In Gombe, we work 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 work with partners to try to continuously use data to improve health programmes while also conducting an evaluation of effects.
In Lagos, we collaborate 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 contribute to the gap in implementation research on what works, why and how in getting life-saving interventions to families at scale. Findings are continuously shared within the countries that IDEAS works and with groups around the world to contribute to best-practice in the measurement of quality, life saving health care for mothers and newborns.
Research areas in Nigeria are:
Focus on a core set of priority interventions is key to tracking progress in maternal and newborn health. Working with the MNH Partnership in Gombe State, IDEAS uses survey and routine data sources to track progress at six-monthly intervals, making sure that data is available and accessible to inform decision making in the State.
Together with the Gombe State Primary Health Care Development Agency, IDEAS has co-hosted six-monthly ‘Data-driven Learning Workshops’ since 2016. These workshops represent a learning tool to help strengthen data-informed programme decision making.
Partners come together for collective sharing and review of progress in the previous six months, reflecting on targets and the inter-dependency of demand and supply side efforts. Following this reflection, the group makes decisions about what new actions are needed to drive further change. IDEAS provides technical support in the interpretation and use of data, including focussed actions that aim to support improvement in the quality of routine data sources.
Measurement for maternal and newborn health faces many challenges, especially for care that is delivered around the time of birth. Women may not be able to accurately report on the clinical care that they receive, and the measurement of the quality of care provided (including respectful care) lacks standardised methods. IDEAS aims to improve the measurement of priority indicators for maternal and newborn health through two work streams. Using data from observation of births in health facilities as gold-standard we test the validity of maternal reports on care provided, and evaluate the reliability of different data sources to provide comparable estimates. In addition, we conduct research on methods for linking household and facility data to produce actionable measures of effective coverage for maternal and newborn care.
IDEAS carries out qualitative studies to assess what happens to donor-funded maternal and newborn health innovations that are scaled-up in the longer term and how the foundation and other donors can take steps to foster sustainability. One such innovation is the Village Health Worker scheme. This scheme introduces a new cadre of community-based health workers who provide information and support to families, to improve health care behaviours in the home and increase uptake of appropriate and timely health care services when required.
The study focusing on sustainability and scalability of the scheme has generated important knowledge on sustaining health programmes in low-income settings. The study enabled implementing partners to introduced real time improvements to the scheme. Overall, it builds on previous IDEAS’ studies of scale-up and the work of other academics, and responding to the Bill & Melinda Gates Foundation interest in scale-up both geographically and with a longer-term legacy.
Lagos State accounts for a significant proportion of the national burden of maternal and neonatal mortality because of its large population. To this end, Lagos State Ministry of Health and its agencies have been leading Quality Improvement (QI) initiatives in health facilities within the state.
While QI health interventions are increasingly being implemented in diverse contexts there is limited evidence about how generic QI health interventions can be adapted to suit different contexts. The Lagos QI Collaborative that delivers QI in three distinct facility environments, Primary Healthcare Centres (PHCs) and both public and private hospitals, presents a unique opportunity to generate evidence on how to adapt a single intervention to fit different contexts. The process evaluation will cover all three collaboratives using both quantitative and qualitative methods.
We hope that findings from this evaluation will generate the needed evidence to guide scaling-up the intervention to all facilities within the state. More broadly, the findings could serve as a guide for adapting the intervention to other states in Nigeria and countries with a similar context.
Blog PostFirst results from the Gombe State Maternal and Newborn Health Partnership
Together with implementation partners the Society for Family Health, the SAQIP project of PACT Nigeria and Evidence for Action Mamaye, IDEAS has...
Journal articleFrom Theory to Implementation: Adaptations to a Quality Improvement Initiative According to Implementing Context
Access to maternal and newborn care is increasing but due to the poor quality of care provided this doesn’t necessarily lead to fewer avoidable...
Blog PostHow do we measure women’s experience of childbirth care?
When women go to a health facility to deliver, they expect to be looked after – to receive all the clinical care necessary to ensure their...
NewsCritically examining quality-adjusted coverage measures
Improving coverage measurement continues to be a key area of ongoing research with the IDEAS team. Currently the team is working in collaboration...
Journal article‘A seamless transition’: how to sustain a community health worker scheme
This paper, published in Health Policy and Planning, presents a qualitative study focussing on the Village Health Worker (VHW) Scheme’s...
Journal articleImproving the use of focus group discussions in low income settings
This paper authored by Pauline Scheelbeek et al and published in BMC Medical Research Methodology describes how six exercises were used in 32...
Journal articleUsing social media to improve routine data quality metrics
How is this all linked to social media? The study, published in BMJ Open, measured changes in data quality metrics before and after the...
Blog PostListening to Gombe Mothers
Feedback from patients about their experience of health care is a critically important step to improving quality of care. But mechanisms for...
Journal articleHalf-way there: positive steps in maternal and newborn care in Northeast Nigeria
This IDEAS-led study, authored by Josephine Exley et al and published in BMJ Open, offers unique insights into the quality of care provided to...
Research briefGombe MNH Partnership – Results leaflet in English