Gates End of Project Summary


The NPHCDA with the support of PRRINN-MNCH introduced the ‘Bringing Primary Health Care Under One Roof’ (PHCUOR) initiative as part of a new Government reform designed to improve Primary Health Care Service Delivery.

The NPHCDA and partners have been championing the implementation of “PHC Under One Roof” since its endorsement by the National Council on Health in 2011. The Goal of “PHCUOR” is to reduce the fragmented ways in which Primary Health Care Services are delivered in Nigeria by promoting integrated management systems under one Authority.


The capacity and competency of the SPHCDA/Bs and Local Government Health Authorities is crucial to maximally benefit from the performance-based disbursements of the Basic Health Care Provision Fund as authorized by the newly enacted National Health Act of Nigeria 2014. The incremental financing made available for basic services such as Antenatal Care and Routine Immunization will afford improved service coverage, equity and quality, thereby saving lives.

In view of this, Preston Associates for International Development with funding from the Bill and Melinda Gates Foundation supported the NPHCDA by working together to enhance her ability to provide overarching guidance to the States as they position to benefit from the performance-based disbursements of the Basic Health Care Provision Fund. The overall aim being to promote effective and efficient PHC service delivery in Nigeria.

Summary of Projects

Development of PHCUOR Rapid Diagnostics Tools: The RDT is a self-administered tool for assessing the operationalization of Primary Health Care under One Roof (PHCUOR) and the organizational and, managerial capacity of the States’ Primary Health Care Development Agencies. This tool is also intended to be consequently used by the states to carry out intra-assessments to ensure compliance with the PHCUOR model.

Key Benefits of the RDTs include

  1. Cost Effective: The self-administered RDTs is inexpensive to use. It does not require the services of consultants/ data collection officers.
  2. Allows for thematic area prioritization: RDTs can be administered in piecemeals. i.e SPHCDA/Bs could focus on any domain.
  3. Convenient: RDTs are short, clear and simple. They are also fully automated for easy scoring and analysis.
  4. Accessible: The RDTs are available for use both offline and online. It can easily be downloaded from the PHCUOR e-Hub platform.
  5. Serve as an advocacy tool: Provides evidence to partners that informs what support to be provided to State.

INTENDED OUTCOME: Empowered SPHCDA/Bs with capacity to conduct intra-assessment on alignment with PHCUOR model prior to national Scorecard assessment.

Creation of PHCUOR electronic Hub: The electronic hub is to facilitate the sharing of experiences, dissemination of tools, latest news updates and guidelines, as well as, accessing Frequently Asked Questions as it concerns PHCUOR implementation. This will enhance effective management of explicit and tacit knowledge. It will also enable Partners to keep up with the latest development in states, leading to more synchronized PHCUOR strengthening support.

Participants are required to come with their laptops as training sessions will be hands-on and interactive.

Key Benefits of the e-Hub include:

  • Cost Effective: The e-Hub allows NPHCDA and States to share documents and guidelines without having to worry about cost of printing and distribution.
  • Instant: States can have access to tools and information immediately they are uploaded. No more long waiting hours/ days to receive documents or information.
  • Convenient: Anyone with either a mobile phone, tablet or computer can access the platform. Thus it can be used on the ‘go’.
  • Far-reaching: The e-Hub can be accessed from all over the world. From the most remote locations to the most advanced cities. It is truly a Global platform.
  • Evidence for advocacy: Provides evidence to partners and stakeholders that informs what support to be provided to State.

INTENDED OUTCOME: Enhanced knowledge-sharing capacity on PHCUOR to and amidst States.

Development of Action Plans from the review of organizational and leadership capacity and competencies of SPHCDA/Bs in Northern Nigeria: Sokoto SPHCDA and Kano SPHCMB were both critically assessed to identify gaps in its managerial and organizational capacities and competencies. Recommendations were made to address the identified gaps.

How this is different:

  • Assessments like the National Scorecard 3, look at State performance in implementing PHCUOR by different thematic areas with a quantitative focus without providing information on how to improve performance.
  • Our work involves a Qualitative approach which goes beyond assessing performance but also looks at processes involved in achieving results. Simply put, our tools will go further and answer the hows and the whys.
  • The “Fit-for-Purpose” approach takes into consideration the different dynamics needed at different levels to achieve desired outcomes.
  • We aim to understand why present barriers exist through the review of the organizational culture, value system and political economy analysis

INTENDED OUTCOME: Action-plan for enhanced SPCHDA/B in Sokoto and Kano states respectively based on recommendations from in-depth empirical assessment.


SPHCDA/Bs prioritizing of these recommendations would play a crucial role in further strengthening their organizations for optimum performance and ultimately improving health outcomes. NPHCDA and Partners should continue supporting State SPHCDA/Bs to make use of the agreed action plans to tackle identified barriers in order to close existing gaps.