UNDERSTANDING INTERNAL ACCOUNTABILITY IN NIGERIA’S ROUTINE IMMUNIZATION SYSTEM: PERSPECTIVES FROM GOVERNMENT OFFICIALS AT THE NATIONAL, STATE, AND LOCAL LEVELS

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ERCHICK DANIEL J.; GEORGE ASHA S.; UMEH CHUKWUNONSO; WONODI CHIZOBA

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Journal: International Journal of Health Policy and Management Year:2017 | Volume:6 | Issue:7 Page(s): 403-412

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Title

UNDERSTANDING INTERNAL ACCOUNTABILITY IN NIGERIA’S ROUTINE IMMUNIZATION SYSTEM: PERSPECTIVES FROM GOVERNMENT OFFICIALS AT THE NATIONAL, STATE, AND LOCAL LEVELS

Author(s)

ERCHICK DANIEL J. | GEORGE ASHA S. | UMEH CHUKWUNONSO | WONODI CHIZOBA | Issue Writer Certificate

Keywords

VACCINES

IMMUNIZATION

HEALTH SYSTEMS

ACCOUNTABILITY

NIGERIA

Abstract

Background: Routine IMMUNIZATION coverage in NIGERIA has remained low, and studies have identified a lack of ACCOUNTABILITY as a barrier to high performance in the IMMUNIZATION system. ACCOUNTABILITY lies at the heart of various HEALTH SYSTEMS strengthening efforts recently launched in NIGERIA, including those related to IMMUNIZATION. Our aim was to understand the views of health officials on the ACCOUNTABILITY challenges hindering IMMUNIZATION service delivery at various levels of government.Methods: A semi-structured questionnaire was used to interview IMMUNIZATION and primary healthcare (PHC) officials from national, state, local, and health facility levels in Niger State in north central NIGERIA. Individuals were selected to represent a range of roles and responsibilities in the IMMUNIZATION system. The questionnaire explored concepts related to internal ACCOUNTABILITY using a framework that organizes ACCOUNTABILITY into three axes based upon how they drive change in the health system.Results: Respondents highlighted ACCOUNTABILITY challenges across multiple components of the IMMUNIZATION system, including vaccine availability, financing, logistics, human resources, and data management. A major focus was the lack of clear roles and responsibilities both within institutions and between levels of government. Delays in funding, especially at lower levels of government, disrupted service delivery. Supervision occurred less frequently than necessary, and the limited decision space of managers prevented problems from being resolved. Motivation was affected by the inability of officials to fulfill their responsibilities. Officials posited numerous suggestions to improve ACCOUNTABILITY, including clarifying roles and responsibilities, ensuring timely release of funding, and formalizing processes for supervision, problem solving, and data reporting.Conclusion: Weak ACCOUNTABILITY presents a significant barrier to performance of the routine IMMUNIZATION system and high IMMUNIZATION coverage in NIGERIA. As one stakeholder in ensuring the performance of HEALTH SYSTEMS, routine IMMUNIZATION officials reveal critical areas that need to be prioritized if emerging interventions to improve ACCOUNTABILITY in routine IMMUNIZATION are to have an effect.

Cites

Strengthening Care Delivery in Primary Care Facilities: Perspectives of Facility Managers on the Immunization Program in Kenya

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APA: Copy

ERCHICK, DANIEL J., GEORGE, ASHA S., UMEH, CHUKWUNONSO, & WONODI, CHIZOBA. (2017). UNDERSTANDING INTERNAL ACCOUNTABILITY IN NIGERIA’S ROUTINE IMMUNIZATION SYSTEM: PERSPECTIVES FROM GOVERNMENT OFFICIALS AT THE NATIONAL, STATE, AND LOCAL LEVELS. INTERNATIONAL JOURNAL OF HEALTH POLICY AND MANAGEMENT, 6(7), 403-412. SID. https://sid.ir/paper/338571/en

Vancouver: Copy

ERCHICK DANIEL J., GEORGE ASHA S., UMEH CHUKWUNONSO, WONODI CHIZOBA. UNDERSTANDING INTERNAL ACCOUNTABILITY IN NIGERIA’S ROUTINE IMMUNIZATION SYSTEM: PERSPECTIVES FROM GOVERNMENT OFFICIALS AT THE NATIONAL, STATE, AND LOCAL LEVELS. INTERNATIONAL JOURNAL OF HEALTH POLICY AND MANAGEMENT[Internet]. 2017;6(7):403-412. Available from: https://sid.ir/paper/338571/en

IEEE: Copy

DANIEL J. ERCHICK, ASHA S. GEORGE, CHUKWUNONSO UMEH, and CHIZOBA WONODI, “UNDERSTANDING INTERNAL ACCOUNTABILITY IN NIGERIA’S ROUTINE IMMUNIZATION SYSTEM: PERSPECTIVES FROM GOVERNMENT OFFICIALS AT THE NATIONAL, STATE, AND LOCAL LEVELS,” INTERNATIONAL JOURNAL OF HEALTH POLICY AND MANAGEMENT, vol. 6, no. 7, pp. 403–412, 2017, [Online]. Available: https://sid.ir/paper/338571/en

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