Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4173
Country/Region: Nigeria
Year: 2007
Main Partner: John Snow, Inc
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $1,433,281

Funding for Biomedical Prevention: Injection Safety (HMIN): $1,433,281

Making Medical Injection Safer (MMIS) implemented Injection Safety (IS) programs in five states (Anambra, Edo, Cross River, Lagos, Kano) and the Federal Capital Territory since 2004. We use the four technical areas approach as recommended by the World Health Organization (WHO) and Safe Injection Global Network (SIGN) to address challenges which may be encountered in programming for the prevention and management of the medical transmission of HIV, specifically through unsafe injections. These are capacity building, behavioral change of healthcare personnel and communities, ensure availability of needed equipment and supplies and appropriate healthcare waste management. This activity is related to the JSI MMIS Track 1 activity.

A significant change in MMIS activity from COP06 to COP07 is the expansion strategy within selected local government areas (LGAs); this will entail coverage of IS in sites supported by other PEPFAR Implementing Partners (IPs) in addition to sites supported by JSI/MMIS only, such as Government of Nigeria (GON), faith based and other private health facilities. MMIS' support to USG IPs will range from training and co-ordination of all USG sites while procurement and supply of commodities for safe injection and waste management will cover only non PEPFAR sites after training completion (PEPFAR sites will be required to purchase their own commodities). MMIS can also support the setting up of supervision system at sites level, as they will do for USG IPs in addition to training support.

MMIS will continue to build capacity towards the four technical areas mentioned above in the 462 previously supported health facilities. In addition MMIS will extend its activities to an approximated 100 supported public and private health facilities through ad hoc partnership with corresponding IPs and or Government of Nigeria. As of April 2006 MMIS provided training to 5,207 individuals, exceeding their COP06 targets (3,000) by 2,207. In COP07 MMIS will provide IS training to a total of 8,000 individuals using WHO AFRO/JSI training curriculum. The FMOH is in the process of adapting this particular training curriculum for use in Nigeria. MMIS will institutionalize supportive supervision system by strengthening infection prevention committees at facility level. Additional Training coordinators and consultants will be hired to accommodate these scopes of work. Advocacy and behavior change communication (BCC) efforts include periodic advocacy meetings at all levels of healthcare management and dissemination of BCC materials, tools, job aids, posters and pamphlets to health care providers.

MMIS will also promote safe injection practices, and oral medication to reduce unnecessary demand for injections at community level through Community Based Organizations (CBOs) interventions and mass media. Collaborative BCC work will continue with national and local institutions/organizations such as NAFDAC, and local/community and religious organizations. MMIS subcontracted BBC activities to AED (Academic for Educational Development). MMIS will continue to work towards commodity security. MMIS is procuring IS commodities such as injection devices and safety boxes through its sub-contractor; PATH (Program for Appropriate Technology). Commodities are stored at the Government Central Medical Store in Oshodi (Lagos) and distributed by UPS to the focal States' stores. Sites pick up their supply on a quarterly basis from the States stores. MMIS has established a tracking system to collect data on consumption and stock levels along the supply chain. MMIS will support health care waste management through provision of seed waste segregation commodities and through building needle pits and encouraging the building of incinerators for proper disposal in accordance with WHO standards such as encapsulation in rural areas.

A midterm National IS assessment is planned for 2007 to measure impact of MMIS intervention and to look at adherence to safe injection practices and proper waste disposal among other things. MMIS also plan to do a desk review of the injection practices in the informal sector, which includes the patent medicine vendors, traditional healers, traditional circumcision practitioners and uvulectomist. MMIS is working towards sustainability through both enabling environment and capacity building of human resources. MMIS is working with the Federal Ministry of Health (FMOH) and other stakeholders (such as the Nursing Council of Nigeria and Medical and dental Council of Nigeria) on national IS and healthcare waste management policy. Besides, JSI/MMIS is working with training health institutions (such as Medical, Dental, Pharmacy, Nursing and Midwifery schools and Schools of health technology) to review, include and updated safe injections issues in their various curricula. In addition continuous on the job training is taking place at the sites mentioned above. CONTRIBUTION TO OVERALL PROGRAM AREA

As MMIS plans to extend coverage to some sites supported by other PEPFAR IPs; this integrated HIV/AIDS programming will improve collaboration amongst partners, will maximize the impact and will contribute to the prevention of 1,145,545 new HIV infections by 2010 and contribute towards the PEPFAR global achievement of the 2,7,10. This will also improve the equity in access to HIV prevention services to the communities most in need; both rural and urban by reducing the risk of transmission to the community as well as to health care workers. These activities would contribute substantively to NACA's 5-Year Strategy Frame work implementation; develop strong links between MMIS services and other service providers such as PEPFAR IPs, National Programme on Immunisation (NPI), UNICEF, the World Bank and WHO, working on HIV/AIDS issues, IS and healthcare waste management.

Subpartners Total: $0
Program for Appropriate Technology in Health: NA
Academy for Educational Development: NA