[{"bbox": [134, 152, 1165, 234], "category": "List-item", "text": "g) **Supply is not enough when demand for health services is suppressed:** An important barrier to the utilization of health services is the lack of, or low demand for such services, where adverse social norms often supress their uptake."}, {"bbox": [95, 257, 1165, 630], "category": "Text", "text": "III. **Data issues:** Finally, the digital transition and shift towards evidence-based decision-making exposed the weak health information systems for tracking progress and created new human resource and technology needs at national and sub-national as well as institutional and facility levels. Adaptive learning underpinned by system thinking and driven by horizontal and vertical coordination and implementation mechanisms have been sparsely seen in the SRHR space. While progress has been made in institutionalizing the RMNCAH+N¹³ scorecards and other initiatives at federal and state level, with 36 states now developing quarterly analysis and using them to plan and manage health programmes, the systematic utilisation of evidence for decision making and resource allocation is still poor. Gaps in the quality of routine data, disconnect between researchers and decision-makers, poor funding of research, and the lack of appreciation of the need for empirical evidence for health planning, implementation and evaluation were identified as factors frustrating the optimal performance of the health care system. Sustaining, good fiscal governance and inclusive access to finance require accountability and dialogue based on credible and transparent data/evidence, which is not readily available. Putting this in place requires coordination that brings oversight institutions and other agencies together, including data interoperability and supporting the collection and harmonization of data using non-health sector community instruments."}, {"bbox": [95, 643, 1165, 697], "category": "Text", "text": "Identification of main stakeholders and corresponding institutional and/or organisational issues (mandates, potential roles, and capacities) to be covered by the action:"}, {"bbox": [134, 708, 1165, 1185], "category": "List-item", "text": "- **National (Federal) authorities**, specifically public administration in the key ministries involved in cooperation with the EU. On the basis of the MIP priority areas, various ministries and national institutions should be involved in both design phase and implementation of intervention. These include, in particular: **Ministry of Health**, **National Primary Health Care Development Agency** (NPHCDA) with mandate for PHC implementation oversight, **National Health Insurance Authority (NHIA)**, and others with oversight on social determinants of health, including FMWASD (Federal Ministry of Women Affairs and Social Development), FMYSD (Federal Ministry of Youths and Sports Development), Ministry of Education, NIPRD (National Institute for Pharmaceutical Research and Development), **National Population Commission (NPopC)** with responsibility for coordinating the implementation of the National Population Policy and the Demographic Dividend agenda, **Ministry of Finance**, **Budget and National Planning** (for planning, budgeting/finance relevant to foster multisector leadership and coordination on the demographic dividend agenda in Nigeria) as well as the Nigeria Governors Forum (for high level oversight and accountability at the level of Executive Governors). Also important are the Nigeria Centre for Disease Control (NCDC) for disease control, NACA (National Agency for the Control of AIDS), **NAFDAC**, **National Agency for Food and Drug Administration** (drug, SRHR commodity quality assurance and regulation), **National Assembly** that have legislation, appropriation, accountability, and oversight function on health. At the same time, the intervention will involve entities supporting persons with disabilities, such as the National Commission for Persons with disabilities (NCPD)."}, {"bbox": [134, 1186, 1165, 1478], "category": "List-item", "text": "- **State (and local) authorities** stakeholders are particularly crucial as the Action aims to also strengthen system capacity at four levels – State, LGA (Local Government Area), PHC/service provider and community and improve knowledge and accountability for health and nutrition results. Such stakeholders include **State Ministries of Health, Women, Youth, Budget and Planning**, State Primary Health Care Development Agencies/Boards, State Health Insurance Agencies (responsible for coverage of the population on essential health services towards financial risk protection), State House of Assembly (for legislation, appropriation, accountability, and oversight function on health as well as LGA (Local Government Area) **Primary health Care Coordinators**, who are the health managers at the local government level. Key ministries such as the Local Government Service Commission can be engaged to leverage on their coordination of these institutions for sustainability. Governmental and private institutions and organisations who provide social and health services for clients with disabilities are also important partners."}, {"bbox": [134, 1478, 1165, 1532], "category": "List-item", "text": "- **Media and Civil Society actors.** CSOs (including those working on disabilities and with gender transformative approaches to combat harmful practices and change social norms) and local NGOs with health"}, {"bbox": [85, 1557, 1143, 1626], "category": "Footnote", "text": "¹³ RMNCAH+N Scorecard is an integrated, action-oriented management and accountability tool that supports the Ministry of Health Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition Investment Framework, Health Sector Strategic Plan, and the Government’s commitment to Universal Health Care."}, {"bbox": [1038, 1681, 1144, 1705], "category": "Page-footer", "text": "Page 7 of 26"}]