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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

News
IDEAS at #HSR2018

New evidence presented as posters (above) included: Sustainability for a Village Health Worker scheme in Nigeria Availability of routine facility...


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Ethiopia
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General
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India
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Nigeria
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Community-based newborn care
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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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Behaviour change
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Capacity strengthening
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Context
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Economics
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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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Implementation strength
Research brief
A qualitative study of the scalability and sustainability of the Village Health Worker scheme in Gombe State, Nigeria

Key findings show changes that were made to the VHW scheme to increase its sustainability in the 57 wards where it is being implemented to...


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Nigeria
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Fostering innovation sustainability
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Implementation projects
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Research findings
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Scale-up
Journal article
Six steps to prevent a development project ending in the graveyard

In reality however, in more cases than not, once donor funding dries up, the project comes to an end, thereby limiting the project’s longer term...


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Ethiopia
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India
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Nigeria
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Fostering innovation sustainability
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Scale-up
News
IDEAS Summer Seminar Series

More than seven years later, the team is building on the wealth of data, results, partnerships and learning created in the current second phase of...


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Ethiopia
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General
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India
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Nigeria
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Community-based newborn care
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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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Research findings
Research brief
Data-driven learning cycles and their impact on data use for decision making

The implementation partners are The Society for Family Health, SAQIP through a grant to PACT Nigeria and Evidence for Action through a...


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Nigeria
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Supporting local decision-making
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Capacity strengthening
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Evidence for policy and practice
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Local data use
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Research findings
News
Hiring a Research Fellow based in Lagos, Nigeria

The post-holder will have a PhD in public health or a closely related discipline, or equivalent demonstrated experience in research; demonstrated...


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Nigeria
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Understanding quality improvement
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Evaluation methods
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Research findings
Blog Post
Slow and steady – validating health data in Gombe State line by line

As an output from our first data quality learning workshop in March 2017, LGA M&E officers and MNCH coordinators were excited about revitalizing...


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Nigeria
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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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Evidence for policy and practice
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Local data use
News
“To know what is happening to women and newborns you need to collect accurate information” Preparing for a health facility survey in Nigeria

One way to measure whether the partner projects that IDEAS works with are making a difference is by continuously checking in with the people and...


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Nigeria
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Improving measurement
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Supporting local decision-making
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Tracking progress
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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
Blog Post
Better quality routine health data through a WhatsApp group? What comes out of the Data Quality Workshops in Gombe State

To strengthen the quality of routine maternal and newborn health data in Gombe State in 2017 the IDEAS project initiated a total of four data...


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Nigeria
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Supporting local decision-making
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Tracking progress
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Local data use