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H e a l t h F a c i l i t yA s s e s s m e n t R e p o r tHow prepared is ourhealthcare system for theCOVID-19 pandemic?

May 2020

Health Facility Assessment Report How prepared is our healthcare system for the COVID-19 pandemic?

May, 2020

2 Health Facility Assessment Report: How prepared is our healthcare system for the COVID-19 pandemic?

Christian Aid is a Christian organisation that insists the world can and must

be swiftly changed to one where everyone can live a full life, free from

poverty.

We work globally for profound change that eradicates the causes of poverty,

striving to achieve equality, dignity and freedom for all, regardless of faith or

nationality. We are part of a wider movement for social justice.

We provide urgent, practical and effective assistance where need is great,

tackling the effects of poverty as well as its root causes.

christianaid.org.uk/nigeria

Contact us

Christian Aid Nigeria Country Office Plot 802, Off Ebitu Ukiwe Street Jabi District Abuja, FCT Nigeria T: +234 (0) 703 255 9282 E: [email protected] W: christianaid.org.uk/nigeria UK registered charity no. 1105851 Company no. 5171525 Scot charity no. SC039150 NI charity no. XR94639 Company no. NI059154 ROI charity no. CHY 6998 Company no. 426928 The Christian Aid name and logo are trademarks of Christian Aid © Christian Aid May, 2020 Christian Aid is registered with the National Planning Commission of Nigeria.

Authors:

This document was developed by Christian Aid with funds from UK aid from the UK government.

Acknowledgements:

A very big thank you to all our implementing partners who supported in the data collection process. We appreciate

the members of the MEAL team who supervised the entire process and ensured the data was appropriately

managed. Thank you for your expert advice.

Health Facility Assessment Report: How prepared is our healthcare system for the COVID-19 pandemic? 3

Contents

Executive summary 5

Introduction 6

Purpose of the assessment 6

Objective of the Assessment 7

Methodology 8

Scope of the Assessment 8

Type of Health Facilities 8

Areas covered within health facilities 8

Sample size 8

Data Collection Instruments 8

Training and field strategy 9

Training of data collection teams 9

Fieldwork Strategy 9

Quality Assurance 9

Data Analysis 10

Constraints and limitations 10

Data management 10

Key findings 11

Availability of Bed spaces 11

Type of facilities and services provided 11

Health Workers and their distribution 12

Health Workers trained on National COVID 19 Protocol and Guidelines 13

COVID 19 case management and facilities for Infection Control 13

Recommendations 15

Annex 17

Cover: Data collection at Health facility assessment in Ihugh Primary Health Care, Vandeikya LGA, Benue State

Photographs: Christian Aid


List of Acronyms

CA Christian Aid

CLHEI Community Links and Human Empowerment Initiative

COVI9 19 Corona Virus Disease of 2019

DFID The United Kingdom Department for International Development

EYN Ekklisiyar Yan’Uwa ‘a Nigeria (Church of the Brethren in Nigeria)

HFA Health Facility Assessment

IDP Internally Displaced Persons

LANW Legal Awareness for Nigerian Women

LGA Local Government Area

MCHC Maternal and Child Health Centres

MVF Mercy Vincent Foundation

PHC Primary Health Centres

PPEs Personal Protection Equipment

UNICEF United Nations Children Fund

SOPs Standard Operating Procedures

WHO World Health Organisation


Executive summary

As part of the response to the COVID-19 outbreak, Christian Aid Nigeria is responding to a DFID call for proposal

to support preparedness and response to primary and secondary impacts of COVID-19 on the most vulnerable

individuals and communities. This requires series of proven and cost-effective measures for saving the lives of

IDPs, Returnees and vulnerable populations in hard to reach areas of Benue, Borno and Kaduna states of Nigeria.

This is a five-month project funded by DFID and being implemented by Christian Aid Nigeria and Afghanistan

through local partners. In Nigeria the intervention is implemented by a local consortium led by Christian Aid Nigeria

and four local partners: Mercy Vincent Foundation (MVF) and Ekklisiyar Yan’Uwa ‘a Nigeria (Church of the Brethren

in Nigeria) leading project activities in Borno state, Legal Awareness for Nigerian Women (LANW) is leading

activities in Kaduna state while Community Links and Human Empowerment Initiative (CLHEI) is responsible for

Benue state.

Existing health care delivery system both in the public and private sectors were assessed through a survey labelled

Health Facilities Assessment (HFA). This survey was conducted by Christian Aid partners and led by Christian Aid

Nigeria in three states across 12 Local Government Areas (LGAs). The objective of the survey was to assess the

existing health services profile, physical infrastructure, equipment/supplies, human resources, auxiliary services

and quality of health services been rendered to the communities.

Standardised questionnaires scripted into kobocollect mobile applications was used to collect quantitative data at

the community level (a total of 56 health facilities across the three states were assessed and a total of 1308 health

personnel across the three states’ LGAs were interviewed directly to sample their opinion and perception of the

Covid-19 pandemic and also about their knowledge of this pandemic. Data was analyzed using Power BI application

and frequency tables were generated community wise by type of health facilities. Standard ethical considerations

for conducting research were adhered to strictly, especially those dealing with confidentiality of study participants

and respect for socio-cultural systems and structures.

The health facility assessment has revealed that:

The study covered 56 health facilities across 12 LGAs in Benue, Borno and Kaduna states. These 56 facilities

have a combined total of 642 bed spaces to serve the health need of an estimated 2,826,379 persons in 3397

communities, this falls short of WHO’s 5 bed spaces to every 1000 population recommendation

The dormant service types available in the accessed facilities is clinical services, as 66.27% of the target

facilities render clinical services, 25.30% of them render Pyscho-social support and the remaining 8.43% render

other forms of health services.

There are a total of 1308 staff across all 56 health facilities assessed with 491 females representing 37.54% of

the total work force who are full time health workers, 26.91% (352) are full time male workers, the other 465 are

part time health workers and volunteer staff. Of these, 227 are volunteers comprising of 119 females.

With 1308 health workers across the target health facilities, only 207 have been trained on COVID-19 national

protocol. Kaduna state contributes the highest number of trained health workers with 104 trained staff, 65 of

these staff are concentrated in one LGA of the state – Markafi LGA. In Benue state, across all 4 LGAs only 26

Health workers have been trained on COVID-19 national protocol while in Borno state 78 health workers have

benefitted from the trainings on COVID 19 protocol


98.21% of the health workers interviewed attest that they are aware of COVID-19 and only 2.79% said they

were not aware of the global pandemic.

The respondents also revealed that most of the trainings on Covid-19 were facilitated by the various state

government through the state ministry of health with WHO and UNICEF being the second highest providers of

COVID 19 trainings to health workers.

Basic and/or Comprehensive Emergency Care Services on Covid-19 are not available in some of the surveyed

health facilities. Underlying reasons are non-availability of service delivery protocols/guidelines, inadequate

human resources, lack of facilities for infection control such as hand washing facilities for all staff and patients,

gloves, adequate ventilation, safe distancing for patients and waste disposal.

Keeping in mind the findings revealed through this Health Facility Assessment, certain interventions are required to

improve the prevention of Covid-19 pandemic at both the primary health facilities and the public/comprehensive

health centres across the target LGAs. The availability of basic and comprehensive Covid-19 Emergency Standard

Operating Procedures must be ensured at appropriate levels of health care centres at all community level. All Covid-

19 related posts should be occupied at all health centres and protocols/guidelines should be shared with

these facilities. Availability of all physical resources and essential Covid-19 supplies including face masks/Personal

Protective Equipment supply must be ensured at all levels and mechanism outlined for their regular maintenance.

Testing centres and/or laboratory services should be made available. Public health centres facilities should also

be strengthened in this regard. See the Full Report of the HFA for more details.

Introduction The global COVID 19 pandemic have impacted heavily on vulnerable communities in Nigeria, the impact of this

pandemic further worsens already depleted access to essential health services in Nigeria. To support health

facilities in dealing with the increasing pressure on health service delivery following the COVID 19 outbreak in

Nigeria and ensure that target communities continue to have access to basic health services, a component of the

DIFID COVID 19 RRF has strategically targeted health facilities and health workers in target LGAs for COVID 19

related support.

This document is a report of the needs assessment study in Benue, Borno and Kaduna states among facility health

workers and physical assessment of health facilities in the target communities. It is intended that this report will

guide the development of humanitarian intervention in these locations, and the information in this report will be used

by stakeholders, government and other humanitarian actors in addressing the critical needs of primary and

secondary impacts of COVID-19 on IDPs, Returnees and vulnerable populations in hard to reach areas of Nigeria

target states.

Purpose of the assessment

The purpose of this assessment was to generate information for the Localised preparedness and response

to primary and secondary impacts of COVID-19 on IDPs, Returnees and vulnerable populations in hard to reach

https://app.powerbi.com/view?r=eyJrIjoiMTk0N2YzNmMtYjAxMS00YzM4LWE3MjYtMDkwOThmOGUwNDNlIiwidCI6IjlkY2MzYzI4LTcyZTktNGUxYi1iNTExLTJjOWJmM2JjNTg3OCIsImMiOjh9


areas of Nigeria. The outcome of the survey will enable Christian Aid Nigeria (CAN) and the government to

reposition health care system in the public sector and coordinate with the private sector while taking advantage of

the ideal opportunities offered by this project. Christian Aid’s response on the Covid-19 intervention is basically an

effort to establish benchmarks for setting targets, devising strategies and plans to achieve the project objectives.

Objective of the Assessment

Overall, the objective of the survey was to describe the availability, functioning and quality of health care delivery

system in the public and private sector of the selected target of intervention with focus on Covid-19 response

services. The specific objectives of the survey are:

1. To evaluate the availability of various service packages especially for Covid-19 pandemic.

2. To assess the availability of resources and provision of the health care services to the indicated target groups

in project areas.

3. To recognize/identify gaps in the processes and quality of care related to Covid-19 services provided at public

and private health facilities.

4. To depict some basic issues concerning provider-client interactions taking place in the health care facilities in

the project communities.

5. To evaluate the essential support services for optimal functioning of the health care delivery system on Covid-

19 in target communities.


Methodology

Design: The survey was based on general observation, examination of facility records, and interviews with facility

personnel. A cross sectional quantitative study was conducted, and data collection was done using structured

questionnaires

Scope of the Assessment

The assessment was conducted in three states (Benue, Borno and Kaduna) across 12 LGAs in 54 communities.

Type of Health Facilities

Primary Health Centres (PHC)

Reproductive Health Services Centre

Basic Health Units

Maternal & Child Health Centres (MCHC)

Private Hospitals

Maternity Homes

Areas covered within health facilities

Essential support services such as laboratory, doctors’ consulting rooms and ambulance services

Facility management support; such as facility environment, waste disposal, service delivery, guidelines and

referral system.

Sample size

A total of 53 health facilities were targeted, their distribution according to location is provided in the annex.

Data Collection Instruments

The study was conducted using structured Standardised questionnaires scripted into Kobocollect mobile

applications for the collection of quantitative data at the community level (a total of 13408 individuals where directly

interviewed).

The instruments for the needs’ assessment was designed by Christian Aid’s MEAL unit with inputs from Christian

Aid’s implementing partners. This was again critically reviewed by Christian Aid’s technical programme team to

ascertain the comprehensiveness of the tool before deployment on the field for the training of enumerators and data

collection. During the training of enumerators in the three programme states, the instrument was reviewed again by

the trained enumerators to test run the tool.


Training and field strategy

Training of data collection teams

The training of the enumerators for the collection of data was done per state. This was carried out by Christian Aid

trained staff and all 4 local partners involved in this intervention. With the support of Christian Aid MEAL staff,

partner trained staff were properly guided to ensure that they receive the same quality of training on the tool before

they finally move into the field for the data collection exercise. Across the three states, 94 enumerators and 4

supervisors (1 per partner organisation) were trained on 10th of May 2020 on the use of the scripted Kobo

questionnaire and were further trained on how to handle the mobile data collection system and Mobile Data

Collection Devices.

The objective of the training was to give the enumerators a general overview of the study “Facility Assessment” in

Benue, Borno and Kaduna States. The questionnaire guide was also clarified with key emphasis on content

understanding for the instrument, data quality and interview management and other necessary procedures to be

adhered to during field work.

Fieldwork Strategy

There was wide variation in terms of size and complexity of the facilities to be surveyed. In order to make best use

of resources, the following field work strategy was implemented.

– A total of 3 teams- one team per state were organized for the entire fieldwork. Each team comprised of

average of 12 members depending upon the size of the sample in district. Each team was headed by a

team leader who was responsible for quality assurance of data collection and overall coordination of team

in the field.

– Before starting the field work, meetings were held with community heads for seeking support and

facilitation. There were no recorded issues relating to non-cooperation of the facility staff.

– Prior notice was sent to community heads and facility to be surveyed indicating time and date for the visit

of the team.

– The teams visited facilities on working days only and visits on off days were normally avoided unless there

was a specific appointment with the facility in-charge.

– Full team worked for an average of 6 days to collect data from community target communities

– The teams were required to follow the detailed Field Work Plan at all costs. The facilities that were not

covered according to the plan were postponed to the end of the survey ensuring that the Field Work Plan

was not disturbed due to problem at few sites.

Quality Assurance

Key measures for quality assurance of data were:

Survey instruments were extensively reviewed by both partners and CA technical staff before finalization.

Intensive training was imparted to the survey teams, which was followed by careful and effective supervision by

CA team during field work.


Team leaders edited questionnaires on site and referred mistakes to the enumerators for correction/

clarification. This field editing ensured completeness of the questionnaire and correction of mistakes/

inconsistencies.

To further strengthen the quality assurance mechanism, supervisors from CA accompanied enumerators to the

field. The supervisors used a standard checklist to ensure uniformity of the supervision process. The feedback

received through supervisory visits was extensively discussed among CA staff/partners and immediate steps

were taken to implement identified actions.

All questionnaires received from the field were edited and coded by trained CA staff before data entry

Data Analysis

Data collection was done using Kobo collect and analysed with the Microsoft Power BI application. The data was

analysed by type of the health facilities and by community with focus on predefined indicators.

Constraints and limitations

All efforts were made to minimize the systematic errors in design phase, data collection and analysis but still there

were certain inherent constraints and limitations in survey which are summarized below:

As the scope of survey was broad, therefore a combination of methodologies was inevitable, and few

compromises had to be made in this balancing exercise.

In health care delivery system diverse types of services are delivered through multiple mutually interacting and

coordinating systems of auxiliary and support services. These services are managed in the same premises

and under the same management resulting in complexity of need assessment for a specified area of

intervention.

Scope for aggregate analysis was limited as the survey was conducted in 12 local government areas across

our 3 target states purposely selected communities and analysis of the results may not be taken as

representative of respective states or the country as a whole.

Data collection in the survey was highly dependent on facilities available within the communities, therefore the

results should be interpreted with caution.

Data management

The data for the Facility Assessment was collected using Kobo Collect). In the course of the field work, we carried

out spot checks of interviews done - to ensure data quality assurance and at the end of every day’ fieldwork

questionnaires were uploaded to the Christian Aid MEAL Kobo platform by the enumerators and retrieved by CA

MEAL unit for collation and review.


Key findings

The summary findings for this Health Facility Assessment are findings from the quantitative surveys and additional

evidence from the physical observations.

Availability of Bed spaces

A total of 56 facilities where visited during this assessment, the facilities covered are spread across 12 LGAs in 3

states. They include Agatu, Vandeikya, Kwande and Oju in Benue state, Dikwa, Jere, Konduga and Maiduguri LGAs

of Borno state and Kachia, Kajuru, Kaura and Markafi LGAs of Kaduna state. Theses 56 health facilities serves

3,397 communities with an estimated total number of 2,826,379 persons across all the states. The total number of

bed spaces available across the selected facilities stands at meagre 647 beds spaces as against 972 bed spaces

by the original design of these facilities leaving a deficit of 324 bed spaces.

Type of facilities and services provided

83% of the facilities accessed were primary health Centers, 14% were secondary health facilities and only 3% were

Health Post. All 4 Health post that made up the 3% of sampled health facilities are located in Kaduna state, none

of the target communities in Benue and Borno states have a Health post.

The dormant service types available in the targeted facilities is Clinical services, as shown in the findings 66.27%

of the target facilities render clinical services, 25.30% of them render Pyscho-social support and the remaining

8.43% render other forms of health services.


Health Workers and their distribution

The survey revealed that there is a total of 1,308 staff across all 56 health facilities covered by this assessment. Of

these number, 491 represents 37.54% of the total work force as full-time female health workers, 26.91% (352) are

full time male workers, the rest 465 are part time health workers and volunteer staff. Of these figures, 227 are

volunteers comprising of 119 females


Health Workers trained on National COVID 19 Protocol and Guidelines

Of the 1308 health workers across the target health facilities only 207 have been trained on COVID-19 national

protocol. Kaduna state contributes the highest number of trained health workers with 104 trained staff, 65 of these

staff are concentrated in one LGA of the state – Markafi LGA. In Benue state, across all 4 LGAs only 26 Health

workers have been trained on COVID-19 national protocol while in Borno state, 78 health workers have benefitted

from trainings on COVID 19 protocol. Despite the very low number of trained health workers about 98.21% of them

said they are aware of COVID-19 and only 2.79% said they were not aware of the global pandemic. Most of these

trainings were facilitated by the state government through their state ministry of health with the WHO and UNICEF

being the second higher providers of COVID 19 trainings to health workers.

Of the 3 states accessed facilities, Kaduna state proved to have the highest capacity for contact tracing with a

percentage of 61.54 %, in Borno state, this stood at 33.33% while Benue state had the least capacity for contact

tracing at 11.11%. In total only 29.09% of target facilities affirmed that they have capacity for contact tracing the

other 70.91% reported otherwise.

COVID 19 case management and facilities for Infection Control

75% of the facilities visited said they have facilities for infection control including access to handwashing facilities

for all staff and patients, hand gloves, face masks, waste disposal, adequate ventilation, safe spacing etc. 76.92%

of facilities in Kaduna have facilities for infection control, in Borno state, 93.75% of facilities have infection control

measures while in Benue only 62.9% of facilities have facilities for infection control in place. Only 13 of all 56 facilities

representing 23.64% of facilities responded in affirmative when asked if they have an SOP in place for guiding their

daily operations, the other 76.36% do not have any SOP in place. Considering the very infectious nature of the

COVID 19 pandemic, this percentages are quite low and worrying.


82.14% of selected facilities do not have PPEs for health workers, in total there are only 84 PPEs for 843 full time

health workers across 56 facilities in Benue, Borno and Kaduna states. There are only 2 for facilities in Kaduna

states (in Markafi LGA) 5 for facilities in Benue state while the remaining 77 PPEs where recorded for facilities in

Borno state.


Recommendations

The true impact of a COVID-19 outbreak in our target communities cannot be predicted. However, all healthcare

facilities can take steps now to prepare for such an outbreak and protect both their patients, staff and the

communities at large.

Provision of PPEs:

Findings from this assessment has shown that a staggering 82.14% of Health workers across selected facilities do

not have PPEs. According to reports from various studies on COVID 19, (www.who.int) the coronavirus can remain

stable on surfaces for several hours, these include surfaces like plastic and stainless steel which are very common

items within a health facility. This puts health workers at a high risk of rubbing off these surfaces with their hands

and equipment which becomes very dangerous to them and the patients they serve. As such it becomes very

important that health facilities are provided with adequate PPEs especially basics like face masks, surgical gloves,

disinfectants, surgical gowns etc. Some ways to do these is to:

1. Ensure Health workers are well-trained on the use of personal protective equipment (PPE).

2. Educate community members/train health personnel staff on COVID-19 and what they may need to do to

prepare. The following may be useful to share information about COVID-19:

a. How COVID-19 spreads

b. Clinical management of COVID-19 patients

c. Infection prevention and control recommendations for COVID-19

Training on COVID 19 National Protocol:

With guidance from the WHO a national protocol has been developed to guide health facilities in managing COVID

19 cases, these includes understanding of the symptoms of the diseases, facilitating isolation of cases and referrals

to designated COVID 19 treatment centres. This is to mitigate the spread of the disease while ensuring that

communities still have access to safe and quality health services. However, from this assessment we have seen

that out of the 1308 health workers across the target health facilities only 207 are trained on COVID-19 national

protocol and guidelines, as such it becomes a major need across all 3 states, it must be prioritized for certain states

and locations. for example, in Benue state only 14.81% of the health workers have been trained on COVID 19

protocol, while Kaduna and Borno records a fairly impressive percentage of trained staff on COVID 19 protocol

(92.31% and 75% respectively) the same cannot be said of all the target locations within the states. In Kaduna

state, all 3 of the LGAs have a 100% record of trained staff but Kaur LGA still has only 66% of health workers trained

on the COVID protocol.

Adoption of COVID 19 SOPs across all facilities:

SOPs are tools for standardising operations across facilities for quality assurance control. However, in this

assessment only 23.64% of targeted facilities have adopted an SOP for managing COVID 19 cases and other

services provided within the facilities. It becomes very important for this intervention to support facilities in

developing or adopting SOPs to help ensure that guidance for managing cases are adhered to as well ensure

quality service to community members.

https://www.who.int/health-topics/coronavirus#tab=tab_1


Need for more Full-time Health Facilities and workers in target communities:

This study has revealed that an estimated 2,826,379 persons across all the communities relies on 56 health facilities

for their health needs. These 56 facilities only have 647 beds spaces and 843 full time health workers. This already

puts pressure on the health system without considering the impact of COVID 19 which will further deplete the access

to and quality of health services available to communities as we have already seen globally, which is evidently

worse in poor countries like Nigeria. Following this it becomes necessary that this intervention upskill the capacity

of communities to engage with the state to provide more health facilities, scale up existing facilities and engage

more health workers to address any gap that might constitute a hindrance to health services for community

members.


Annex

Table 1: List and Location of target Facilities

SN Name of Facility Type of Facility Name of community

Name of LGA State

1 Maternal and Neonatal Child Health

Primary Health Facility

Afunori/kamcheji Dikwa Borno

2 Bakassi Clinic A Primary Health Facility

Abakarti Maiduguri Borno

3 Bulabulin dispensary Primary Health Facility

Biafra Maiduguri Borno

4 Gwange Primary Health Care center


Biafra Maiduguri Borno

5 Dikwa secondary Healthcare Secondary Health Facility

Kanumburi Dikwa Borno

6 Bulabulin lima ngarannam Bolori 2 PHC


Bolori 2 Maiduguri Borno

7 1000 Shelter Clinic Primary Health Facility

Mogulanda Dikwa Borno

8 Shehu Masta Camp Primary Health Facility

shuwari Dikwa Borno

9 SNEPCO IHAP + Primary Health Facility

Motor pack/Bulabulin Dikwa Borno

10 Intersos Primary Health Care Bulabulin


Bulabulin Dikwa Borno

11 Gongulong Comprehensive Health Center


Gongulong Jere Borno

12 Dalaram PHC Primary Health Facility

Filinball Jere Borno

13 Dalori Health Clinic Primary Health Facility

Dalori Konduga Borno

14 777 Housing Estate Clinic Primary Health Facility

Moronti Konduga Borno

15 Njimtilo Primary Health Care Center


Njimtilo Konduga Borno

16 1000 Estate Clinic Primary Health Facility

Moronti Konduga Borno

17 General Hospital Obagaji Secondary Health Facility

Obagaji Agatu Benue

18 Comprehensive Health Centre Obagaji


Obagaji Agatu Benue

19 Primary Health Centre Obagaji Primary Health Facility

Obagaji Agatu Benue

20 Primary Health Centre Odugbeho Primary Health Facility

Odugbeho Agatu Benue

21 Primary Health Centre Ogwule Ogbaulu


Ogwule Ogbaulu Agatu Benue

22 Primary Health Centre Usha Primary Health Facility

Usha Agatu Benue

23 Ggeneral Hospital Adikpo Secondary Health Facility

Adikpo Kwande Benue

24 Gabriel Suswam Cottage PHC Primary Health Facility

Adikpo Kwande Benue

25 Primary Health Centre, Ikyogen Primary Health Facility

Ikyogen Kwande Benue



Name of LGA State

26 Primary Health Centre, Jato Aka Primary Health Facility

Jato Aka Kwande Benue

27 Primary Health Centre, Koti Primary Health Facility

Koti Kwande Benue

28 Primary Health Centre, Mbachon Primary Health Facility

Mbachon Kwande Benue

29 Primary Health Centre township Adikpo


Adikpo town Kwande Benue

30 Primary Health Centre,Agenogo Primary Health Facility

Agenogo Kwande Benue

31 General Hospital Oju Secondary Health Facility

Oju Oju Benue

32 Primary Health Centre, Igede Centre Oju


Oju Oju Benue

33 Primary Health Centre, Amenka Primary Health Facility

Amenka Oju Benue

34 Primary Health Centre, Obusa Primary Health Facility

Obusa Oju Benue

35 Primary Health Centre, Oboru Primary Health Facility

Oboru Oju Benue

36 General Hospital Vandekya Secondary Health Facility

Vandekya Vandekya Benue

37 Maternal and child health clinic Vandekya



38 Primary Health care Centre, Vandekya town



39 Modern Primary Health Care, Tsar


Tsar Vandekya Benue

40 Primary Health Care Tsar Primary Health Facility

Tsar Vandekya Benue

41 Primary Health Care Ihugh Primary Health Facility

Ihugh Vandekya Benue

42 Primary Health Care Imoughun Primary Health Facility

Koti yough Vandekya Benue

43 Primary Health Facility Awon Primary Health Facility

Awon Kachia LGA Kaduna

44 Primary Health Facility Ankwa Primary Health Facility

Ankwa Kachia LGA Kaduna

45 Health Post Kwaturu Health Post Kwaturu Kachia LGA Kaduna

46 Health Post Galadanchi Health Post Galadanchi. Kachia LGA Kaduna

47 Primary Health Facility Damisa Primary Health Facility

Damisa, Makarfi Kaduna

48 Primary Health Facility Gazara Primary Health Facility

Gazara, Makarfi Kaduna

49 Primary Health Facility Gubuchi Primary Health Facility

Gubuchi Makarfi Kaduna

50 Primary Health Facility Tudun Wada


Tudun Wada. Makarfi Kaduna

51 Secondary Health Facility Tudun Wada

Secondary Health Facility

Tudun Wada Makarfi Kaduna

52 Primary Health Facility Kallah Primary Health Facility

Kallah Kajuru Kaduna

53 Primary Health Facility Katura Primary Health Facility

Katura Kajuru Kaduna



Name of LGA State

54 Primary Health Facility Rimau Primary Health Facility

Rimau Kajuru Kaduna

55 Primary Health Facility Idon Hanya


Idon Hanya Kajuru Kaduna

56 Primary Health Facility Manchok Primary Health Facility

Manchok Kaura Kaduna

57 Primary Health Facility Zakan Primary Health Facility

Zakan. Kaura Kaduna

58 Health Post Kukum daji Health Post Kukum daji Kaura Kaduna

59 Health Post Bondon Health Post Bondon Kaura Kaduna

Contact usChristian Aid Nigeria CountryOfficePlot 802, Off Ebitu Ukiwe StreetJabi DistrictAbuja, FCTNigeria

+234 (0) 703 255 [email protected]/ngeria

England and Wales registered charity number. 1105851 Scotland charity number. SC039150 UK company number. 5171525 Registeredwith The Charity Commission for Northern Ireland NIC101631 Company number NI059154 Republic of Ireland Charity Commissionnumber 20014162 Company number 426928. Christian Aid is registered with the National Planning Commission of NigeriaThe ChristianAid name and logo are trademarks of Christian Aid © Christian Aid August 2018

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