Research for Policy Action

Jigawa Health Sector Governance Reform Case Study

Over the last 15 years, Jigawa State, in North-West Nigeria, has undertaken a number of reform efforts in the governance of the health sector. These include (1) improvements in planning, budgeting, human resources and information management, (2) the Gunduma decentralisation that reorganised primary and secondary health care service delivery into district level units, and (3) reforms to drugs supply and management through the creation of a Drugs Revolving Fund (DRF) and Jigawa Medicare Supply Organisation (JIMSO). This case study adopts a political economy analysis approach to explore these health sector governance reforms, looking at the most significant health sector governance reforms from 1999 to 2017 It explores the rationale for the choice and formulation of each of these reform initiatives, whilst raising questions on the factors that determined their design, implementationn, and maintenance. Where applicable, it also explored reasons behind decisions to discontinue or or reverse them. The case study examines the structural and institutional factors that influence policy change in Jigawa, as well as how and why individuals and organisations have been driving or resisting change, why and how reforms have been pursued and what outcomes were actually achieved. It documents the extended period of significant improvements in the quality of financial management marked by a major increase in the health budget and good performance in budget execution and the transformation of the medicine supply chain. It also highlights challenges such as information systems management, the unreliability of the administrative data system and the shortage of skilled professionals. The case study provides relevant lessons for other public sector governance reforms and service delivery for other sectors or Nigerian states receiving development assistance.

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Jigawa State Government, Jigawa Medicare Supply Organisation (JIMSO), Health Sector Governance Reform,

Focus Area(s): Home Grown School Feeding

Country of Reform: Nigeria

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