|**State**|**Summary**|**Political support / interference**|**Status of interventions and fund**<br>**utilization**|**Range of solutions**|**Examples of problems fixed**|**Performance on the six**<br>**key indicators (2016)**|
|---|---|---|---|---|---|---|
|Enugu|Very<br>delayed<br>implementation and low<br>expenditure. Momentum<br>appears low in the team.<br>Little to no evidence of<br>thorough<br>problem<br>analysis or of ability to<br>link inputs compellingly<br>with<br>outcomes.<br>Somewhat unimaginative<br>solutions, few of which<br>have been implemented.<br>Major issues of data<br>completeness.<br>Overly<br>reliant on implementing<br>partners.|**Elements**<br>**of**<br>**interference.**<br>Stakeholders in Enugu tend to insist<br>that the political context is highly<br>supportive. But deeper questioning<br>reveals evidence of interference<br>that has affected performance. For<br>example, the SOML account for<br>Enugu was suspended for some<br>months due to an irregular transfer<br>of SOML funds (15 million naira)<br>into the state account that was<br>initiated by the Governor. It is also<br>apparent that additional layers of<br>approval have been added to the<br>standard approval process in Enugu<br>such that the commissioner and<br>Governor have more input in the<br>workplans than ordinarily required,<br>which leads to additional delays in<br>the process. It is unclear what the<br>drivers of these interferences are,<br>but it is clear that they have slowed<br>down<br>implementation<br>of<br>the<br>program substantially.<br>PHCUOR has not yet been fully<br>implemented, and there continue<br>to be issues with health worker<br>salary payments and performance<br>management.|**Expenditure has been majorly**<br>**delayed in Enugu and shows**<br>**little sign of improvement.**<br>Roughly 25% of funds utilized<br>thus far, 50% of which have gone<br>to<br>“crosscutting<br>expenses”.<br>Examples of funds utilization<br>include<br>laptops,<br>plumbing,<br>vehicles, data bundles, training<br>etc. This is partly due to an initial<br>account suspension that was the<br>result of funds being transferred<br>out of the SOML account on the<br>direction of the Governor in<br>contravention of program policy.<br>On re‐activation, they then faced<br>the<br>issue<br>of<br>the<br>existing<br>accountant retiring and the<br>replacement<br>not<br>yet<br>being<br>“activated” on remitta, meaning<br>that no transactions can take<br>place. This has been the case<br>since<br>the<br>previous<br>officer<br>departed suddenly in December<br>2017 (over seven months ago).<br>Standard interventions – like<br>QISS visits, which have been<br>running for many months in Kogi<br>and Anambra – are not yet<br>started<br>in<br>Enugu.<br>Staff<br>repeatedly<br>referred<br>to<br>the<br>actions<br>of<br>implementing<br>partners, rather than the state,<br>when<br>asked<br>about<br>what<br>interventions were taking place.|**Proposed solutions are fairly**<br>**run of the mill**– MNCH weeks,<br>re‐trainings and procurement of<br>drugs ‐ and do not seem to<br>demonstrate<br>significant<br>contextualization<br>or<br>deep<br>understanding<br>of<br>causes.<br>Members of the TWG seemed<br>fairly uninterested/ unpracticed<br>in discussing the drivers of<br>existing problems and were<br>eager to move directly to<br>solutions.<br>PMU<br>members<br>admitted that they are not clear<br>on what is required by a<br>“bottleneck analysis”.|**Implementation**<br>**has**<br>**not**<br>**advanced**<br>**sufficiently**<br>**to**<br>**confirm any problems yet**<br>**fixed.**<br>According to existing DHIS<br>data,<br>which<br>were<br>acknowledged<br>to<br>be<br>unreliable and incomplete,<br>most indicators appear to be<br>regressing as do reporting<br>rates. State officials explain<br>the regression as being the<br>result<br>of<br>implementing<br>partners existing.<br>Implementation that is taking<br>place<br>is<br>driven<br>by<br>implementing partners. For<br>example, improvements in<br>coverage of Penta 3, appear to<br>be driven completely by IPs.<br>The PMU has dedicated 0% of<br>funds to that area so far, and<br>yet it is the area where there is<br>best reporting and signs of<br>increased coverage.|**Regressed.**Enugu had a<br>sum total of ‐12.1%<br>reduction<br>from<br>its<br>baseline according to the<br>2016 MICS survey. We<br>are not privy to the<br>breakdown.|

32