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 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 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 PostNortheast 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 PostLeadership 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. ...
ReportMaternal 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 briefHow 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 PostLeadership 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,...
ReportEvidence to improve maternal and newborn health: The IDEAS Project
Leaflet giving an overview of the IDEAS project, it's aims and evaluation methods
ReportData Informed Platform for Health Feasibility Study Report, Gombe State, Nigeria
Report from a feasibility study for a Data Informed Platform for Health in Gombe State, Nigeria.