Additional Financing Nigeria State Health Investment Project (AFNSHIP)

Timeline: March 2018 – March 2020 | Status: Completed

Nigeria

Project Overview

Improving health outcomes requires sustained investment in health systems, particularly at the primary healthcare level where most people access essential services. The Additional Financing Nigeria State Health Investment Project (AFNSHIP) was established to build on earlier investments in strengthening healthcare delivery and accelerating progress towards better maternal, newborn, and child health outcomes.

Between March 2018 and March 2020, the Health Strategy and Delivery Foundation (HSDF) worked with the World Bank and the National Primary Health Care Development Agency (NPHCDA) to support the implementation of AFNSHIP. The project contributed to ongoing efforts to strengthen service delivery systems, improve programme performance, and enhance accountability within the health sector.

AFNSHIP formed part of broader national efforts to improve the quality, accessibility, and effectiveness of primary healthcare services, particularly for women and children. By supporting implementation and strengthening institutional capacity, the project helped advance health sector priorities aimed at delivering better outcomes for communities.

Despite progress in expanding access to healthcare, many health systems continue to face challenges related to service quality, performance management, resource utilisation, and accountability. These challenges can limit the effectiveness of investments and reduce the impact of health programmes on population health outcomes.

Sustained improvements require strong implementation systems, effective coordination among stakeholders, and mechanisms that enable health institutions to monitor performance and respond to emerging challenges.

HSDF provided technical and implementation support to strengthen project delivery and improve health system performance. The project focused on:

Supporting implementation of health sector strengthening interventions.
Strengthening accountability and performance management systems.
Enhancing institutional capacity within primary healthcare structures.
Promoting data-informed decision-making and programme monitoring.
Supporting stakeholder coordination and collaboration.
Contributing to efforts aimed at improving maternal, newborn, and child health outcomes.

The project emphasised practical approaches that strengthened existing systems and supported government-led implementation.

AFNSHIP contributed to broader efforts to improve the effectiveness of health investments and strengthen primary healthcare systems in Nigeria. Through support for implementation, performance improvement, and institutional strengthening, the project helped reinforce the systems required to deliver quality healthcare services and achieve sustainable health outcomes.

The initiative also demonstrated the importance of aligning financing, implementation support, and accountability mechanisms to maximise the impact of health sector investments.