PACK Nigeria Adult
The KTU and BMJ have been in discussion with the World Bank, Oxford Policy Management and the Nigerian National Primary Health Care Development Agency (NPHCDA), since 2014 to see how we can work together to improve the clinical competence of primary health care workers in Nigeria. Early in 2016 it was agreed that PACK Adult would be localised for use in Nigeria and that a pilot training and implementation programme would be rolled out across 36 primary health care (PHC) facilities in Ondo state, Adamawa state and Nasarawa state.
Since May 2016, the KTU have been working with Professor Joseph Ana’s team of clinicians who represent all cadres of primary care staff, to localise PACK Adult to Nigerian clinical protocols and practice. They have focused on ensuring that the correct scope of practice, prescribing rights and referral levels are incorporated for all cadres of staff who deliver primary care services in Nigeria. Those cadres of staff include Junior CHEWs (Community Health Extension Workers), CHEWs, Community Health Officers, Nurses, Midwives and Medical Officers. The localisation work will be completed by 30th November 2016. In parallel Professor Ana’s team are working with the KTU to localise the PACK training programme for pilot implementation. This preparation work will be completed by the end of 2016.
Pilot training will commence in January 2017 with 2 to 4 Master-Trainers per State being trained to cascade training across 12 to 22 primary health care Facility Champions. Each facility champion will facilitate end-user training onsite with staff, focusing initially on eight priority conditions: acute diarrhoea, pneumonia, diabetes mellitus type 2, pulmonary tuberculosis, malaria with anaemia, hypertension, pregnancy and fever. The immediate evaluation will take the form of a questionnaire to staff carried out at the beginning and end of the 6 month pilot period. This questionnaire will survey staff response to PACK and their views on its usefulness as a primary care improvement tool. Following the pilot and evaluation a decision will be taken on whether to upscale the PACK programme more widely in Nigeria.