[Re: https://www.hifa.org/dgroups-rss/joseph-ana-30-practical-approach-care-k... ]
Dear Mickey,
Interestingly, the majority of people working in front line primary care in Nigeria, are not physicians. The Practical Approach to Care Kit (PACK) Nigeria (Adult and Child) provides a single, integrated, comprehensive, evidence-informed clinical guide to support all cadres working in primary healthcare in Nigeria. It supports junior community health extension workers (JCHEWs), community health extension workers (CHEWs), community health officers (CHOs), nurses, midwives, and medical officers by clearly delineating scope of practice and referral pathways, enabling consistent and standardised care regardless of cadre.
PACK is a health systems intervention developed by the Knowledge Translation Unit (KTU) in South Africa. In 2016, in collaboration with KTU and BMJ, HRI Global localised and rolled out PACK for Nigeria, ensuring it addressed Nigeria’s disease burden and workforce realities. PACK Nigeria aimed to improve diagnostic accuracy, standardise treatment protocols, and enhance referral systems (Awotiwon et al., 2018).
In 2017, PACK Nigeria was piloted in three states:
- Ondo State: Chosen for its strong commitment to primary healthcare reforms. PACK was deployed to improve diagnosis and referral systems (Daily Times Nigeria, 2017).
- Adamawa State: Introduced in Yola, focusing on strengthening frontline decision-making and clinical competence (Awotiwon et al., 2018).
- Nasarawa State: Piloted to test adaptability in diverse healthcare settings, ensuring PACK could be contextualized to local realities (Awotiwon et al., 2018).
These pilots demonstrated PACK’s effectiveness in improving clinical competence and standardising care, laying the foundation for wider adoption.https://gh.bmj.com/content/3/Suppl_5/e001079
Following the success of the pilots, Bauchi State was introduced to PACK as part of the scaling strategy. Bauchi’s inclusion reflected the programme’s aim to cover northern states with significant healthcare delivery challenges.
Subsequently, Borno State also adopted PACK, extending its reach into a region with unique healthcare challenges due to conflict and displacement. The introduction in Borno demonstrated PACK’s adaptability and resilience in fragile health systems.
If any of the HIFA's Nigerian contributors working in these states have used PACK Nigeria, I am sure they will be happy to share their personal experiences. As mentioned PACK was first developed and deployed in South Africa, however, along with Nigeria, PACK has also been localised to Brazil, Indonesia, Ethiopia and Botswana. I suspect the experiences of PACK users in these countries might be of interest to you too.
Best wishes
Mbang