Gombe State Data-Driven Learning Workshops

In January 2016, the Gombe State Primary Health Care Development Agency (the Agency), four national NGOs working to improve maternal and newborn health in the State and a team from IDEAS met in Abuja at the first Gombe State Data-Driven Learning Workshop. Since then, this partnership has come together at subsequent workshops every six months to consider how best to collaborate to enhance maternal and newborn health in the State. In May 2019, the final data-driven learning workshop will take place.

The national NGOs in this partnership are the Society for Family Health, the SAQIP project of PACT Nigeria, the MamaYe project of Evidence for Action and Champions for Change. The NGO projects and IDEAS are funded by the Bill & Melinda Gates Foundation.

NGO projects have different roles but overlap in their support of the Agency.

• SAQIP focuses on 57 of the 114 wards in the state. It supports one fully functioning Primary Health Centre in each ward as well as community organisations such as Mothers’ Groups and Ward Development Committees.
• The Society for Family Health focuses on the same 57 of the 114 wards in the state. It supports the Village Health Worker Scheme, Ward Development Committees and also helps develop systems for the supply of drugs and equipment in the priority facilities.
• MamaYe focuses on evidence- based advocacy and priority-setting
• Champions for Change facilitated State approval of the national task-shifting policy so Community Health Extension Workers would be classified as skilled birth attendants.

The data-driven learning cycle

The work of the partnership can be conceptualised as a data-driven learning cycle, as shown in the figure below, an approach to enhancing evidence-based programmatic and strategic decision-making. The cycle revolves around 6-monthly production of a Results Framework, a table comprising about 100 indicators which tracks progress using data generated through annual household surveys and six-monthly facility surveys, observations, facility data extraction and NGO monitoring and special studies. The partnership examines the data at the workshops and based on this evidence, considers how best to collaborate to enhance the health of women and children in the State.

• Data that drives the cycle is collected during the observe or measure phase. It is used to populate the results framework.
• At the workshop, we reflect on progress described by the data and build on this to undertake evidence-based planning for the next six-month period.
• The Agency and NGO partners act to implement those plans.
• All partners prepare for the next round of observation and measurement.

The intersection and inter-dependence of these NGOs is captured in the Gombe State Pathway to Enhanced Maternal and Newborn Health, which can be seen below. This diagram was developed collaboratively with all partners and is updated annually to reflect current implementation.

The green arrows represent the pathway towards improved maternal and newborn health outcomes. The white boxes represent the opportunities for change and the innovations implemented by NGOs are colour-coded as described in the key.

How do we run the Data-Driven Learning Workshops?

All partners – the Agency, NGOs and IDEAS – agreed that we had come together to collaborate and explore how we can best work together to enhance the health of women and newborns in the State. Our discussions would focus on this aim, they would be non-judgmental and exploratory as we work towards our common purpose.

There are three steps in a workshop

• Partners report on action points agreed at the previous workshop. This maintains the learning cycle by reflecting on successes and challenges of implementation.
• NGO partners present results framework data and we discuss progress based on collective data sources. Our discussions focus on lessons learned from successes and challenges in implementation.
• Partners build on these lessons and on the evidence presented in the results framework to plan for the next phase of implementation.

At the last workshop in December 2018, we were able to track change over time by examining data from three annual household surveys and six biannual facility-based surveys. For most indicators, the substantial efforts of the Agency and of the implementation partners in the priority wards and facilities seem to be paying dividends across facility readiness for life-saving interventions, uptake of services, quality of care and knowledge and attitudes of service users. Where progress was slow, such as knowledge of postnatal danger signs or hand-washing by delivery attendants in facilities, the workshops offered an opportunity to examine the problem and consider options for improvement in a constructive and collaborative environment.

Where we are now

We are now in the seventh data-driven learning cycle and approaching the end of this three-year project. The next workshop in Abuja in May 2019 will be the final one.

Discussions have shifted from how the projects can implement most effectively to how they can best collaborate with one another and with the Agency to maintain achievements in the focus wards and facilities and at the same time support the Agency to scale up good practice to the rest of Gombe State.

We have conducted a study on the effect of the data-driven learning workshops on use of data for decision-making among participants. In the second blog we look more closely at the ethos of the workshops, how they were run and some of the changes that have happened as a result.