Gombe State is a predominately rural state in northeast Nigeria where the burden of maternal and neonatal mortality is higher than the national average, at 1,549 maternal deaths per 100 000 live births in 2015 and 33 neonatal deaths per 1000 live births in 2017. In 2016, when this study started, 29% of women gave birth in a health facility, principally at primary health centres that were managed by the Gombe State Primary Health Care Development Agency.
The Gombe Partnership for Maternal and Newborn Health was a government-led intervention implemented between 2016 and 2019. It aimed to coordinate the actions of multiple partners from non-government organisations and academia toward the goal of equitably improving high quality maternal and newborn health services. It applied an adaptive management approach with partners meeting regularly to track progress, examine monitoring data, and amend implementation as necessary.
The IDEAS project worked with partners to agree a results framework for tracking progress, to generate new data on quality of care, strengthen routine data sources, and to evaluate progress. Data Driven Learning Workshops were convened every six months to guide the adaptive management process whereby all partners came together, reviewed evidence that had been packaged in accessible formats, looked back on progress that had been made in the recent past and then looked forward to plug implementation gaps.
After four years, this government-led partnership achieved improvements in life-saving interventions for mothers and newborns, demonstrating that even in settings where resources are constrained, the needle can be shifted in the right direction. In this example, multiple interventions that spanned different health system pillars were implemented together as a package, and we found that addressing demand and supply-side problems simultaneously was important. But we conclude that essential and reproducible elements of this programme lay not for the most part in the individual components of the intervention, but in the way the programme was designed and implemented through adaptive management, with its focus on government leadership and strong stakeholder partnership
All Tracking Progress related outputs can be found under Resources by selecting that theme from Research Areas.