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“To know what is happening to women and newborns you need to collect accurate information” Preparing for a health facility survey in Nigeria

published 7 March 2018

Is maternal and newborn health in Gombe State, Nigeria, improving and how can we know? Working with the Gombe State Primary Health Care Development Agency (GSPHCDA), the IDEAS project focuses on measurement, learning and evaluation of interventions which aim to bring about better access to quality care for pregnant women, mothers, babies and children.

One way to measure whether the partner projects that IDEAS works with are making a difference is by continuously checking in with the people and health facilities being supported. To this end IDEAS works with a measurement, learning and evaluation partner Data Research and Mapping Consult Ltd (DRMC), to carry out six-monthly health facility surveys and annual household surveys in Gombe State, north-east Nigeria. The next facility survey is taking place during March 2018 and includes multiple components: (i) checking the infrastructure, commodities, supplies, routine record books and staffing of health facilities providing routine maternal and newborn care in the state, (ii) assessing the competence and experience of birth attendants, (iii) observing births in primary health facilities for an in-depth analysis of the quality of care provided, (iv) exit interviews with women who gave birth in health facilities to understand their experience of care, and (v) a community follow up of women whose births were observed during an earlier survey to ask them about events during childbirth and validate their responses against the original observation data.  From the 24th of February to the 2nd of March 2018 a team of enumerators were trained and briefed on the methodology and purpose of the survey, under the leadership of the GSPHCDA and by IDEAS partners including DRMC, Pact and the Society for Family Health (SFH).

The Director Research, Planning and Statistics of the Gombe State Primary Health Care Development Agency during the opening remarks

At the outset of the training the GSPHCD’s Director of Planning Research and Statistics highlighted the importance of high quality data to identify gaps in the health system and enable government to plan appropriate actions. Implementing partners from SFH and Pact supported practical sessions that helped trainees understand the purpose of the interventions in Gombe and enhanced their ability to confidently apply the survey protocols.

Dr Bala from Pact demonstrating during the practical sessions on newborn resuscitation

The intensive one-week training focused on survey methods and protocols in addition to addressing the challenge of agreeing on the correct translation of questions in Hausa.  Through these interactions the sessions also opened participants’ eyes to some of the gaps still existing in the health care system and the potentially life threatening situations many women face. One female trainee mentioned: “The more I participate the more I learn about women (…). I am very surprised of how women are affected by pregnancy and labour (..).” Speaking to trainees revealed some of the unintended effects of carrying out the survey.  One young female participant said “Once a father saw me [doing fieldwork] and how I was a young girl he was very impressed (..) he told me he is now seriously thinking about letting (his daughters) go to school and promised to allow his wives to start going to (the health) facility, because it is a good thing.” All participants agreed that the survey was needed. “The data from the survey can improve the health system” said one and another added “the survey is used to evaluate the performance of programs.”. Asked about ensuring the quality of data, one trainee said: “I will make sure those being asked understand the question so we will get accurate information.” Moreover, making sure to adhere to the survey manual was mentioned as an important step to ensure accuracy and consistency.

Participants at the workshop gained a number of practical insights additionally to an in-depth understanding of survey methodologies and the importance of quality data

The results of this facility survey will be analysed by IDEAS and fed into a results framework which the GSPHCDA and partners in Gombe State will review during the next bi-annual Data Driven Learning Workshop.  Using data to prospectively inform programme decision makings enables all actors in the state to better understand what works, how and why to save maternal and newborn lives.