This IDEAS report studies the interactions between families and frontline workers and coverage of critical interventions for mothers and newborns was conducted between June 2012 and June 2015 in Gombe State, Nigeria.

IDEAS focuses on the changes in indicators that were expected to improve as a result of the specific implementation activities.

The aim was to estimate changes in maternal and newborn health care in areas where Bill & Melinda Gates Foundation implementation projects were operating. In this region, the project was implemented by the Society for Family Health.

This is one of three country-specific reports, along with Ethiopia and Uttar Preadesh, India.

It follows from the 2013 Baseline findings from Gombe State, Nigeria.

The survey results suggest that while coverage of routine care across the continuum did not increase, more women who needed emergency care at the time of birth were able to access it. Important improvements in the coverage of some newborn interventions were observed, especially those that relied on the behaviours of caregivers such as delayed bathing, although none became universal.

The unfinished agenda for change in Gombe State needs the continued promotion of maternal and newborn health issues amongst communities, mechanisms to improve the care provided to mother and baby immediately after birth, enhancing the supply of quality care in facilities, and an urgent agenda to address the considerable and persistent inequity in the state.

Key messages

– Some targeted indicators of intervention coverage improved between the surveys, but access to routine care did not change

– There was no evidence of change in the frequency of routine interactions across the continuum of care from pregnancy to early newborn period

– The content of routine antenatal care, defined by seven core components of focussed antenatal care, did improve

– There was no evidence that the quality of delivery or postnatal care improved. Importantly, large inequities in access persisted, with women in the poorest households having the least health care at each point

– Positively, the innovations were also targeting access to emergency care and there was evidence that this had improved for emergency events around the time of birth