University of Nigeria Virtual Library

Serial No

Author 1

OBIONU, Christopher N.

Author 2

Author 3

Title

National Health Management Information System (NHMIS)

Keywords

Description

National Health Management Information System (NHMIS)

Category

Medicine

Publisher

Publication Date

June, 1996

Signature

FOREWORD

T h e iliiparrance of health information for effecrive managenlent of health services, health resources and the healr!~ system cannot be overemphasized. Government mandate reqaires that a national health informatio;: system shall b e established by a l . h q , 1 oo\:ernmen ts of th5 federalion to be used as a management tool.

T h e Federal M i n i s ~ y or Health has 7 o ~ g recognized that existing healch data systems ha\.e se\.ere shortcomings: dul l , uni-esponsi\re, lack basic infi-astructul-e, cumbersome and I;a\.e performed ineffecti\.ely. The Minisny oigznized a collfe1-snce/\x:orkshol, in 1999 t o articulate the ~ t l - ' ? c i ~ ~ - t . , content and strategy for the implement'ation of a healrh info!-mation system for the country. The X a t i o ~ ~ a l Heal111 Policj- and the recommendations of the heal ti1 i~ l f~ l -mac ion sys ten~ conference pro;-ided the policj conrest and fi-amen ork for launching the Kaijond Health r\lanagemeni Tnforrxation System (KHMiS) P!- gramm me.

-If \x ill- b e ' recalled tha? the p a i d e i ? Xat i~nal - 'Health ' S u m l n i ~ A (September 1995) called for, among other things, the establishment of the NHAIIS PI-ogramme. By preparing this docurne~~i, 1i.e ill the hfinist.1-1 have talien an i~npoi- ant step to\vai-d health reforms b j pro\.iding the decision support sysrem for ihe monitorins, e\.aluation and man:gement of our health care delivery senices and resources.

This document has been prepared with assistance from carnegie Corporation of New York, WHO, UNDP and the World Bank. I t presents the proper fi-amework foi- systematic planning and coordination of national health statistics and information activities in this country.

The NHMiS three-year strategic plan of action, which is aimed at ad~lancing the programme objectives of the NHMIS, forms a pi:rt of this document. It offers various entry points for interventions and active partnership to governments a t all levels, the orgmized p r i ~ ~ ~ r e sector, the. NGOs and internationd organizations, to develop and strengthen the public health inforn~ation system during the next three to five years. I t is my hope that all our collaborators uill identifj \vith our mission and facilitate the in~~lenentat ion of acticities contained in this ,

NHMI S programme document.

Dr. Ihechuku.~ C. hladu1)uilie . . ' . . Tlie Honourable h4inistcr of Health

Fedel-a1 h.linist;-y of Health Lagos.

June 19.',G

PREFACE

Ttlt. Sarional ITealth Policv \ ias- app~-o\.ed and adopted bv the Federal G o v ~ r n m e n t in 195s. :\nwng other t h i n ~ s , it provided for tlle establisl~n~t-nt ot'a co-~rliinated Srltional tlealth Management Infor~natio~l Sjs tem. Several ~ n e v r i n g ~ and steps have been taken to operatiol;alize the noble aspirations brilliantly stated in the National Health Policy. However, this is the first attempt to come o ~ t \vi& a nationally co-ordinated \\-ork-plan for operationalizing a Kational Health hlanage~nent Information Spterns (XHhlIS) programme.

Fra,gnented, &dated and rmcoordinated health infarmation collecting systems, characterized the health management information picture in Nigeria. I t is not imcommon for different org3:ii~ations, including non-go\.ernnlcntal agencies, to release vaq-ing figures pul-portedly rep]-esenting national a\,erages for the same condition. T h e height and depth of these figures are dependent on whoe\,er collecied tl ien~ and for whatever purpose h e y are intended. The codufused situation \\.it11 respect to health information system prompted t!le Federal 3 I i n i s t r~ of Health to seek a lasting solution by la~~nching the Nationd Hea!th Slanage~nent Information Syste:n (51-IAITS) P r o p a n m e

T!lis document contains go\.erninent policy on ihe estabiishment of .-. !laiionnl -bed th rnansgcmen: infi.~.rr.:ti.-.:! -:\.s:i.!n. hsludiag t k

gcal, objectives, current situation analysis, the re\.ised health management information system, the pl-og.anme for the de\.elop~nent and strengthening the . KZAllS, the role of inrcl-national col!aborators, the tiirec-year strategic action plan and u:hc.r re!el. ant appe~dices.

National l e \ d activiries at the Federal 3 l in i s tq of Health and in selected pilot states lln\.e bee11 identified to test the re\.ised HhlIS programme implementation. The selected states representing the four health zones are: Edo, Knduna, Ri\.ers and Yobe. In addition, a number of states have indicated a desire to participate as "ausiliary" states dongside the pilot states, foi the purpose of implernentin~ the revised HMIS. These are: Borno, Imo, Kebbi, Kwara, Cndo, Osun and Sokoto. hloreover, under the UNDP-assisted Health Sector Support programme in Kano and Katsina state$ and the UNDP-assisted National Statistical Information System (NSIS) programme, it is expected that the two states would forrna part of the inirial states to implement the revised HMIS.

The phased nature of the implementation strategy for the National Hea1:h hlanagement Information System programme may appear to paint a picture of espesimentation, but more importantly it

shows a seriousness and a \villingness to learn and input lessons learnt zlongside subsequent implementation.

An action pIan is a statement of intentions loaded with hopeful espectstions, which are at~ainabie if the plan is followed diligeqtly, . .- .

consistently- and \\.it11 sinceritj to improve on its ~ ~ e & e s s e s and plough the lessons learnt lor a better programme achievegent. We have cause to hope t!lat this \ d l be the case with the ,Nl ?'.I!S

- orogralm..e. . .

This document has been prepared by the National Health Management Information System (NHMIS) Unit of the Federal Ministry of Health, Lagos. The field assessment and research ;vork were undertaken by a team of researchers drawn from the Centre of African Settlement Studies and Development, Head Foundation, the University of Ilorin, the Federal LVinistry of Health, the '

Xational P r i ~ ~ a r y Health Care Development Agency , selected stare rninisrries of healih and local government health oficinls. The research teams visited pre-selected pilot and auxiliary s;aLes for the purpose of HMiS fie!(! assessment. T h e names of \-arious contribuxrs are listed in the

I Appendix -i.

I - I he fidd exercise and the ?reparation of rhis I report could not have occuried without the - . ,-a

f insncm support fro * . the Carnege Corporation of New York., the World Bank through the Health System Fund (HSF) project, the Federal Ministry of H e d t h and the data entry and processing support of all the staR of the National Health Management Informatior. Sys tern (NHMIS) Unit.

Facilitation assistance for the review, editorial and proauction of the document was provided by WHO and this is gratefully acknowledged.

Dr. AM. Lecky Consul tan t

Sational H e d ~ h Management Information System Federa! !Ministry of Hedth

Lagos.

AIDS A RI CCCD

CChTY CDD D%S DPRS DRF DSN DTP EDP FHS FhlOH FOS FRSC GIs HIS

%?I HhlIO

. HXIIS HSF ICD IE C TLO MAN LG A MIS hmo

Acquired Immune Deficiency Synd- ome Acute Respiratory Infenion Combating Childhood Communicable D iseases '

Carnegie C;rporacion of New York Control of Diarrhoea1 Diseases Depanment of Hospital Senices Department of Planning, Research and Statiscia Drug Revolving Fund Disease Surveillmce and Notification Desktop Publishing Essential Drug Programme Family Healch Services Fedrra! Mininry of I-lealth . . Federal Office of S~msrics Federal Road Safety Commission Geographic Informxion jystem Health Infomarion S y s ~ e r n H u n a n immunod~iiciency Virus Health h4acau,emer,t Information Healrh Managemem 1nformar;on Officer Hez!rh h4ana;;emecr ir.!crmarior! Sysrez Healrh System Fund Internaciord Classification of Diseasc~ Information, Educarion and Communication International Labour Organintion hianufaccren hssociatlon o i Nigeria L o a l Governrnezt Area Management Infornation Synem Medical Records 0 5 - r

MCH MSH NAFDAC

P Z C PHC&DC SMOH STD T3.4 UN L r n P LWPA

Vh77 WHO

hlaternal Chiid Health Manasemem Sciences for Health Kztiond Agency fgr Food, Drugs f dni~isrrarion and Conrrol

oramme National AIDS 8: STD Control Pro, Narional Council on Health Nor, Communicable Diseases Non Governmental Organimtion National Hedrh indicators . , -. -

4. , . -

National Health Managenem Iniormation5ynem . . .-

National Innitu~e for Medical Research '-

National Minimum Data Sets ..

National Planning Commission Na~ionz! Pap?~la:ior. Commission NayIonai P i i m q Ilea!th Care Development Agency P r i m r y Hed;:? Care Prin:ai>- Healrh Care and Disease ConxoI. S t x e hiinistry of Health Sexually Transmi~rcd Disezsrs - 1 radirionlil BIZ:? Acrendancs United Naiions Unireii Nations Develcrpnent Programme --

. - United Narions Fund for Population . .. . . - . . - . . - . -- -

~ c t l \ w e s . - ' - - ;t . United Nations Children Fund United Scares Agenc;~ lor Internxional

> .

Development ,

Vi!Iqe Healch Work& World Healih Organizicion

TMLE OF CONTEATS

ge FOREWORD PR EFA CE A CKNO WLEDGMENT ABBREVZA TIONS

iT4 TIO NA L HE4 L TH . ' X I C Y D E CLARA TION

irj 7;:e Goal of the Ndtional Hdtb Policy b) Health System Based on Primary Health Care

a) Constit:ltionsl Backg;*oonnd ) Volun :;zV Agencies and Ph;*a;z Seeor c) A Coordinated System d/ l Co)r,m:tnlg I?z.;o!vement

L eae!s of GI re

a) n e National M a n a g e d Process

i ) The National Health Policy ir'j '.. -Progranming i Programmed Budgeting i-~) Plan o f A ction v) Detailcd P~ogramming vzJ Implernen [ation vii) Evaluation

. . . ~zzg .Rep~ogranming ix) Relevmt Hezlth Ir, formation

a) Scope and h r ~ 0 s e b) National f i l th Planning and 3evelopmen~

G u d d i ~ e s c) N a t i o z l Council on Health

. . . . ~e ib i i ca l ~ o r n m i k e e 4 th ; N d i o n i l C o m cii on Health

e) Expert Panek

f) Pkznzing Fzm;io~zs in/-tAr Federa!' rllinistry c.,f I Health

Alanage7id Process at State Level I I h) State Health Ad~isory Committee

i ) Sate Herrlih Plmni?ig Fmctions

ljl Technical Assistance fbr State Health Services ) State Hospitals Management Board I j Local Government Hea/th Committee

POLICY

' v) PGniipai Sourres ofNenlth Daid and . Infcmntion

vij Re~~onsibilities . . At Each L m l - - 7 . . . . . . : ..:, . - _ ; . . ;. . -

CURRENTSITUAUONANALYSIS OFHEALW hlAM GEII~ENT~NFORMA TlON SYSTEM ( H M W ' -. _ ' .

. . . . -. . . . . . .. -.-.

.....

a) Parallel System:

Page TABLE OF COM'.EIVS (CON7D.)

b) Survey Systems c) Programme Reviews and Opemtions/Heaitb

System Reseaxh d j Heaiih Care Lmei-Speci/';c F o m s

e) International Colkcborzrion i;: EeaL~-%l In/iomiziloz System

2 8. iPrlE AM TIO!VA L HEAL I?IA 1\54 GGMENT INFORM4 TION SYS ITEW fiH;tlIS) PR OGRAMME

. . 6) Data - bases

1 Legal Framewo-

33. TEE RE I/ISl?D HEAL T~MAIW GEMENT INFORMA n O N SYSTEM

a) l 3 e Revised HMIS Forms b) HMIS Special Pqoose Fonns c) Speck1 Health Programmes d) Heczlrh and Demographic Su7ve;r e) D A ~ Flow System

,YHNIS Pabl ica t iom e) Argtionizi Healt,ll Indicators and Illinimunz

D a z Sets Managing HMIS Units

FUNDI~VG AND S U S T ~ IMBILIT A PPEIVD I CES

1

APPENDIX 1: NHMIS TEX EE-YEA R S W I TEGIC P U N OF ACTION APPENDIX 2: N f i I S DA TA FL 0 W CE4 R TS A PPLXDIX 3: NH,W EXPA-WDED OPERA TIOiWL OR GA NOGMM APPENDIX #.%A L 1 . 0 ~ 4 L H E A L T ~ ~ . - OBJECTIVES & INDIG1 TORS A PPEiYDIX 5: G UIDEL I1VE.S ,FOR THE DE VEL OP1tIEiV'T OF STA TE HMIS APPENDIX 6: C131 CULA R ON NHMIS APPENDIX 7: LIST OF C0,WXIBUTORS

viii

Commim~ent to tisalrli Policy a! a!! levels (assessed in [ e m s of r source allocation, equ ip . or-misstion frame work a d involvement of commuciry).

1.1 Increase in cudy?:ac zilocation to htalih @ y at lea : 10% by the year 2900).

1.2 increve in annual ?z: capita (national) expendir~res on hta!th

1 3 Increase in heaith buager a!location to PHC

1.4 Increzse in a c r ~ a ! -

exccnditurts o'acnual budget oi; he.,!&

- 2.1 Iccrezse the anncz! State budge: on h e k h t~ 2: if=:

1 C ? b by rk-. year 2000

APPESDIX 4: NATIOKAL HEALTH OEJECTXI'ES AND ~ B ~ C A T O R S

of natlonai health objectives and indicators have been put together for comprehensive monitoring and evaluation of the national health m. The objectives and indicators were selected based on available resources, relevance to national health policy and ease of data collection.

Propoirlon of m u a ! budge: rliocared to he&%

P r i cz$x expendir~rcs on neai~h 3: narional ievel

Proportion of hzakh budget !allocated to PHC

Proponion of L G h w?h health comminezs - - .

:a) Peicmt o:aiinual :;a:: budget a1loca:ed to ieairi!

Acrdai na~ionai rxprndizr- on he2ltn x !OO Total population

A m ~ a l FMGi! expex!in?rzs or. heairh r 100 4 m a l anzual FMCH budgzr on jea!h

'9: Vunber oFLGXs ujL5 heair!! :ccmirrers x 109 ---

hIin k r y Finance, FbIOE, '. SMOYLGA

I

PHC Budeer x 100 Total health budget

2.2 IRcr:asc in the wmber of LGXs in ihe State wich hea!th cornm!nres.

j.! inciezsc ~ 5 e anmai LG.4 budge: on hea!rh to at l e s 50% by rhr year 2000.

3.3 Increve in the number of PHC-numbered houscs in t\c LGA

(c) Per capita allocation on heaith at the State -

level

(d) Proponion of State heaith budget allocz:ed to PHC

. -. . - . . . . .. ..

Percent of LG.& wirh healti: cornminees - -

(a) Pexem of LGA budget aiiocaeri ro heaith

CD) A C N ~ espedi rurs of LGA budget on healrh

Per q i r a hea!~'1 expendimre at the LGA . lwel

proportion of houses with PHC nunber ,in L!e LGA

Annual Stare heaith budge:

(c) State budoet on health x 100 state pOPulation

(d) Stzte budzet on PHC x 100 - Totrl State hai th budget - -

. 4.- ---.- - - - - - . - - - - . - - Totd no. of LC.& il fie - a e - with healt! csmmine3 x 100 T o ~ l Wo. of LC.& in the rare - -

(a) LGA allocaiion tc health x ioo

Amxai LGX budget

@) A m a i LGA budget on healti? x 100

Annual LGA budget

Acfiia! LG.4 expendi?xz on healih x 100 Total LGA population

N w b e r of PHC-nmberet houses in the LGA x 100 ~ o k i ho. o f ho&k b i d e LGA

--

SMOH

SMOH

LGA. NPHCDA, Survey

LGA, NPHCDA, Survey

LC.% NPHCDA. hTC, Survey

LG kealt'l Dept., LG Works Dept., Suivey - -

3 ;I ;- fn: ., z E y Q

?-;. - 5 : ? - q

2., % ' 2 !? Z! a 3 2 < ,.. , < 5 ru F:? 2 :r ?; 3: '-0 5 , ~3 ; s "'

8 , < 8 : re g.a il 3 3 ,- tr c

i 5 X p f 3-- ;J 5: : 2. ;

0 a, n - I " .

Risk Redution Objectives: 3.3 Increase m&aceprive p r d e n c e . rare by at lejsr60%, from'lO% ip 1993, by the vex 2000. 3.4 Increase by 50% rhe proportion of inorben who practise MISreasr-feeding for &e fix four postparram n;onrhs and continued breast-feeding with : - supulemem up to the second year. 3.5 kcme by at i eas 50% rhr propoxion ofyouxg women ivhose fm as. at rzx+ao,e is zot 1.- thjn 18 vears. 3.6 Redme by IL I& 50% the propor,icn of w o m a havirg cbiiben - - ant' are 3 .

. 1 Number of womm u h g , ' Survey Proportion of v o m a conuaceptives --

- I x 1.0CO HospiraI I - - -. -> :-

using contraceptives _ . . - -Total Women of Reproductive Age' - .

. . - - . - . - -- -

Proponion of women that Number of women breast-feedine x Survey are breast-feeding - - / _ - ID0 -

Toral no. of morhen h r h children

Proporion of t e e n q ~ - N~-,!xr of rnanir~er < 18 vears x Survey i C 0 . - ..

marriage - - - - Toral no. of f e n d s 10-18 vexs

Pnpor ion of womes over i X u b u of wonen o ~ c r Xy;s f 5lLive-r

I Total go. of &!iveT.es P:oporion of womea 1 Nunher of iemdes ~ ! r received I Sun-ey arr+ncbn asre-nard dinic j anrenx;i - a e r1.C.X -

Total 30. of deliveries 1 Proponion of wonen I Nude r of =omen pranising Sun-ey

] h m 5 1 rr;;dirional habio X!.~CC

cot-exec! ~ i i h IT SIX -Y-

Lmmunizxlon I Tocoral Vcc-n oi Xmro&c~Ivt Ace . . . -

Pertesii-,i ot z l i c n d : - .I S u ~ i e r of Y. w a n . i i i d i n l ! ~ ~ ~ , . : . . zrpnd;lnca I ;;re-cars! s l c.2

I Toid no. of & ! k . < i ! ~ , . , .

' I - - - : I . . . . - _-

['erienqc oi ~ d t h Nun'se: of n-ajrh izc;;!;ifc n.ir5 j >-?;.':~DA, . . I hciliik n-21 essen!!:;., ess:zrki cxc X I C.2 j I:.,; .s, FOS

1 . - : r eexke t n s r o c : ! ~ I ord 20. oi h c i h f;iiJiiIes i

I I 1 3.13 Train and re-& h d g h worken I Percentage of trained

I in the rianagemem of reproducti-e hedrh workers in I health. reproduaive hezlth

i 1 3.14 Develop appropriate protocol to Proponion of h e k h I I f i d k x e 2 prorzpc refe.d rysezn io: facilities with r e f r d

t I . -

! ( advznced I2c mrrpon inrerrenrion. I orotocoi I i 1 3 . 3 L.wt _pq( . l i~ j iz h e ICPS ro hioh I ProporLon of ~ 0 ~ 2 2 ~ rha: . ,

i I . .. - 1 : . . I qu.&t;, pr tv~mive and he& p r 3 ~ ~ ~ i 3 ~ ;xeive quaiicy )l&h c u e .. I -

se.wicu fcr & a-amc-2

I Cooiroi of i I WHCDA dixrhoeal diseases PHC&DC 4.1 Reduce &~~hoea r n o n d k y ir: U-5 Percenrage of c!Gi&n !!- (C3D) ia ugder- xGOs I by 52% 5y d e yar ZEN. Syn who die of Garrhoea

Servica 0 bjccdva:

- - +-=.-??. - :.---- . - --- 4.4 o * h -. -.:iPirce;12;e of n o h e n pf&or,lon bf zi0the.s who xc with correct knovl&e on

k I i I howle&czb!s about the pre,ararion I c h prelararioc a d i e of A A

I ' I I a-14 us: ;f GRT/SSS. (l-l:?i in 11990) 1 OR?/SSS I 1 NPHCDA - 1.45 hcrz h e pmponion of Odch / P e r e s c q e ~f fadi:ir .

I &{OH 1 'SA:IS -+A 1- one h d t h ork kc ( *th 2 I tA OC? h&h 1 = r e d b s;;ikd case mzczqeme3r uc worker triad clsc

rqdsr. (80%) s-q~piy of ORT ' I I ""'"'at.

zlchers

Number of rained hul& Workers in re~rodunive h d t h x 100 Total no. of W W o r k e n Number of health facilities with referal protocol

h d : h c x r Y

T d no. o i W i U

Nu-5er of 5-5 dearhs from Diarrhoea Toa! na. of diarrhoea d e d i - I SO. of new c;ss ci

. - dI~~hoe2 .1n LL-:, x ICZO 7

i oca! GO. of &!&-en C5yi-s

Ncmber of s e t h e r s askg . OP,T/SSS

x lQG Toid no, of w o n e r v k h 3 i ! e s 1

Numbei of mort t rs -::!I wrrm knowledo,~ and use of SSS x 100 -a! a o t h e s

71 Hospi~al Records

1

Survey t Hospiial Records I i

Hal& Status Objertivc 5.1 Reduce by at l e s t 50% dea th due co acute respiratory infecrion in U-5 by h e year 2W. - - - . . . .

Esk Rcdudion Objective: 5.2 Incr=: tkc p r o p o ~ i c n of mochers/ur~-gi~2.r; who &OW s i p

5.3 Increase the p r o p o ~ i o n of heallth fadlities able to give cor res use macaoement of pneumonia 5.4 h c r e u e the proponion of health facilities with protocol o r z~cdjrds of p ~ c r i c e (SOP>/;rezrmer,t ;;?muds.

-

Semiccs Objective: 6.1 Incr-ae coverzge for pofi.onyditis ic-mur.&tion to a: ! e s ?C% by the yr;;r Z K W (65.5% in i9SC)

\--?-=--- -

HA& S U ~ L S Objccives: 7.1 Redwe the prevalence of oven-eighc in the gened popuIation to maximum of 50% by the yur 2000. 7 3 Rrducc the iccic!rnce of mLxd grouth m o ~ g U-5 TO not morz t h z 15% by the year 2CCG. (43% h 1990).

73 EIiG~li:e, by -rhe year iCCO, ;A t bcidenc of s;xq.i (an;;dy u n d t n c ~ i s h e d for qe) 1.~70% p0under 5. (9% a t d y u ~ & r r ; o w ~ t t d a d 2% sevdy u ~ t r n c ~ ~ ~ h e d , IFW)

Percencq of deaths due to m

- ~p p~ -

Pcrczntage of mchers -. l o -. & i C / --

s f z o c c m s of ,%Xi ropo&or? ~f h d i h workers who on correcly recall the management of pneumonia Percentage of hellth Fzcilities with m m d

Number of deaths due to ARI x -- -

1GO - Total no. of deaths from all Gusa iq U-5 with UiT

- -

N m b e r of mothers interviewed N:m,ber of hd:! ixdities with

Hospital Records Survey

-- 'TI

0 3;

1hlPLEMENTINC AGEWCY .

NASCP, hiOF, Mm of Juaice , Nariond

%.19&plemenc the Declaration - , Percen~ge of resolurions Number of resolurions -Qrican Agenda for Anion on MDS - implemenred implemented x 100 md other international resolutions on Number of resolution passed

112 Reduce tile propcmoa oi smokers ia the popu!arior, Syar l e a 50% by rhe 1-m zXO. (9% smokers in 1989) 113 R?dxe the p:sdcrrc:: of cfiabe:~

(horn 18% and 7% respectively iar mals

- - Risk lieduction Objrcrives: 11.5 hc iezc the propor~lon of the ppu!uion with cba.g~! a t k g habits dmed a: r e d x i ~ g d ie t z . i = r intake sad

ir, r w 1 l x p:1 )~:ld CX::&~ -

11.5 i ::case the propofilon of he mpdacion a-ich re?ors.:d rrducsior, ffi so&m and fat in:&

SOURCE ,DATA. .

(DATA S'Z'STEW Survey

11.7 Reduce rhe prevalence of overweight in the population to no more rhsn 25% of people zg?d 20 and above, and ijOh oi those a e d 19 xx! below.

c~l'.'es: Service Obje-*' ;!.a + t . q z r ~ r;..t:hoG for r!x d-xcion

. ? : a d p r o c ~ i s l ~ g o: ~y+ez~:vts in PXC

Pret-alencc rare of overweight

Number of m o l e wer-a;eio,hc Survey Toral popuiauon

Health Slatus Objectives: 1.1 To :educe i ~ c pr-vzlencz of ovemei<hi iil :he p z r a l popi~i e .::.'?y at itaji 50% by h e year St30j. -

13 To reduce the incittence of stunted g o w h among children under 5yrj (ro not more tnan 15% by the year 2000) baseline 43% in 1990.

1 3 To e!imin.-r: t!x incidence of under-nocrish,.r..-nr ;n childien unde: 5yrs (Bue!ine - 9% miidly under-i?ou?shed 2nd 2% severe!y under-noci!sheL 199C).

Risk Redudoc Objectives: 1.d T3 11~dl;:e ssdiun m d sa!r inhake L? ad?!: popukion.

1.5 Increase the proponion of ht general ppula:ion that t k e good dies and engage in regu!ar fines5 activi~ies.

Percentas? of cXC-sn under jyrs with stunted ~ 0 V v d i .

?ropocion of :hilk=a u n ~ e r 5yrs ha: are undernourished

taking e x e s s scdium -

and sait

Propxion of [he popuir:icn ?;?a: tJke ~ o o d lie: and erigzge iil re:.;!~._r fi:ness activities

Number of children under Syears with stunted erowth x 100 Total no. of children under 5yn.

N u ~ b e r ois5i ldi~n sn2-r 5 ~ . undtmourisht? x 100 Total no. ofchiidren under 5yrs.

X ~ i b e : of rdulti *Skkg excess &ism ma sait . - ' x 1Ofa . .

Tota! adult pooula?ion

Survey, FOS

S m e y , FOS

Scrvey, TOS

Survey, FOS

FMOH i NPHCDA

schools rirar provide g o d nuriition S: i:l;ness e h c x i o n as pan oicheir cur:cdum (by a; least 50% by rhe year 2000)

Health Status Objecti\-es: 2.1 To rcdnct the incidmcz of . . ci~z- tze s;r?oK;ne r-!xed d'zks.

Sen'ices and Protection Objectives: 2 3 To iniiudc acri-s-zokins educational pro=rzmzxs iq (2-

ccr;icu!a of schools (2; kz; 50?5 5:- ihe year 2000).

Proponion of sckmls ~ n a t provide nutri~ion & fitness education

Ptrctnnge of cause- specific smoking-rc!xed &xhs

? : c v t ! t m of iigxene smoking among youths and adults

?ropozion of alcohol :;id diug-re!artd nomiicy

N w , k of schools witli nuckion Ifmess mmcul~m x 100 Total No. of schools

N ~ ~ b e r bf deaths due to lung cancer - x :00.000 -- Tea! popiarion

above

Ylcmjer o i d ? x > 5 dus !3 dcohoi a7d ! r ~z - zb~s_p x ! C@.XG r o d ppu1af;cn .

Survey, FOS

Hospital daia, S w e i l l m c e sys:em, c m c z r regisry

Hospital d~m, Survey

bourhs who have used alcohol and drug: by 4096

Services and Protection Objectives: 33 Include educational . . prcgrnmes on alcohol and drugs in !hr curriaia of at l e s t 507% of (he prinxry 2nd s e c c n d q schools.

2.4 Iri:rsr?sc ro ?[ !ex! 28% ?hc - . p ~ d z i c n o f PHC faciiitits proviti~..g counse!lins and r e 5 m l s:;vices rezardinz a!cohol and

4.3 To achlec: sopulation s o u t h rate of less :?an 2% (about 3% in 1992)

Ticvalencr oiaicohol . /Gvg Ise amor,; youi.:~

Percentage of schools wi& health edutsrior, on akohoi and d r ~ s abuse

. - , -

Ropcnion of PHC fkil ir izs r o v i c i n g counsel!ing ard rC?r;3! services far viciims of alcohol and d r q ~ ' C U S ? .

?roporrion o iwomtn below q e 18 a i d above age 35 giving kinh to children.

a!cuhol and dnzs x 190 T d popuiation of youv& aged i 5- 18,m.

Number of schools irnpiemtn:ing health education on alcohol and % abuse x 10.004 Totai no. of sct..ools

- - . Xuruk: b i PHC 5aciLrizs.providln; counstiling a d x fxra l s e r i i c ~ for v ic ths ofa!coho! and iruo a b u x a Totai no. of PHC facilities

Nm'cer of.womn Sc!ow age ! 8 m d a b v e age 35 oezing chiicken x 100 - Totai no. of -MU

and nore- x 1170 Toel no. of WT-4

Survey

Sil-tey

PHC M%E, Sur.?ey E

' g 3 5:- G*. TI L 0 r~ 3 7: v + 2 - m : p- $" -1 3 ; j b \ _ q n -.. el3 ' ? : 3 2 3 1 J ~ -. ,. 3 s j d i;. :;, - , ; 7 . 0 - m - . . - - . X 3 3 5 4 .

' . s..: -- , (la $ 2 2. 2 2. $ ;;- 2. 3 2 g . . ;

3. e ;: '52- o 2 + I.J ig 2 2 3 r ~ : $2 Y 2 E 2 " -. r3 2 :

3 U r~ : 3 0 0 . . g 0 z y ? % ! E' r .-. 3' -' - ,, ,;;, -, 2 f ,!. c> <D U Q e 0 . I t ? E n b I 3 ?? e ; " g 3 - 5 2 ID; i .p , FJ, 2 ;? % s $: ;< 2 - - - -. n Z ~ p i 21 R ..* o " , S 2 3 2 5 3

T (1 3, rp 2;' 0 b , ? 2 k , S !

,? 3' r u 5' a tz !" IlQ 3 . @ ; < m 0 (

ua m 0 3 - .. , .;.% 2 z !

5 ;.. b 0. - 0

0 rw " ... 5 ; ; 2. ';' -0

T i

3 2 3 3 I

-1 x ua 0

t"

elB L I cl- 5 rn X . C ? . z .

I !, 'C1 5 3. % (I I.: 0 r

r7 "I'

Y E3- 0

N, r, .- 4 M Dl 'V

,... Cl. 0 I: P

(1 1) g. 3

sysicrnaric he&$ educzdon I - r q u e n c y of t!!r ievcl programma unaemken by h e LGAs, campaigns. ofhealth education starc and fedml health au~borities in a Survey

campaigns undertaken given year by the different levels of service delivery

i n d ~ s ~ i - s th2: 2;r l c l y ::gis:erd md :ecelvt regliar f a c : s ~ i i i i c ~ s i y impecion (:a - a k h i s :O 1 O O j by the year ZOO0 Perentage of

2ctoritsfindusiries ?nt receive a w u a i

- . . . F x t o r y ~ i n a u q

iqect ion. 1.4 To i x r e u e he ~di~s t r ies with on-sk fa~orics.,'indus:rits wPh !ccupa:iond mediczl scnice on-si:: ccccparional aise this io 75%) mcdicsi scrvicr.

. . .

proviiicri of on-si:e 1 Faaory L-qxcrcra::

Warer Suppiy 1 1

facilities to meet special necds of working morhers.

i Industrial Pollu~ion ! Factory 1nips:ro:ats

I Housing I FHA. F9S. N?:iCD%,

Surveiiiance &U routine 6.12 from FMOH, siruauoo analysis (Surveys) -

Conrol

i FHA, FOS, NPXCDA, FMCE

Sumeillance dzta, FXIOH, Swrey s

1.5 To L?cr:xe LO jC% rhs propriion of indus~ies bar have- on-sire facilities to meet special needs of workin? mothers by the yeu 200 1.6 To put in place and .Increase ro 50% the proponion of industries with on-sire facilities to nee1 the syxial n&s of [he handicapped vio:t;er by the ye-:. 2000. 1.7 To in.:ie~t Lqe ~ e n e : ~ ! er,:%nrr,:nul hcalth axvzr.nrss

I

1.8 To increse to 75:; rhe prapo~ion of industries tha: have adfaux5 fzrrot-y pollurior, control progrmrn: by t!!c y e x 1300. 2.1 To inc:e=je by 50?4 -:ye

nuxber of househoids u.i!h access to i e g ~ ! ~ supply of safe u.ar:: (l.e. wiriin 200 metes or 15 =in;. walk) 2.2 To i~creaje k e propozioii G I Nig?rix households wi;,'! adequate houi i~g according to p ~ k i i c heai:h hcuing s - z x k d by Lye ye= 2000. 2 3 To iiiciease to 80% Niserizr. h o ~ s ~ h o i d j wit? acces to s a r . h y

. .

sewage a i d dlsposzl faciiities iricludi-,g Vp lanines

on-sire facilities to E,&. special needs of working mothers. Percentage of

on-site facilities to meet special needs of b e

effective po!.!utior, c w m l

with accss :o q u h sujpiy oi.wi;arer as d s f u d

\

on-site faciliries to n e s t specizi needs of workino norhers x 100 Total no. of IndusiriedFactories

. - .

Number of factories5ndusrries with on-site facilities to meet special needs of the handicapwd rrorker x 100 - --

. .. Tomi no. o f :x ror id~ausr r ; r s - i otl! KO. of pmordorguiz3:ions

an.z- s i e r , v i r o m e n ~ . p i l u t i o n . . . . - . . - . . . . -L_ --<L.L' x100

Toni popu!a:ionior~ani~iion ?!n~->er of facroriesi'industries that have eTcCive piiution c o ~ t r o l p r o m m e x 100 - 1 eta! nc. of fxiorics!indusxies Nm'xr cf households wit? access

x !CO - ; oi31 no. of househo1~3

ri& adquare housino x 100 Toul no. ofhouehoids in h e

Number oiXigrrian iiousehoids with access :ojaoitary sesvaz~ge and dispcsai fxilities i n ~ l u d i r ; ~ VIP !ar%es x 100 Nmber ofXgeilrs? household in

hspecronrr Surveillance Data, FMOK

- Factory Inspectorare Surveillance data FMOH, Surveys

Factory Inspec:ora:c, Survtillznce Datq FMOE. Ssrfeys Pl~blic iieai-5

uectov-:t kns: recork, su?xys

F

Pubiic Xsriih ir~pecmzxe, . . - recordi, slxveis

Works'Housing FOS

NPHCDA, M i n i v of Worh'Eousing, FCS

i

XU'PHCDA. FOS. FMOH, S i i n i ~ of Works and

25 To increase the number.of public and private'institutions with adequate toilet facilities

2.6 To increase the number of public a d privzte buiidino,~ with =dequarc w a s ? v:aw i-;$im~c

Li .To inciease h e r.u;i;bs: ~f mzts, .;cads wife r d x p r e w z i e water draihs 1

t S To inciezse h e k q w n c y of adequate removal and proper disposal oisoiid wzste in Nigerian senlcmenrs accordhg to pubiic hca!;h sitndarcb 7 9 To ??cieax k c ncn:i:r of -. N i ~ e t i m households a d pubilc =acing oiaces w i ~ i adzquai? kixhen azd o L k f d .hygicn:: faciliries (store, h o d box, W g e e!c) .

P e r c e n ~ p of pubiic u d privare institutions wirh adequate toilet facilities

Percenrase of public and private bui1di;lg w i h adeqna:: wzjre ivarer d ? 2 i n q

Psrc=n~%r of s:rr?is 2nd r0.b wi:,", adiqua;.: \c;jic

water inins

cnvefing all seniemcn. Pcrcmrage ofpzblic eating piaces rhzt ucderrakz ~ r i o d i c f o ~ d handlers tcsn k r s t25

- , , - a? Oi C23:.15 :;31Kl P r c s n ,

RTA

Number of N i z e ~ a n pubEc t n d P ~ b l i c Fieal~CI private innitutions wih adequate Inspectorate, toilet facilities x 100. records, surveys Number of public and private institutions in the community Number of public and private I ' Public Inspectorate, buildings u.iih adequate wane water records, surv~)ls drzir,a%e s 100 ( Tom! nc. ofpublic 2nd p:ivar~ buildings. 1 1 -- X m b e r oisireers aid roads with j Pubiic ! T . S ? ~ : ~ O ~ P ,

Toa i no. of Snees B RE& I

h'unber of LGAs with functional I Pubhc Inspectorare, conrnuniv wasre disposa! services records, surveys in 21: serr!ements 'i !DO Tord as. of 5G.h I i Scmbei cf h'igxim hol&e50ids 3 3 j Pub!ic Hs~L'',. pcblic earins p ixcs tvirh adequs;e kitchen and sther hod hygiene . 1 facilities x 100 I

Torai no. o i i-~crrsik~oidj 0: earicg i

Nu,?.t.er ofLG.A.j u.1 J fiicc;ion2! i PC:-::- ~ t t - Z . :.-&:.A >-::' 1 abzwi r r and iublic food hyg-ienc 1 ic:p~::o;z:~ 1 services cover?n,o all sm!eaenrs 1

1.6 To increase the . proportionaf households with regular supply of safe drinking water (to at l e s t SO?& by h e year 2000)

Provision of houie501Gs with regular supply of safe drinking water

1.1 To incizaje rhe n m b t r OF faciliries ;o improve ihe ~ r o p i i o n of o p u i ~ i i o ~ having access i o hc2!ih fxihtim

1.2 To incrzue h e number of healm uporkea in thecountry.

. . . . .

. ,

ig :T& ~ncreashh:: o f - nvo-way r e 2 d syaem in iupoor, of PHC. " -'

3.1 To achieve a minimum o i thre: anendancos for each p ~ n o n , ~ e r year, kcL~ding . . out-p~tient and hovital visis.

N ~ m x r . ~ f households wirh 1

100 - Total no. of households

Survey. FOS Number of hooseholds thzi have food s e w ~ i ~ -t 100 - : a u l no. of housekolb

f Z' -.

Ijtilisxion 0:' Y e i ? Facilities

1

I Denral2nd Oni .

Health

School Heslch f ; ? y i c ~ s

! Laboratory Servics . . .

I FMOH I 3.1 To increase the numb-: of

in-patient beds from the presen? 2 per 1OOO to al least 4 per I000 (by the year 2960)

Fhl!=H, F?iIE f 6.1 To inczase the nczbe: of

i i:h~oij wig? health services

FMCHI SMOH, KCCIS, 7.1 To increue b e nurnbe: of 5 . . . - - - .

he& fac:G;ies iha :pr jv ia t - .

Private Sec:or rwnrial Iaborztory sergice:

I 7 1 To increrse the nmibc; of n k r d la5oratct-y ersocnr!

Ratio of hospiral beds per 1000 population per year.

P x e x a g e of erncloye;.~ cavered 5y E-&A Insurance Scheme

Pcxentsg? oihealt!! faci!ities eqcipped :9 rr-zr dtixal! o n 1 kid! !

Total no. of beds available for in-patient care x 1000 Total population.

@) N u ~ b e : of LGAs with two o: more practising physicians

x 100 Total no. of LGAs

Numb-: of ?..i;oi~iets cove:?? x 190 - - A otal no. o i cmp!c.,- 2:s

Nnmbcr cthealth fxiiities ir. LG.A equippid to provide c e m i : or?: h,-?lr:! je~, ' ic=s x 130 - i o ~ ! no. 6th-21th fxiliries in

. . LGA - -

iSumber of sc;lqriis in LG.4 wit:-.

g 'X ;;- M 9, q v r ;; 3- - 'A J , !?. id 13. 3 0

IJ -1 :J --. -. -- !:: 9 . r D -1

L1L 0 P- f;. :

9. rn 0 - j

0 3 7 ti' ; a Cil Cl

I!.?. ? i "I. --. -1 I U ..- z = --. <, g x . ; g g I. g . 5 . o r u N VI , r ~ m ID , f'-! 2 2. 5. .

" w 0 2, 5 . m 3 0 2 :

n f:: " -a F 0 &/a G' 2 5 a r!

C +. . 0

. , g X' & n n - ?

I --- t3 n 5

-4 ibrali+n Xassan, T I ~ C Cooriinzcor Mika ,M hfalah, DPHC Coordinaror Hassan Mai Kime, EPI Manager Dr. A.A Yusuf. PlMO Nguru General Hcspital Mrs Talatu Aliyu, Matron Mallam Aliyu Mohammed, Secretary Eieccrds cler!-:

Dr. 0 . Onotade Dr. G.A Alabi Dr. Sam Agbo Prof A. Alausa Prof 'qi Erinosho Prof R M. E'akubu Dr. L OKor Dr. G. N. 05' ' :mu 3 r d O. Xale ?rof 0 . 0 7 m a Z c Dr. C.M. h u m

Inrernaticnd Acencies Dr. Everest Xjdesani Dr. M. Veren3ov Dr. '*. L. ?Li& Dr. T. Aye!? Dr. -7. Sogmjoko Dr. T. Okorosoh Dr N 2 e Grange '\Ir. :AT, EgVooh

C,iSSAD CASSAD College of Medicine, LUTH Post Graduate Medical College O p n Sizte Uaiversity, Ago Iwoye Ahmad3 Edlo Univzrsiq, Zaria U3TX Tj>.=x - Crii-ersirj or'ibadan . Universiq of 1bad.m L'niversiry of Ibadar,