logo

Citizen Feedback Mechanisms in the Nigeria States Health Investment Project

 

A health care centre included in the project.

A health care centre included in the project.

Despite Nigeria’s strong economic track record, poverty is significant, and reducing it will require strong non-oil growth and a focus on human development. Constraints have been identified to enhancing growth, including the investment climate; infrastructure, incentives and policies affecting agricultural productivity; and quality and relevance of tertiary education. In spite of successful initiatives in human development, Nigeria may not be on track for meeting most of the Millennium Development Goals (MDGs). Underpinning these challenges is the core issue of governance, in particular at the state level. Fiscal decentralization provides Nigeria’s 36 states and 774 local governments considerable policy autonomy, control of 50 percent of government revenues, and responsibility for delivery of public services. Capacity is weak in most states, and improving governance will be a long term process.

The ICT for Social Accountability project aims to use information and communication technologies (ICT)— primarily the mobile phone—to engage communities in Nigeria and enhance social accountability in a World Bank project. Through a mobile reporting tool and a network of reporters, beneficiaries of the Nigeria States Health Investment Project will be able to report on the quality of service they have received. The tool will be used by patients to provide feedback on services received as a mean for cross verification of results reported by clinics receiving economic incentives under the performance based financing scheme.  The citizen feedback will then be integrated into the monitoring and evaluation (M&E) of the program and, ultimately, will impact how the programs are designed and administered. An ICT based system will be developed to enhance 3rd party verification by the end beneficiaries of health services delivered. The pilot will support the key objectives of NSHPIC project, which is to build social accountability through community management of health facilities and performance measurement of health outputs and quality of care, including client perceptions of quality of care. The common mobile based tool is being built on an open source platform, and adapted to the needs of each particular project through a participatory design process working directly with the end users in the project context. The tool, now developed and under testing will be launched in September for its use in Nassarawa and the Federal Capital Territory. In the mid-term it is envisioned to its use to other states these two projects are being implemented and to other projects and sectors in Nigeria that are in need of mechanisms for engaging end beneficiaries and service providers.