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:
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.
Blog Post
First results from the Gombe State Maternal and Newborn Health PartnershipTogether with implementation partners the Society for Family Health, the SAQIP project of PACT Nigeria and Evidence for Action Mamaye, IDEAS has...
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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
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Capacity strengthening
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Evaluation methods
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Evidence for policy and practice
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Implementation projects
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Intervention coverage
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Local data use
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Research findings
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Scale-up
Published content
Research brief
Gombe MNH Partnership – Results leaflet in English
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Nigeria
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Improving measurement
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Tracking progress
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Understanding quality improvement
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Evidence for policy and practice
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Intervention coverage
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Research findings
Research brief
Gombe MNH Partnership – Results Leaflet in Hausa
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Nigeria
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Improving measurement
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Tracking progress
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Understanding quality improvement
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Evidence for policy and practice
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Intervention coverage
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Research findings
Journal article
Are we using the right approach to change newborn care practices in the community?Changing behaviors is usually a core component of the role of community health workers (CHWs), but little is known about the mechanisms through...
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Ethiopia
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Nigeria
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Community-based newborn care
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Understanding quality improvement
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Behaviour change
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Context
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Evidence for policy and practice
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Research findings
Blog Post
First results from the Gombe State Maternal and Newborn Health PartnershipTogether with implementation partners the Society for Family Health, the SAQIP project of PACT Nigeria and Evidence for Action Mamaye, IDEAS has...
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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
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Capacity strengthening
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Evaluation methods
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Evidence for policy and practice
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Implementation projects
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Intervention coverage
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Local data use
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Research findings
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Scale-up
Journal article
“Everything is from God but it is always better to get to the hospital on time”Zelee Hill and her co-authors aimed to identify facilitators and barriers for women to deliver their babies in health facilities in Gombe State,...
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Nigeria
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Understanding quality improvement
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Behaviour change
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Context
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Evidence for policy and practice
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Research findings
Journal article
Are health facilities in low-income settings able to provide good quality routine MNCH care?This paper, authored by Keith Tomlin and others, looks at health facilities in three settings with high maternal mortality to assess their...
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Ethiopia
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India
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Nigeria
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Tracking progress
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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
News
In memory of Deepthi WickremasingheDeepthi was a Research Fellow, specialising in qualitative research, systematic literature reviews and information and knowledge...
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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
Journal article
What influences women’s choice of place of delivery?The study published in BMJ Global Health and authored by Nasir Umar and others is based on a discrete choice experiment following a comprehensive...
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Nigeria
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Improving measurement
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Tracking progress
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Understanding quality improvement
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Behaviour change
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Context
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Evidence for policy and practice
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Research findings
Blog Post
“I felt like I should have delivered at home”The Northeast of Nigeria has some of the highest rates of maternal and newborn deaths in the world. Drastically reducing this number of...
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Nigeria
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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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Research findings