LHSS is working with the Nigerian government and local stakeholders to advance health systems strengthening and domestic resource mobilization priorities. Through close collaboration with government and local partners, our work aims to:

• Expand financial risk protection to reduce financial barriers and out-of-pocket payments.
• Increase coverage for the poor and improve equitable access to essential health services for the most vulnerable populations, especially women and people with disabilities.
• Increase the number of fully functioning facilities providing essential health services.
• Increase utilization of state health insurance schemes and the basic healthcare provision fund for HIV/AIDS and TB services.
• Increase government funding and expenditure for HIV/AIDS and TB services. 

Progress Highlights

• In collaboration with other implementing partners, LHSS supported the Federal Ministry of Health (MOH) to lead a national multi-stakeholder meeting to review the Basic Health Care Provision Fund (BHCPF) 2020 operational guidelines and discuss challenges. LHSS also leveraged the quarterly meeting of the Forum of CEOs of Nasarawa State Health Insurance Agencies to conduct a peer learning activity on how to engage local governments in achieving their equity goals. LHSS shared a process map with step-by-step guidance based on its work in Nasarawa to help other states achieve similar results.
• LHSS collaborated with the Health Sector Reform Coalition to review results of the pilot implementation of the BHCPF accountability framework in Nasarawa, the Federal Capital Territory, and Ogun. Findings revealed governance gaps at national and state levels. Results were shared with the National Health Insurance Authority, National Primary Health Care Development Agency, and Ministerial Oversight Committee. LHSS also consulted with the National Governor’s Forum and is helping to refine the framework in Nasarawa for national adoption in FY24.

• In Plateau State, LHSS worked with the Plateau State Contributory Health Care Management Agency to conduct house-to-house verification of BHCPF enrollees in three pilot Local Government Areas (Jos North Jos South and Bassa) to identify and reassign enrollees to closer facilities to improve and expand utilization. To date, approximately 700 enrollees have been visited across 64 wards. Of these, 203 are being reassigned to more accessible BHCPF facilities. This activity was conducted in collaboration with the State Office Coordinating Unit, the agency responsible for maintaining the social register. 

• In Plateau and Nasarawa States, LHSS supported the primary health care boards to conduct quarterly quality assessments in all their BHCPF facilities using the agency’s quality assessment mobile application.

• LHSS is facilitating collaboration between the EKO Social Health Alliance team of Lagos State Health Management Agency PLHIV support groups, and PEPFAR-supported implementing partners in Lagos State. Working together, they have identified strategies for promoting BHCPF enrollment of general and vulnerable populations, including PLHIV and orphans and vulnerable children, to improve access to essential health services. 

• Following a landscape assessment of public financial management capacity, LHSS provided training to Kano State AIDS Control Agency staff directors and program officers in writing persuasive requisition memos and the use of expenditure reporting templates. Following the training, agency officers developed and submitted 10 requisition memos totaling $195,000 (NGN 148M). Of these, three requisitions have been approved to procure a total of $143,000 (NGN 108M) in HIV rapid test kits and laboratory consumables.