BMJ Global Health: Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Nigeria

8 November, 2018

We share below the publication on the PACK Nigeria programme (Adult) pilot that took place in 51 primary health care facilities in three states in Nigeria in 2017: READ ON

'Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Nigeria

Ajibola Awotiwon1, Charlie Sword2, Tracy Eastman1,2, Christy Joy Ras1, Prince Ana3, Ruth Vania Cornick1, Lara Fairall1, Eric Bateman1, Audry Dube1, Robyn Curran1, Inemesit Udoekwere3, Unyime-Obong Essien3, Okorie Assem3, Theresa Sylvester Edu3,Hajia Binta Ismail4, Olalekan Olugbenga Olubajo4, Joseph Ana3

1. Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa

2. BMJ Global Health, BMJ, London, UK

3. Health Resources International West Africa, Calabar, Nigeria

4. National Primary Health Care Agency (NPHCDA), Abuja, Federal Capital Territory, Nigeria

BMJ GLOBAL HEALTH Volume 3, Issue Suppl 5

BMJ Global Health Oct 2018, 3 (Suppl 5) e001079; DOI: 10.1136/bmjgh-2018-001079

Correspondence to: Dr Ajibola Awotiwon; ajibola.awotiwon{at}


Nigeria, in its quest to strengthen its primary healthcare system, is faced with a number of challenges including a shortage of clinicians and skills. Methods are being sought to better equip primary healthcare clinicians for the clinical demands that they face. Using a mentorship model between developers in South Africa and Nigerian clinicians, the Practical Approach to Care Kit (PACK) for adult patients, a health systems strengthening programme, has been localised and piloted in 51 primary healthcare facilities in three Nigerian states. Lessons learnt from this experience include the value of this remote model of localisation for rapid localisation, the importance of early, continuous stakeholder engagement, the need expressed by Nigeria’s primary healthcare clinicians for clinical guidance that is user friendly and up-to-date, a preference for the tablet version of the PACK Adult guide over hard copies and the added value of WhatsApp groups to complement the programme of face-to-face continuous learning. Introduction of the PACK programme in Nigeria prompted uptake of evidence-informed recommendations within primary healthcare services.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Joseph Ana.


@Health Resources International (HRI) WA.

National Implementing Organisation: 12-Pillar Clinical Governance

National Implementing Organisation: PACK Nigeria Programme for PHC

Publisher: Medical and Health Journals; Books and Periodicals.

Nigeria: 8 Amaku Street, State Housing & 20 Eta Agbor Road, Calabar.

Tel: +234 (0) 8063600642

Website: email: ;

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group:

jneana AT