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projects being executed <strong>to</strong> empower women do<br />
not attempt <strong>to</strong> integrate women in<strong>to</strong> formal wage<br />
employment outside the agricultural sec<strong>to</strong>r.<br />
Formation <strong>of</strong> political parties, cultural practices<br />
and high cost <strong>of</strong> election (women can‘t access loan<br />
from financial institutions until their husbands<br />
guarantee) poses a barrier <strong>to</strong>wards the<br />
achievement <strong>of</strong> Goal 3. Also, no projects were<br />
designed <strong>to</strong>wards achieving an increase in the<br />
proportion <strong>of</strong> women in national and state<br />
parliaments.<br />
Most <strong>of</strong> the agencies/programmes under the<br />
FMOH complain that after the DRGs funding had<br />
been secured using a given work plan, the DRG<br />
money was spent without recourse <strong>to</strong> the work<br />
plan, or <strong>to</strong> the department/programme that drew<br />
up the work plan. In rural areas, this situation<br />
further conflated with unavailability <strong>of</strong> skilled<br />
staff required <strong>to</strong> run the large number <strong>of</strong> PHCs<br />
that are under construction for two reasons.<br />
Firstly, there is a shortage <strong>of</strong> skilled health<br />
workers. Secondly most skilled health workers<br />
prefer <strong>to</strong> live in urban areas. That was why there is<br />
a serious mal-distribution <strong>of</strong> skilled health workers<br />
in <strong>Nigeria</strong>. In addition, these staffs need <strong>to</strong> have<br />
their skills updated regularly.<br />
Absence <strong>of</strong> facility management /maintenance<br />
components built in<strong>to</strong> many projects also meant<br />
that they are in danger <strong>of</strong> falling apart, a few<br />
months after completion. A remedy <strong>to</strong> this is <strong>to</strong><br />
make sure that the community feels that they own<br />
the project, as they are the direct beneficiaries, and<br />
that it is in their own interest <strong>to</strong> make sure that the<br />
facilities are maintained. There is also the need <strong>to</strong><br />
make sure that all partners adhere <strong>to</strong> their<br />
commitments in the MOUs they signed for both<br />
the NHIS MCH scheme and the MSS.<br />
On the M&E side, the biggest challenge has<br />
always been lack <strong>of</strong> appropriate and timely<br />
information from the MDAs. The M&E teams still<br />
experience difficulty in locating some <strong>of</strong> the<br />
projects as no GPS locations were given in most<br />
instances. In Ekiti State, for example, some <strong>of</strong> the<br />
benefitting communities could not assist in<br />
locating the projects because <strong>of</strong> low community<br />
awareness. In a specific instance, as a result <strong>of</strong><br />
lack <strong>of</strong> appropriate information, NMET was<br />
unable <strong>to</strong> assess the implementation <strong>of</strong><br />
programmes under Family Health Division, Health<br />
System Strengthening and HIV-AIDS Division<br />
(NASCP).<br />
OSSAP-MDGs, which is responsible for the<br />
coordination <strong>of</strong> MDGs-DRGs programmes and<br />
projects, has carried out its mandate effectively<br />
due largely <strong>to</strong> all programmes and projects housed<br />
in a single administrative structure. This has<br />
afforded ease <strong>of</strong> coordination at the national level,<br />
but difficult <strong>to</strong> rhyme with the CGS mono<br />
structure in most states. The result is <strong>of</strong>ten the<br />
absence <strong>of</strong> synergy between all stakeholders at the<br />
state levels thereby leading <strong>to</strong> acrimony or<br />
duplication <strong>of</strong> resources <strong>to</strong>wards the same aims<br />
and objectives. This also poses a lot <strong>of</strong> hindrances<br />
in the execution <strong>of</strong> M&E exercise; there is near<br />
<strong>to</strong>tal dearth <strong>of</strong> information on locations and scope<br />
<strong>of</strong> projects executed by federal MDAs <strong>to</strong> state or<br />
LGAs authorities.<br />
The OPEN M&E system was introduced by<br />
OSSAP-MDGs <strong>to</strong> shift the emphasis from simply<br />
moni<strong>to</strong>ring DRG ―spend‖ <strong>to</strong> providing more<br />
detailed information on the extent <strong>to</strong> which the<br />
―spend‖ actually reflects the realities on the<br />
ground, i.e., the extent <strong>to</strong> which debt relief gains<br />
have been spent on projects aimed at achieving the<br />
MDGs and reducing poverty, the quantity and<br />
quality <strong>of</strong> services and goods provided or created,<br />
and whether the projects are leading <strong>to</strong> the desired<br />
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