading systems strengthening and capacity building initiative. IMPACT provided a framework and a platform on which significant other work was built. During this time, IMPACT resulted in many deliverables that were both locally appropriate and globally relevant. This brief provides an overview of the initiative and outlines the experiences, effective strategies, achievements and lessons learnt during the process. The brief also provides an opportunity to build on the successes of PATHS and sustain the notable momentum that IMPACT has generated.