Implementation of the Nigeria Quality Initiative (NQI) Project

Timeline: November 2014 – October 2017 | Status: Completed

Lagos and Niger States, Nigeria

Project Overview

Delivering high-quality healthcare requires more than expanding access to services—it requires systems that consistently promote safety, effectiveness, and continuous improvement. Between November 2014 and October 2017, the Health Strategy and Delivery Foundation (HSDF), in partnership with the Bill & Melinda Gates Foundation and the Private Sector Health Alliance of Nigeria (PSHAN), implemented the Nigeria Quality Initiative (NQI) Project to strengthen healthcare quality within Nigeria's health system.

Implemented in Lagos and Niger States, the project supported efforts to institutionalise quality improvement by working with healthcare facilities and government stakeholders to strengthen governance, improve clinical and operational practices, and encourage the routine measurement of quality indicators.

The initiative recognised that sustainable improvements in healthcare quality depend on strong leadership, engaged health workers, and systems that continually monitor performance and respond to identified gaps. Through collaborative learning and technical support, the project helped establish a stronger foundation for quality improvement within participating health facilities.

As Nigeria sought to improve health outcomes, variations in the quality of care across healthcare facilities remained a significant challenge. Weak quality assurance systems, inconsistent adherence to standards, and limited mechanisms for monitoring and improving performance affected the delivery of safe and patient-centred care.

Addressing these challenges required coordinated efforts to embed quality improvement into everyday healthcare practice and strengthen the institutional systems responsible for maintaining high standards of care.

HSDF worked closely with government institutions, healthcare providers, and partners to integrate quality improvement into routine service delivery. The project focused on:

Strengthening quality improvement structures within healthcare facilities.
Supporting the adoption of quality standards and evidence-based practices.
Building the capacity of healthcare teams to identify and address quality gaps.
Promoting routine performance monitoring and continuous improvement.
Encouraging collaboration between public and private sector stakeholders to improve healthcare quality.