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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Early results of an integrated maternal, newborn, and child health program, Northern Nigeria, 2009 to 2011
BMC Public Health, Volume 13, No. 1, Article 1034, Year 2013
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Description
Background: This paper describes early results of an integrated maternal, newborn, and child health (MNCH) program in Northern Nigeria where child mortality rates are two to three times higher than in the southern states. The intervention model integrated critical health systems changes needed to reinvigorate MNCH health services, together with community-based activities aimed at mobilizing and enabling women to make changes in their MNCH practices. Control Local Government Areas received less-intense statewide policy changes. Methods. The impact of the intervention was assessed using a quasi-experimental design, comparing MNCH behaviors and outcomes in the intervention and control areas, before and after implementation of the systems and community activities. Stratified random household surveys were conducted at baseline in 2009 (n = 2,129) and in 2011 at follow-up (n = 2310), with women with births in the five years prior to household surveys. Chi-square and t-tests were used to document presence of significant improvements in several MNCH outcomes. Results: Between baseline and follow-up, anti-tetanus vaccination rates increased from 69.0% to 85.0%, and early breastfeeding also increased, from 42.9% to 57.5%. More newborns were checked by trained health workers (39.2% to 75.5%), and women were performing more of the critical newborn care activities at follow-up. Fewer women relied on the traditional birth attendant for health advice (48.4% to 11.0%, with corresponding increases in advice from trained health workers. At follow-up, most of these improvements were greater in the intervention than control communities. In the intervention communities, there was less use of anti-malarials for all symptoms, coupled with more use of other medications and traditional, herbal remedies. Infant and child mortality declined in both intervention and control communities, with the greatest declines in intervention communities. In the intervention communities, infant mortality rate declined from 90 at baseline to 59 at follow-up, while child mortality declined from 160 to 84. Conclusions: These results provide evidence that in the context of ongoing improvements to the primary health care system, the participatory and community-based interventions focusing on improved newborn and infant care were effective at changing infant care practices and outcomes in the intervention communities. © 2013 Findley et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Findley, Sally Evans
United States, New York
Mailman School of Public Health
Uwemedimo, Omolara Thomas
United States, New Hyde Park
Cohen Children's Medical Center of new York
Doctor, Henry Victor
United States, New York
Mailman School of Public Health
Nigeria, Kano
Prrinn-mnch Programme
Green, Cathy
United Kingdom, Lewes
Health Partners International
Adamu, Fatima Lamishi
Nigeria, Kano
Prrinn-mnch Programme
Afenyadu, Godwin Yao
Nigeria, Kano
Prrinn-mnch Programme
Statistics
Citations: 30
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2458-13-1034
e-ISSN:
14712458
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Quasi Experimental Study
Study Locations
Nigeria
Participants Gender
Female