Baseline Assessment to determine Access, Availability and Distribution of Medical Abortion commodities (MA combi-pack) in Healthcare Facilities in Ogun, Benue, and Jigawa States

Introduction/Background:

One of Nigeria’s critical health priorities is reducing unsafe abortions, which has led to the development of the Guidelines for Safe Termination of Pregnancy (SToP) for therapeutic abortions. However, these guidelines predominantly support surgical methods, which demand stringent infection prevention measures due to their invasive nature. Medical abortion, using a combination of mifepristone and misoprostol (combi-pack), provides a less invasive alternative that can be administered at the primary healthcare level. Expanding access to medical abortion for therapeutic reasons would reduce the financial burden on the health system, especially concerning infection control in surgical procedures. It would also extend access to safe abortion services to more women at the community level.

Given this context, Ipas Nigeria Health Foundation is implementing the Strengthening Access, Availability, and Distribution of MA Combi-pack Products in Nigeria project which aims to catalyze state-level initiatives that enhance access to therapeutic abortion services in public facilities, ultimately reducing unsafe abortions.

Objectives

The objectives of this baseline assessment are to:

1. To Identify and assess current practices in the procurement, storage, and distribution of MA combi-pack medication in select facilities across Benue, Ogun and Jigawa States
2. To assess government budget allocation and other funding mechanisms for the purchase of MA commodities within intervention states.
3. To Measure the availability and stock levels of MA drugs in government healthcare facilities (primary, secondary and tertiary), focusing on potential gaps in access.
4. To Highlight existing barriers to inform intervention strategies to improve the supply chain, procurement practices and availability of MA combi-pack products across intervention states.

 Methodology

A consultant will lead an assessment of the availability, access, and distribution of MA combi-pack medications across tertiary secondary and Primary health facilities in Jigawa, Ogun, and Benue states. The consultant will analyze the assessment data and develop a report with findings and recommendations to improve current systems. Using a mixed-method approach—including both quantitative and qualitative data collection, analysis, and interpretation—the assessment will also seek to compare any differences in the supply chain and availability of MA commodities across these states. Note that the sampling should include at least 1 tertiary facility per state.

 

States	No of facilities	Facility type & Coverage
Ogun	12	1 Tertiary, 1 Secondary per senatorial district
Benue	12	1 Tertiary, 1 Secondary per senatorial district
Jigawa	12	1 Tertiary, 1 Secondary per senatorial district
Total	36

Period of Performance:  December 2024 – January 2025

Place of Performance: Benue, Jigawa and Ogun States

Scope of Work

• Review relevant literature, policies, and reports on MA commodities supply chain and procurement practices in Nigeria, focusing on Ogun, Benue, and Jigawa States.
• Highlight guidelines existing World Health Organization (W.H.O) prequalified manufacturers and distributors of MA commodities in Nigeria
• Highlight current national and W.H.O guidelines for MA commodities procurement.
• Conduct interviews with key stakeholders, including healthcare providers, facility pharmacists, procurement officers, facility managers and relevant government representatives including the state drug management agency, to understand current MA practices and challenges. The interview will seek to address the following questions:
  • What are the gaps and issues affecting the MA supply chain across different level of facilities in these states?
  • What are the sources of MA commodities found in facilities providing services?
  • Are there structures existing in the states that can be strengthened to improve MAavailability?
  • What are the current facility case load and MA commodities quantification practices?
  • What are the funding sources for MA commodities procurement and existing gaps?
• Data Collection of existing MA commodities
  • Develop a data collection tools to gather quantitative and qualitative data
  • Conduct facility assessments in a representative sample of healthcare facilities (Tertiary, Secondary and primary) across the three states.
  • Review facility register and procurement logbooks to document MA commodities usage
  • Review log-book of state drug management agency
• Analyze collected data to assess current practices, identify challenges, and compare findings across the intervention states.
• Present key findings and state specific recommendations for the various stakeholders to improve MA combi-pack access, availability and distribution.
  1. Along the final assessment report, develop power point presentation that summarizes the assessment findings
  2. Attend report dissemination meetings with key stakeholders in the 3 interventions states

Deliverables/Milestones

S/N	Deliverables/Milestone	No. of Days
1	Submit draft workplan, tools and budget for state level assessment	2
3	Facility and state level assessment of MA commodities (MA combi-pack) availability completed	14
4	Draft progress report of summary findings, documented learnings, and recommendations	5
5	Final report with recommended action plan	2
	TOTAL	23 days

Submission Requirements

Ipas Nigeria Health Foundation requests proposals from qualified individuals with experience in strengthening MA supply chain systems.

The submission should include:

1. A 2-page narrative of the proposed approach/methodology showing an understanding of the Scope of work and deliverables.
2. Proposed consultancy rate/fee/budget as applicable
3. A CV and suitability statement