Maternal, Newborn and Child Health programme, Nigeria

The UK aid-funded Maternal, Newborn and Child Health programme (MNCH2) improved access to high quality maternal and newborn health care and routine immunisation to reduce maternal, newborn and child deaths. Options worked as part of the MNCH2 programme team (led by Palladium) to improve essential health care for pregnant women, newborns and children in six northern states: Katsina, Kaduna, Kano, Yobe, Jigawa and Zamfara. The programme trained health workers, strengthened health planning and financing, and tackled drug supplies to improve the quality of services delivered. It also raised awareness, provided emergency transport and improved referral systems to increase timely access to life-saving care.

Options supported the use of data on use of services to ensure that planning and decision-making by facilities and government staff responded to actual need. We helped communities and civil society groups to access information on health services, and to use this information to demand better services when and where they are needed. Across the programme we provided technical expertise to ensure that MNCH2 improved the quality of services – through training, lobbying for additional resources, better planning and resource management, and ensuring that staff and equipment were available at facility level.

We did this by:

• Supporting the expansion of Maternal Death Review Committees, ensuring lessons from maternal deaths prompt changes in health facility practices and improved service quality for other mothers.
• Strengthening Facility Health Committees as forums for reviewing and improving facility management, involving communities in decision-making, and discussing service quality.
• Gathering information on quality of care from patients and their communities, and presenting this in accessible formats such as scorecards. Insights from community scorecards were compared with the health facility staff’s own assessment of services, prompting discussion at Facility Health Committees.
• Establishing robust state-level accountability mechanisms to track progress on health sector plans and budgets. We used this evidence to catalyse action to improve health outcomes. We improved quality of care by ensuring the delivery of integrated RMNCH services in health facilities, focused on improving basic and comprehensive emergency obstetric care services.

Project achievements

By 2019, this programme aimed to increase skilled birth attendance from 19% to 45% across the six northern states. The programme estimated that it will save the lives of 60,000 children, 42,000 newborns and 2,000 pregnant women in the six programme states.