Nigeria

IDEAS works in Gombe State in north-east Nigeria and uses multidisciplinary research methods to provide a rich source of data for funders, governments and non-governmental organisations working in maternal and newborn health.

Our findings contribute to the gap in implementation research on what works, why and how in getting life-saving interventions to families at scale. IDEAS’ research in Gombe State addresses the urgent need for better measurement and learning. Findings will be 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.

IDEAS’ work in Nigeria is led by Country Coordinator Dr Nasir Umar and is implemented in conjunction with Data Research and Mapping Consult Ltd – IDEAS’ measurement, learning and evaluation partner in Gombe. The Gombe State Primary Health Care Development Agency provides leadership for translating findings into action.

Research areas in Nigeria are:

Tracking progress

Focus on a core set of priority interventions is key to tracking progress in maternal and newborn health. Together with the Bill & Melinda Gates Foundation, a maternal and newborn health dashboard was created in 2014 . The dashboard tracks population level coverage indicators for contacts with health services and for life saving interventions, together with facility level indicators of service readiness to provide life saving care. At six-monthly intervals IDEAS generates the primary data required to populate this dashboard and works with partners to reflect on progress.

In addition, IDEAS primary data collected in intervention and comparison areas is used to evaluate progress in the state against a set of priority indicators for maternal and newborn health. Final results will be available in 2019.

Supporting local decision making

Beyond the maternal and newborn health dashboard, a more detailed results framework is an important tool to help local stakeholders identify and focus on key implementation objectives within a complex environment. Working with the State Primary Health Care Development Agency and Bill & Melinda Gates Foundation implementation projects, IDEAS has developed and supports a Gombe State results framework that combines population level coverage with implementation targets. This is populated every six-months with estimates generated by IDEAS’ surveys, monitoring data provided by implementation partners and routine government data. Collectively, partners review each results framework update at ‘Data-driven Learning Workshops’ and use it as a learning tool with which to improve programme decision making.

At these workshops there is collective sharing and review of the most recent results, and all the participants reflect on the targets and the inter-dependency of grantees’ efforts. This is followed by consultation on the decisions needed to drive 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.

Improving coverage measurement

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 received, and the measurement of the quality of care provided (including respectful care) lacks standardised methods. We aim to improve measurement of priority indicators for maternal and newborn health by comparing the coverage estimates derived from multiple sources. 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, methods for linking household and facility data to produce effective coverage measures of care are under development.

Fostering innovation sustainability

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.

This work will generate important knowledge on sustaining health programmes in low-income settings, building 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.

Published content

Journal article
Adding Content to Contacts: Measurement of High Quality Contacts for Maternal and Newborn Health in Ethiopia, North East Nigeria, and Uttar Pradesh, India

Families in high mortality settings need regular contact with high quality health services. This paper presents a method for estimating the population level coverage of high quality contacts.

Report
Dissemination activity and impact of maternal and newborn health projects in Ethiopia, India and Nigeria

Report on the dissemination activity and impact of Bill & Melinda Gates Foundation implementation projects.

News
Household, frontline worker and facility follow-up surveys begin in Ethiopia and Nigeria

The endline data, to be collected in April and May 2015, will be compared with baseline data collected in 2012, and any changes in healthcare...

Journal article
‘Scaling-up is a craft not a science’: Catalysing scale-up of health innovations in Ethiopia, India and Nigeria

A study of the scale-up of health innovations in Ethiopia, Nigeria and India, showing that multiple steps are required, including: planning; advocacy; using evidence; involving government; partnership, together with time, money and coordination, and the commitment of implementers, donors and government.

Blog Post
Northeast Nigeria myths and superstitions pose more barriers to health of women and babies than conflict

“The conflict is not much of a problem to my work. The persistence of local myths and superstitions around pregnancy and birth is more of a...

Blog Post
Leadership in maternal and newborn health: Fatima Muhammad, Nigeria

To attain your dream is the most beautiful thing. You need to be focused and ready to work hard. Find people who will support and encourage you. ...

Report
Maternal and newborn health care. Baseline findings from Gombe State, Nigeria

The baseline study, carried out in Gombe State, North-Eastern Nigeria, in 2012, gathered information about the frequency, quality and equity of interactions that women have with frontline workers during pregnancy, delivery and in the first 28 days after birth, to estimate the coverage of life-saving interventions that frontline workers are able to deliver to mothers and newborns.

Research brief
How to catalyse scale-up of maternal and newborn innovations in north-eastern Nigeria

A study of scale-up focussing on the north-eastern Nigerian states of Gombe, Bauchi, Yobe, Borno, Adamawa and Taraba

Blog Post
Leadership in maternal and newborn health: Dr Yashua Alkali Hamza, Nigeria

Since then, she has gained multiple awards for her work in improving the health of children, including the Pediatric Association of Nigeria award,...