Improving Health and Well-Being in Nigeria

Experienced Leader in Innovative, Scalable and Sustainable Health Programmes
Futures Group and sister company GRM International have been implementing programmes to improve public health and human development in Nigeria since 1984, with funding from DFID, USAID and other donors. Futures Group and GRM currently implement nine current or soonto-be-launched projects in Nigeria, with activities at national, state, and local government area levels. We have an active presence in or provide technical support to partners in various states, including Kano, Katsina, Jigawa, Yobe, Zamfara, Adamawa, Bauchi, Kaduna, Sokoto, and Taraba in the North-West and North-East regions. Futures Group and GRM International are part of a group of international health and development companies with a joint focus on partnering with institutions, governments, and businesses worldwide to improve people’s lives. We have managed more than 700 projects in over 120 countries over 40 years for private, government, bilateral and multilateral clients and we have over £140 million in annual revenue.

Program Areas
• • • • • • • Maternal and Child Health Population and Family Planning Sexual and Reproductive Health HIV and AIDS Infectious Diseases Gender Poverty And Equity

Technical Services
• Policy and Advocacy • Research and Strategic Information • Health Markets and Private Sector Engagement • Modeling and Economic Analysis • Health Systems Strengthening • Strategic Consulting • Economics and Financing • Program Management

Strengthening capacity at all levels of the national healthcare system
Futures Group helped establish and strengthen longitudinal paper and electronic records at 34 AIDSRelief (2004-2012) Nigerian Local Partner Treatment Facilities and 40 satellite sites across 16 of Nigeria’s 36 states and in the Federal Capital Territory. Under the Targeted States High Impact Project (TSHIP) (2009 – 2014), which aims to strengthen healthcare delivery in Bauchi and Sokoto states in northern Nigeria, Futures Group completed studies on the distribution of long-lasting insecticide-treated bed nets, on factors influencing use of long-acting methods of contraception in hard-to-reach communities, and on oral rehydration therapy corners for managing diarrhea in children under five. Under COMPASS (2004-2009), Futures Group facilitated a bottom-up policy approach to address the needs and concerns of communities, and ensure that government programmes and policies reflect community priorities. Community advocacy results included the development of a strategic plan for the National State Primary Health Care Development Agency to operationalise its goals and objectives in Bauchi, and the drafting of the Integrated Maternal and Child Health Care bill to address gaps in maternal and child health care delivery in Kano. Through work with ENHANSE (2004-2009), advocacy skills building workshops trained more than 1,360 individuals, including programme officers in the Ministry of Health’s Family Health Department and members of the Nigeria Network of NGOs and CSOs in Population and Reproductive Health (NINPREH). Following the training, NINPREH took a lead role for advocacy campaigns in Nasarawa that led to the adoption of the Child Rights Act and to the passage of two laws in Anambra State, including a law to confer certain reproductive rights for women and a law to prohibit all malpractices against widows and widowers.

Futures Group and GRM Offerings:

Futures Group Nigeria Suite 301, Kano House 73 Ralph Shodeinde Street Central Business District, Abjua Nigeria Futures Group Europe, Ltd. 2nd Floor Turnberry House 100 Bunhill Row London, EC1Y 8ND U.K. tel +44(0) 20 7250 0556 fax +44(0) 20 7336 8742 Futures Group One Thomas Circle, NW Suite 200 Washington, DC 20005 U.S.A. tel 202.775.9680 fax 202.775.9694

www.futuresgroup.com www.grminternational.com

Record of Results: • Under the Health Policy Project, advocacy secured $3 million per year from the Government of Nigeria to purchase family planning commodities from the United Nations, and an additional $8.34 million at the London Family Planning 2020 Summit for family planning and reproductive health programmes. • Under USAID-funded MEASURE Evaluation (1997-2014), collaborating with Ahmadu Bello University and Obafemi Awolowo University, Ile-Ife to offer two-week courses on monitoring and evaluation. Strengthened the universities to deliver and sustain the courses on their own. Supported Obafemi Awolowo University to pilot a Monitoring and Evaluation diploma course. • Through ENHANSE, supported the National Agency for the Control of AIDS / Zain Partnership that provided free SMS behaviour change messages, free-toll lines for counselling, and billboards with HIV/AIDS messages.

Strong leadership implementing social change projects in northern Nigeria
The DFID-funded State Accountability and Voice Initiative (SAVI) (2008-15), implemented by GRM, is a state-level programme increasing the ability of citizens to claim rights and hold governments accountable. Through SAVI’s gender and social inclusion mainstreaming, issue-based policy advocacy, and monitoring initiatives, the Kano State House of Assembly passed the State Primary Healthcare Development Bill in 2012. The law will furhter strengthen advocacy for adequate funding in state budgets for free maternal, newborn and child health services. GRM is also influencing the attitudes and behaviours of youth in Nigeria by promoting equity and empowerment of women and girls through the DFID-funded Voices for Change (V4C) (2012–2017) programme. Initiatives such as these allow GRM to deepen our understanding of demand side issues, ensuring more targeted approaches to improved health service delivery. The Mobilising for Development (M4D) programme (2012–2018) is engaging excluded groups, including adolescent girls, in health and other services. The programme aims to have an impact on 650,000 people in 270 communities in nine of the 94 Local Government Areas in Kano, Kaduna, and Jigawa.

Advocating for Better Health for Women and Children
Dr. Dogo-Muhammad, CEO of Nigeria’s National Health Insurance Scheme, was disappointed by a lack of progress expanding healthcare coverage across Nigeria. The Health Insurance Scheme had failed to attain the goal of bringing family planning and reproductive health services to at-risk pregnant women in 12 of Nigeria’s poorest states. Dr. DogoMuhammad was concerned that the country wasn’t ready for these services. He believed people were skeptical of the health insurance programme, seeing family planning as a means of government control. Knowing that Nigeria had one of the highest maternal mortality rates in the world, Dr. Dogo-Muhammad forged ahead and approached the Health Policy Project to conduct an analysis of the costs and benefits of including family planning in health insurance packages. Using Futures Group forecasting tools, Health Policy Project team members analyzed data on reproductive health and family planning services. With the data in hand, the team met with the senior staff of the national health insurance programme. Nigerian decision makers asked, “How can we afford these services?” The Health Policy Project team explained that family planning benefits would save lives, helping women avoid risky births. The cost of upfront investments in reproductive health and family planning far outweighed the benefits in lives saved and high-risk births avoided. After considering the data and discussing it with the Health Policy Project team, decision makers agreed to include family planning in two of Nigeria’s National Health Insurance programmes. When implemented to scale, the programmes will cover hundreds of thousands of Nigeria’s poorest pregnant women in 12 states.

Supporting global, regional and national initiatives to improve reproductive, maternal and newborn healthcare
With DFID support in India (2012-2015), Futures Group is making family planning services available to poor, young, and low parity couples using innovative publicprivate partnership models, including social marketing, social franchising, a demand-side financing mechanism, and mobile medical units. The programme has commenced design of its Integrated Client Counselling, Tracking and Follow up System (ICCTFS); operationalised a clinical outreach team model; as well as designed and developed a concept note for Entertainment-Education shows to generate demand for services at the community level in Bihar and Odisha. With DFID support in South Africa (20122015), Futures Group is strengthening delivery of school health, ward primary health care, and obstetric and neonatal emergency services. The programme is also improving demand and accountability for health services, and using new data and knowledge to remove barriers for uptake and access of services. The programme is supporting regional initiatives, such as the African Union Campaign on Accelerating Reduction of Maternal Mortality in Africa (CARMMA), through strengthening district capacity to improve maternal and child health clinical governance. By April 2013, 16 of 25 districts have integrated CARMMA within their District Health Plans. We also helped organise the AU conference taking stock of CARMMA progress, attended by presidents from Nigeria and South Africa, and several government ministers. In Kenya (2013 – 2018), Futures Group’s latest project under DFID’s Reproductive Health Framework, Futures Group will deliver increased family planning services in Kenya by creating and maintaining a Sector Wide Approach for family planning, and adopting a Total Market Approach to dramatically grow Kenya’s family planning market and meet unmet need. The programme is also employing a “Making Markets Work for the Poor” (M4P) approach to increase sustainability, focusing efforts on rural women and adolescent girls, as well as employing extensive and innovative Social and Behaviour Change Communications to increase demand and reduce social barriers for family planning, and strengthening health system commodity logistics. The programme is currently in its inception phase.

Global experience managing large and complex health programmes in challenging settings
Futures Group leads USAID’s global USD $250 million Health Policy Project (HPP) (2010 – 2015), which operates in 14 countries, including Nigeria, Ethiopia, Mozambique, and Afghanistan. It aims to strengthen developing country national and subnational policy, advocacy, and governance for strategic, equitable, and sustainable health programming. The project addresses key health issues — family planning and reproductive health, HIV, and maternal health — and promotes health systems strengthening and programme integration. Futures Group has also held predecessor contracts, the Health Policy Initiative, Task Order 1 (HPI) (2005–2010) (USD $99.9 million globally) and POLICY Project (1995–2006) (USD $237.1 million).

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