Evaluation of Community Health Intervention Packages Under the Ward Health System in Jigawa State, North West Nigeria

The Ward Health System is Nigeria's decentralised primary healthcare delivery architecture, and the community health intervention package it mandates is intended to bring essential health services to the community level. This study evaluates the implementation and outcomes of community health intervention packages under the Ward Health System in Jigawa State. A mixed-methods process evaluation design is applied, selecting 24 ward health system facilities from six local government areas through stratified random sampling. Facility records are reviewed for community health intervention package service delivery data including immunisation, growth monitoring, skilled birth attendance, and family planning coverage, while structured surveys are administered to 48 ward development committees and 120 community health workers. Six focused group discussions with community members assess service awareness, quality, and utilisation. Quantitative outcome data are compared against Jigawa State health targets using SPSS, and qualitative data undergo thematic analysis. Evidence from the National Primary Health Care Development Agency's 2023 Ward Minimum Health Care Package assessment reveals that fewer than 30 percent of Jigawa ward health system facilities are delivering the full complement of community health intervention package services, with financial flow irregularities and community health worker absenteeism as key bottlenecks. The Community Health Systems Framework guides the evaluation approach. Findings will support Jigawa State's Primary Health Care Management Committee in addressing implementation constraints. Keywords: community health intervention, Ward Health System, primary healthcare, Jigawa State, North West Nigeria.