Media Charged To Promote Quality Service Delivery for improved outcomes in health and education in Nigeria

Evidence, policy messages and possible actions

The Nigerian Media has been charged to support the process of bringing positive change in Service Delivery Performance for quality services in the country's education and health sectors. 

The media  was charged during a two day outreach and engagement workshop organised by the African Economic Research Consortium, (AERC) in collaboration with the Nigerian Institute of social and Economic Research (NISER) in Abuja. 

 

African Economic Research Consortium (AERC) in collaboration with Nigerian Institute of Social and Economic Research (NISER) will host a two day workshop with the Nigerian media and civil society organisations on Service Delivery Indicators (SDI). The meeting is scheduled for September 22-23, 2016 at the Reiz Continental Hotel Abuja, Nigeria. The objective of this workshop is to to create high level public awareness about the state of quality of service delivery in health and education in Nigeria. This will allow the media and civil society organizations in Nigeria to support the process of bringing about positive change in service delivery performance and possible policy actions for better quality service delivery in education and health sectors.

The overall objective of the SDI project though is to gauge the quality of service delivery in primary education and basic health services and to provide a set of robust measures for benchmarking service delivery performance in Africa. This will enable the governments and citizens identify gaps and to track progress across countries over time. It is envisaged that the high public awareness and persistent focus on these indicators will mobilize policymakers, citizens, service providers and donors to ensure and enforce accountability along the service delivery value chains.

The Service Delivery Project started in 2007, when the Steering Committee at its meeting in June 2007 identified the need to benchmark service delivery in Africa as a crucial component of the Institutions and Service Delivery project. To this end, AERC convened a special brainstorming session on Construction and Operation of Service Delivery Indexes for Africa in December 2007 in Dar es Salaam, Tanzania. The objective was to institutionalise the regular production of a report on service delivery indexes for Africa by AERC, in collaboration with the WB and other partners.

The SDI project started as a collaborative project of the World Bank and AERC, which later incorporated the William and Flora Hewlett Foundation and the African Development Bank (AfDB). Pilot surveys were conducted in Tanzania and Senegal in 2010 to kick-start the project, with the first survey conducted in Kenya in 2012. Other surveys followed in Nigeria, Togo and Uganda in 2013. The indicators examine the the efforts (what providers do) and abilities (what providers know) of health providers and educators, and the education and health facilities’ resources (what providers have to work with-infrastructure and inputs) that contribute to a functioning school or health facility.

The SDI survey in Nigeria

The SDI surveys in health and education were carried out in Nigeria between June 2013 and January 2014. Using the standard SDI methodology adapted to the Nigeria context, the SDI health survey was carried out in 12 states selected across the country’s geopolitical zones, while the SDI education covered only 4 states.  A total of 2,480 health facilities and 760 primary schools were surveyed. The focus of both the health and education surveys is the assessment of quality of services at the primary level.

Summary of key findings for Nigeria SDI

1.      Facilities’ resources (what providers have to work with-infrastructure and inputs)

Overall, significant gaps exist in the availability of minimum Inputs required for service provision in the states surveyed

Health

·        Infrastructure (toilets, clean water and electricity) availability was a key challenge, especially the availability of improved toilets, which stands at merely 34 percent of health facilities.

·        About half (51%) of health facilities had met the minimum medical equipment requirements, i.e. a thermometer, any weighing scale, sphygmomanometer, stethoscope for health posts, and additionally sterilizing equipment and a refrigerator for health centers and hospitals.

·        Health facilities, on average, had 49 percent of all essential drugs available at time of the survey.

Education

·        Only 18 percent of schools had minimum infrastructure. Very few schools have functional, improved and accessible toilets (27% have clean toilets), 38 percent of pupils have English and Mathematics textbooks.

·        Only 54 percent of schools have minimum teaching materials

2.      Providers’ knowledge and abilities (what providers know)

Health

·        Generally, there is a lack of minimum knowledge among health professionals in all states.

·        Health professionals could only correctly diagnose 40 percent (i.e. approximately 2 in 5) of the tracer cases presented to them.

·        Only 16 percent of the health providers assessed in Nigeria were able to correctly diagnose 4 or all of the 5 tracer cases presented to them.

Education

·        The number of teachers is not the biggest challenge facing Nigeria’s education sector, but the fact that many of the teachers lack the necessary skills.

·        English and mathematics teachers who were assessed scored an average of 32.9%, with only 3.7 percent of the teachers obtaining a score of at least 80% on the assessments.

·        Challenges in teachers’ knowledge and abilities constrain learning outcomes in Nigeria.

3.      Provider’s effort (what providers do)

Improper human resource management evinced in the high rates of workers absence. Approved absence contributed largely to the high rates of absenteeism

Health

·        Overall absence from health facilities in all twelve states surveyed stood at 32 percent. High absence rates also mean that the workload is concentrated among fewer providers, resulting in higher caseloads.

·        More than 42 percent of the absence was management-approved, comprising approved absences, official missions, salary retrieval, training, etc., bringing into question how efficiently the time of providers was being utilized.

Education

·        Teachers spend less than 3/4 of the scheduled teaching time on actual teaching activities. On average, 13.7 percent of providers were found to be absent from school. Of those at school, about a fifth (19.1 percent) were not in the class teaching. While at school, teachers spent on average about 20.7 percent of the time on non-teaching activities.

·        Over 86 percent of teachers were absent with management approval

4.      Public versus private schools

Overall, private schools nearly consistently performed better than public schools across all indicators.

·        Absence from school in public schools was more than double the absence rate among private school teachers: 16.9 versus 5.5 percent.

·        Private school teachers were also more likely to be in class and, thus, spent more of their time in class on teaching activities than public school teachers did: 22.8 versus 9.5 percent.

What does this mean for Nigeria

The SDI results clearly shows that the problem of service provision in health and education in Nigeria is not availability of personnel or geographical structures, but more about the low productivity of available workers. Low productivity of workers may be attributed to several causes including low levels of technical knowledge required to deliver services, low levels of provider effort, lack of motivation to work and absence of necessary input to deliver services.

Increase in spending on education and health will not necessarily result in improved services if concerted efforts are not made to address these issues.

For more information on the SDI http://www.sdindicators.org/

 

Should you have any questions or feedback, please contact:
The Executive Director
African Economic Research Consortium (AERC)
Middle East Bank Towers, 3rd Floor, Jakaya Kikwete Road,
Tel: (254-20) 273-4150 / 273-4157;           Fax: (254-20) 273-4173
exec.dir@aercafrica.org or communications@aercafrica.org       
www.aercafrica.org
@AERCAFRICA