Increasing voice and accountability in the health sector

Better use of Nigeria’s resources is critical to reduce poverty and accelerate progress towards attaining improved health goals. State and local governments manage 50 per cent of national revenue and are responsible for most health services. The Partnerships for Transforming Health Systems (PATHS) is a DFID-funded programme which is strengthening state and local government health sector systems. Now in its second phase, the programme will improve the planning, financing and delivery of sustainable and replicable primary health care services in the states of Enugu, Jigawa, Kaduna, Kano and Lagos.

Options is supporting citizens and civil society to hold service providers and governments to account for better services, and foster a health system that responds to the communities’ needs. We are using both ‘long-route’ and ‘short-route’ approaches to strengthening accountability through the programme:

  • Short-route approaches focus on accountability between citizens/clients and service providers at the community and facility levels. We are doing this through setting up Facility Health Committees, which are groups of volunteers who together represent and act as a spokesperson for people in the community. The committee establishes a dialogue between the health facility and the community to make sure health services respond to local health needs.
  • Long-route approaches improve responsiveness of government to citizens/clients by strengthening the voice of civil society groups, and building their capacity to use data to advocate for better services.

We are using community scorecards to assess community participation in health, training and mentoring Facility Health Committees, supporting NGOs to track progress in improving health service delivery.

Project achievements:

  • We have established, trained and mentored 633 Facility/Ward Health Committees. They have created stronger linkages between the community and the health service providers and are now being embedded within government systems.
  • In Lagos, following training, the Ward Health Committees mobilised resources worth NGN 4.7 million to pay for improvements in health facilities.
  • We established an alliance for Facility and Ward Health Committees to share lessons learned and best practices from their own experience.
  • Three rounds of community scorecards have been produced across the states, giving valuable insights into community perception of health services. 


3,946 Facility/Ward Health Committees established, trained and mentored 

Funded by: 

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