scholarly journals Spillover Effects of HIV Foreign Aid on the Delivery of Maternal and Child Health Services in Nigeria: 2008 – 2018

2021 ◽  
Author(s):  
Sunny Ibeneme ◽  
Kevin Croke ◽  
Humphery Karamagi ◽  
Jesse Bump ◽  
Joseph Okeibunor
Keyword(s):  
Child Health ◽  
Foreign Aid ◽  
Health Systems ◽  
Maternal And Child Health ◽  
Spillover Effect ◽  
Health Systems Strengthening ◽  
Child Health Services ◽  
Development Assistance For Health ◽  
Hiv Programs ◽  
And Child Health

Abstract BackgroundThis study expands the current body of knowledge by investigating the impact of the Global Health Initiatives (GHI) on the Nigerian health system. Using robust multilevel analytic approaches, this study examined system-wide impacts of foreign aid on the Nigerian health system– a country that has witnessed substantial Development Assistance for Health disbursements in the last two decades, yet has one of the worst maternal and child health indices globally. Most of the health aid to Nigeria has been for HIV programs; and has sparked debates among stakeholders. Critics have asserted the possibility that HIV aid might not be working and could have had unintended negative consequences on the delivery of non-HIV services. Others maintained that such prioritized attention to HIV could have had a crowding-out or negative spillover effect on the delivery of other health programs in Nigeria. Thus, the focus of this study is to ascertain the nature of the spillover effect of HIV aid on the delivery of maternal and child health services in NigeriaResultsThis study identified that donor HIV financing to Nigeria increased up to 2012, and decreased steadily afterwards between 2008 – 2018. This was suggested to be linked to PEPFAR priority shift to health systems strengthening in the second round of their funding cycle. This study also identified a negative spillover effect of HIV-specific aid on the delivery of non-HIV services, and is suggested to be attributed to the prioritized attention given to HIV programs by global health systems.ConclusionsStudy findings provide systematic evidence to inform policy on the frameworks for developing a national roadmap for the effective alignment of GHIs’ coordinating mechanisms with national health priorities. Future studies should explore the effects of the Development Assistance for Health among low- and middle-income countries including Nigeria to provide evidence for policy, and substantiate how the growing interests in health systems strengthening is overcoming vertical programs and fostering systemic improvements. Government should identify turnaround strategies to strengthen Nigerian health systems for the Sustainable Development Goals, and formulate policies that improve the effectiveness of GHIs in Nigeria.

scholarly journals Lessons for responding to COVID-19, from Exemplars in Under-five Mortality Reduction

2020 ◽  
Vol 4 ◽  
pp. 120
Author(s):  
Lisa R Hirschhorn ◽  
Nathaniel Gerthe ◽  
David E Phillips ◽  
Oliver Rothschild ◽  
Manpreet Singh ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health Systems ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Data Systems ◽  
Under Five ◽  
Success Stories ◽  
And Child Health

COVID-19 may not have the same direct effects on children as it does on older adults, but its indirect effects still pose a threat to child health, by disrupting delivery of routine health services like immunizations. This has happened during previous crises, and early indications point towards similar disruptions due to the coronavirus pandemic. To mitigate this, countries need to build resilient health systems capable of maintaining essential maternal and child health interventions, while also responding to COVID. How can this be accomplished? To find some answers, we can learn from countries in the past who improved health outcomes in the face of challenging circumstances. Specific to child health, countries with positive-outlier performance in reducing under-five mortality provide helpful strategies. These lessons include a clear national plan that drives rapid response, leveraging existing data systems to inform decision-making, engaging communities via community health workers, and focusing on equity. Today, countries around the world are facing the challenge of responding to the pandemic while building resilient health systems that continue to deliver invaluable maternal and child health services. Studying lessons from previous success stories can help inform the road ahead.

scholarly journals Identifying inequities in maternal and child health through risk stratification to inform health systems strengthening in Northern Togo

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0173445 ◽  
Author(s):  
Katharine J. McCarthy ◽  
Sandra Braganza ◽  
Kevin Fiori ◽  
Christophe Gbeleou ◽  
Vivien Kpakpo ◽  
...  
Keyword(s):  
Child Health ◽  
Risk Stratification ◽  
Health Systems ◽  
Maternal And Child Health ◽  
Health Systems Strengthening ◽  
And Child Health

Child Saving and Child Spacing in Africa: The Evolution of a Concept

1973 ◽  
Vol 3 (4) ◽  
pp. 765-768
Author(s):  
Robert D. Wright
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Child Death ◽  
Child Health Services ◽  
Tropical Africa ◽  
Low Visibility ◽  
Child Spacing ◽  
High Level ◽  
And Child Health

In tropical Africa the primordial presence of enormous young child death rates precludes a successful frontal attack on birth rates through specialized programs. Experience in Nigeria indicates that gradual, quiet pressure can influence the power structure to tolerate and eventually espouse child spacing as an integral part of a program of services for child saving. The approach involves four phases: a low visibility start; obtaining high level acceptance; establishment of a federal training center to train cadres for state training programs; and deployment of trained primary care auxiliaries as a local maternal and child health-family planning service. In tropical Africa governmental attitudes toward family planning range from positive policy, to neutrality, to strong opposition. At present most Anglophone countries are favorable. Most Francophone countries are opposed. The general trend is toward a more favorable attitude toward family planning when it is a part of maternal and child health services.

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