Nigeria is located in West Africa sharing the border with Benin in the west, Cameroon and Chad in the east, Niger in the north and the south by the Atlantic Ocean. With a population of about 162 million it is the most populous African country. The country comprises of 36 states and a Federal Capital Territory, Abuja. Nigeria has abundance of natural resources, particularly oil and natural gas. Half of the population lives in rural areas. The life expectancy at birth is 54 years for women and 53 years for men (NDHS, 2008).
National Population Commission (NPC) [Nigeria] and ICF Macro. 2009. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro.
Key MNH Indicators for Nigeria
Maternal Mortality Ratio: 560/100,000live births* (2015)
Neonatal Mortality Ratio: 37.4/1000 live births* (2015)
% Skilled Birth Attendance: 34%* (2015)
Ante-Natal Care (at least one visit): 53% **(2015)
Ante-Natal Care (at least four visits): 51%** (2015)
WHO statistics, 2015
**Nigeria Demographic and Health Survey 2013
CMNH has been working in Nigeria since 2009 on the following programmes:
- Making it Happen (MiH)- completed December 2015
- Independent evaluation of Maternal, neonatal and child health week (MNCHW).
- Support to the provision of essential maternal and newborn healthcare services in Nigeria.
- Knowledge and Skills Retention Study (KSRS)
- Community health workers for maternal and newborn health; case studies from the field
The MiH programme aims to reduce maternal and newborn mortality and morbidity by increasing the availability and improving the quality of Skilled Birth Attendance (SBA) and Emergency Obstetric and Newborn Care (EmONC). The programme was delivered in 11 countries: in Sub-Saharan Africa and in Asia between 2011-2015.
The programme has resulted in:
• 854 in service health care workers trained in EmONC
• 87 course facilitators trained in EmONC
• 177 health care workers trained in data collection and usage
The proposed project, jointly developed by the CMNH-LSTM and by Wellbeing Foundation (WBF), presents a plan to support the Ministry of Health (MoH) in enhancing the capacity of health workers in Life-Saving Skills (LSS) in Essential Obstetric Care and Newborn Care, data collection and its use as well as quality improvement methodologies in four LGAs in Kwara State.
Interventions will be delivered with a view to strengthen existing systems and to ensure
Sustainability. Alongside implementation, a research component will be embedded in the work plan to ensure that the effects of the proposed approach to capacity building of health workers is documented and disseminated.
Twelve BEmONC and CEmONC health care facilities in four local government areas will receive all the interventions in a stepwise manner by the end of the 24 month project.
The KSRS was conducted in six African countries including Ghana assessing how long knowledge and skills are retained after EOC&NC training and looking at the optimum time for the retraining of health care.
The study also identified factors that influence knowledge and skills retention post training including workload and cadre of staff. Skills and knowledge were tested before and immediately after training and then at 3, 6, 9 and 12 month intervals.
The total recruitment across the five countries was 512 health care providers or 87.5% of the target.
• Nurse/midwives knowledge and skills at 12 months were higher than levels immediately post training
This operational research lends itself to the global discussions and debates on the health workforce shortage noted by WHO in 2006. It seeks to identify the scope of practice of community health workers providing maternal and newborn healthcare in low-and-middle-income countries, explore the factors influencing their effective performance and document stakeholders’ recommendations for improving the performance of community health workers. Using qualitative methods, we conducted key informant interviews and focus group discussions with over 300 stakeholders at different levels of the health system in Bangladesh, India, Kenya, Malawi and Nigeria.