A qualitative study of the scalability and sustainability of the Village Health Worker scheme in Gombe State, Nigeria: Findings from the consolidation phase

A second round of qualitative data collection, for an exploratory study to understand factors that contribute to or hinder the sustainability of the Village Health Worker (VHW) Scheme, took place in Gombe State in January and February 2018. We conducted in-depth interviews with 13 purposively selected interviewees from the Gombe State Primary Health Care Development Agency (the Agency), which leads the work. Changes being made to the VHW scheme, that are designed to increase its sustainability in the 57 wards where it is being implemented include: • Introduction of Tier Two VHWs, to improve coverage of VHWs in rural communities • Increased involvement of Ward Development Committees in decision-making, VHW selection and supervision • Improved incentives to motivate and retain VHWs • Investigation of alternative sources of funding, beyond the end of 2018 Areas of concern for the sustainability of the VHW scheme are: • Sustaining intensified monitoring and supervision amid transport and funding challenges • Concerns about political sustainability of the scheme after elections in early 2019