COMMUNITY HEALTH INFLUENCERS, PROMOTERS, AND SERVICES PROGRAMME(CHIPS)
Given the poor maternal, newborn and child health indices in Nigeria, NPHCDA is working on strategies to improve these critical health outcomes and speed up progress towards Universal Health Coverage. To achieve this goal, the government and partners are developing the community Health influencers, promoters, and Services (CHIPS) programme.
CHIPS programme is designed to improve on the village health worker concept established by the NPHCDA and endorsed by the Federal Government of Nigeria. It is structured to stimulate and support households in communities to seek and obtain primary health care services through interventions at the community-level.
CHIPS programme harmonizes existing community-level service structures that have a similar scope with the village health worker concept into an improved, better focused, and coordinated approach.
In order to improve critical health outcomes in Nigeria, high-impact interventions need to be implemented to bring primary health care services close enough to households in communities. Worldwide, community health volunteer programmes have demonstrated the ability to positively impact health outcomes. While carrying out interventions to improve the supply of primary health care services, it is crucial that community-level health personnel focus on ensuring that households that need such services are informed and motivated enough to demand as well as use these services at all levels. The intervention also needs to be implemented nationally, be locally contextualized and driven, connected to community level accountability structures, the local and national health system. It is on this basis that the NPHCDA is guiding the implementation of the CHIPS programme.
The implementation process includes three phases:
- Pre-implementation: This period includes the engagement of stakeholders, baseline assessment, development of work-plan, procurement of CHIPS commodities and programme launch
- Implementation: Selection, training and deployment of CHIPS agents to their respective communities to carry out their functions.
- Monitoring and Evaluation: This phase involves the conduct of systematic collection and analysis of information/data on the CHIPS programme to assess progress and improve the implementation.
The CHIPS programme aims to:
- counsel, offer basic preventive care, identify health problems, provide pre-referral care and follow-up support and care for Maternal & Newborn Health Services;
- identify, counsel and refer for Child Health services including immunization and nutrition;
- educate, provide essential care and refer as appropriate for Malaria, diarrhea and fast Breathing;
- provide basic first aid and refer for advanced care;
- counsel on Community Water, Sanitation & Hygiene (WASH);
- counsel, identify health problems, support, refer and monitor treatment for HIV/TB/Hepatitis/NCD;
- counsel, identify health problems and refer to reproductive, sexual & adolescent health;
- support community surveillance and reporting of diseases with epidemic potential;
- collect and report community data appropriately.
The role of NPHCDA
NPHCDA and partners will providing guidance for the transition from the different village health workers to CHIPS. The implementation of the CHIPS programme, which will be driven by states, is coordinated through a model that brings all stakeholders at all levels under one roof to: minimize duplication of efforts, reduce inefficiencies, strengthen effectiveness, and deliver results. The NPHCDA and SPHCDAs, working with partners and other stakeholders, will ensure active engagement and coordination through the following approaches:
- High-level advocacy to the various stakeholders at all levels for political commitment resource mobilization and buy-in for the CHIPS programme.
- The mobilization of developmental partners to realign their existing investments to ensure efficient use of resources with the goal of attaining the PHC revitalization objectives through the CHIPS programme.
- Leveraging the strengths and competencies of stakeholders in terms of human resources and technology to improve the functionality of the CHIPS programme.
- Align private sector priorities to promote public health priorities by leveraging private sector capabilities (innovation), influence (advocacy) and resources (financing).
The aim is to have 100,000 CHIPS across the country, including in the hard-to-reach areas. The CHIPS programme will complement the revitalization of 10,000 primary health centers PHC “one functional primary health center per ward strategy” of the Federal Government.
The programme was officially flagged off by His Excellency, the President Federal Republic of Nigeria on February 6th, 2018. He issued a directive for its implementation across the 36 States and the Federal Capital Territory.
The government aims to reduce barriers to access by taking services closer particularly to pregnant women, women of childbearing age, newborn and children. The agents will also promote health by avoiding delays in the decision to seek care, in reaching care and in receiving adequate healthcare.
Services provided by the CHIPS agents will include demand generation, behaviour change communication, referral and community engagement; WASH and first aid; maternal new-born and reproductive sexual health; disease-specific care – Malaria, diarrhea & Fast Breathing-; disease-specific prevention (TB, HIV, NCDs) and surveillance; nutrition, immunization & growth monitoring; data management.
UNICEF, WHO, BMGF, Core Group, Plan International, CHAI, AAH, SFH, UNAIDS, NURHI 2, MNCH 2, CS-SUNN, Future Assured, Water AID NIGERIA, CRS, M.I, FHI360, Nutrition International, Christian Aid, Malaria Consortium, MCSP, and others.
NPHCDA & partners will provide coordinated support to SPHCDA for harmonization and transition of all existing community-level service structures that have a similar scope with the village health worker concept into the CHIPS Programme in order to:
- Minimize duplication of efforts.
- Reduce inefficiencies and wastages.
- Strengthen effectiveness & delivery of results.
- Conduct joint supportive supervisory visits and generate results for rapid action.
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