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A government-led maternal and newborn health partnership in a rural Nigerian setting improves life-saving care for mothers and newborns.

This paper, recently published in BMJ Open, sets out to quantify changes in the coverage, quality and equity of essential care for mothers and newborns in Gombe state, Northeast Nigeria. The Gombe Partnership for Maternal and Newborn Health was implemented between 2016 and 2019. The partnership between multiple non-governmental actors was coordinated and led by the Gombe State Primary Health Care Development Agency. It included interventions aiming to increase demand for routine professional care; improve trust and accountability between families and the health system; and improve supply of safe, effective and high quality care.

The evaluation undertook four annual household surveys, and carried out seven facility and birth attendant surveys at six-monthly intervals. The team then estimated changes over time in 18 maternal and newborn health indicators, and compared these between intervention and comparison areas.

Results show that 16 of 18 indicators improved over time in all areas and 8 indicators saw greater improvement in the intervention area. However, the coverage of post-partum and post-natal checks for mothers and newborns continued to be low.

Indicators assessed for equity were initially inequitable with lower coverage among the poorest households. By 2019, although improvements had been seen within all household wealth quintiles, patterns of inequity largely persisted. Only for the indicator of one ANC visit, did a pro-poor change occur.

This study is a clear indication that where there is government leadership and strong coordination among implementers, important improvements in MNH can be achieved, even in resource-constrained settings.

Authors

Profile picture of Dr Barbara Willey
Dr Barbara Willey

Assistant Professor in Epidemiology

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Dr Nasir Umar

IDEAS Nigeria Country Coordinator and Research Fellow

Profile picture of Emma Beaumont
Emma Beaumont

Research Fellow in Medical Statistics

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Professor Elizabeth Allen

Professor in Medical Statistics

Jennifer Anyanti

Society for Family Health

Abubakar Bala Bello

Pact, Abuja, Nigeria

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Josephine Exley

Research Fellow

Magdalene Okolo

Society for Family Health (former)

Profile picture of Professor Joanna Schellenberg
Professor Joanna Schellenberg

IDEAS Co-Principal Investigator and Professor

Profile picture of Dr Neil Spicer
Dr Neil Spicer

Associate Professor

Umar Adamu Usman

Data Research and Mapping Consult Limited, Abuja, Nigeria

Dr Ahmed Gana

Office of the Honourable Commissioner for Health (and former Executive Secretary GSPCDA), Gombe State Ministry, Gombe, Nigeria

Dr Abdulrahman Shuaibu

Executive Secretary Gombe State Primary Health Care Development Agency

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Professor Tanya Marchant

IDEAS Principal Investigator and Professor