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Nigeria

IDEAS worked in Gombe State in north-east Nigeria and in Lagos State in the south-west.

In Gombe, we worked under the umbrella of the Gombe Maternal and Newborn Health Partnership, led by the Gombe State Primary Health Care Development Agency.  Using multidisciplinary research methods that provide a rich source of data, we worked with partners to try to continuously use data to improve health programmes while also conducting an evaluation of effects.

In Lagos, we collaborated with partners to understand how a quality improvement scheme that is implemented in public and private health facilities operates, and to generate lessons on whether and how health system context affects quality improvement.

Our findings contributed to the gap in implementation research on what works, why and how in getting life-saving interventions to families at scale.

Research areas in Nigeria are:

Tracking progress

A government-led partnership came together in Gombe State, northeast Nigeria, to improve outcomes for mothers and newborns.  Actions across multiple health system building blocks were coordinated and progress reviewed at regular intervals. Data was a key input to partner decision-making. Overall, there was improvement in indicators on access to care and on the quality of facility-based care, and government leadership was seen to be crucial, although the mechanism for sustaining progress remained uncertain.

 

Improving coverage measurement

Measuring effective coverage for maternal and newborn health

Our research aimed to improve the measurement of priority indicators for maternal and newborn health, including quality of care measures. A number of problems needed to be addressed: (i) generating greater clarity around what it was possible to measure, and how; (ii) understanding which data should be used to drive decisions; (iii) developing methods for linking household data on access to care with facility data on quality of care; and (iv) creating actionable effective coverage measures for facility-based childbirth care.

Improving measurement for respectful maternity care 

We aimed to study positive and negative facility childbirth experiences and to determine best practices for measuring respectful maternity care. In Gombe State, Nigeria, we did research to understand 1) mistreatment during facility childbirth, 2) the utility women placed on attributes of childbirth care experiences, 3) the validity of measures of childbirth care experiences derived from exit interviews, 4) the validity and acceptability of capturing childbirth care experiences though telephone interviews, 5) the feasibility and acceptability of primary healthcare provider-led phone follow-up with mothers shortly after childbirth.

Fostering innovation sustainability

We studied how to scale-up and sustain maternal and newborn health innovations in Ethiopia, northeast Nigeria and Uttar Pradesh in India. We defined ‘scale-up’ as the adoption of donor-funded health innovations beyond original programme districts, and ‘sustainability’ as the longer-term implementation of donor-funded innovations that have been scaled-up.

 

Understanding Quality improvement 

Quality improvement collaboratives are increasingly popular in low- and middle-income settings, often being implemented on a large scale. However, relatively little is known about the influence of context on implementation; consequently, new implementers may not benefit from the knowledge of what worked, what was adapted, and why. Working with partners in Lagos State, Nigeria, we studied the implementation of a complex quality improvement initiative that was driven by government and supported by a non-governmental organisation. Evidence revealed considerable influence of internal and external contextual factors, necessitating adaptations throughout implementation.

Published content

Report
IDEAS Phase 2 Final Report 2022

In 2016, the IDEAS project entered a second phase of work, building on lessons learned from phase one. Five key research themes were...


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Ethiopia
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General
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India
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Nigeria
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Fostering innovation sustainability
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Improving measurement
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Supporting local decision-making
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Tracking progress
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Understanding quality improvement
Journal article
Measuring women’s experience of childbirth care

Valid methods for assessing women’s experiences of maternity care are essential to the global efforts toward providing positive childbirth...


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Nigeria
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Improving measurement
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Understanding quality improvement
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Evaluation methods
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Evidence for policy and practice
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Research findings
Journal article
Operationalising effective coverage measurement

Estimating effective coverage of childbirth care requires linking population based data sources to health facility data. For effective coverage to...


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Nigeria
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Improving measurement
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Evidence for policy and practice
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Intervention coverage
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Research findings
Past event
Health Systems Research 2022

This year’s HSR conference has the theme of Health Systems Performance in the Political Agenda: Sharing Lessons on Current and Future Global...


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Ethiopia
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General
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Nigeria
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Improving measurement
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Understanding quality improvement
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Research findings
Past event
IDEAS webinar series: Part 4 Operationalising effective coverage of childbirth care in Gombe State, Northeast Nigeria

To ensure greater accountability for high quality care, effective coverage measures are now recommended so that measures of access to care are...


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Nigeria
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Improving measurement
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Evidence for policy and practice
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Intervention coverage
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Research findings
Past event
IDEAS webinar series: Part 3 Women’s experience of facility-based childbirth care in Nigeria

The WHO guidelines on positive pregnancy, childbirth and postnatal care all emphasise the need to eliminate mistreatment and to promote respectful...


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Nigeria
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Improving measurement
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Understanding quality improvement
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Evidence for policy and practice
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Research findings
News
IDEAS webinar series 2022

IDEAS webinar series in collaboration with the MARCH Centre and Centre for Evaluation IDEAS Phase 2 has focussed on understanding what works,...


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Ethiopia
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General
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Nigeria
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Improving measurement
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Supporting local decision-making
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Understanding quality improvement
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Behaviour change
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Context
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Evaluation methods
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Evidence for policy and practice
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Implementation strength
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Local data use
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Research findings
Journal article
How context influences quality improvement initiatives

This study, published in BMJ Open Quality, aims to understand the influence of context on the choice of change concepts implemented by public...


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Nigeria
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Understanding quality improvement
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Behaviour change
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Capacity strengthening
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Context
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Evidence for policy and practice
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Research findings
Journal article
To call or not to call: comparing results from face-to-face surveys and mobile phone interviews

This IDEAS-led study, published in BMJ Global Health, analysed the validity of data generated through telephone interviews, when compared to data...


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Nigeria
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Improving measurement
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Evidence for policy and practice
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Intervention coverage
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Research findings