Limits...
Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria.

Abegunde D, Orobaton N, Sadauki H, Bassi A, Kabo IA, Abdulkarim M - PLoS ONE (2015)

Bottom Line: For several of the indicators, a modest improvement from baseline was found.However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level.Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015.

View Article: PubMed Central - PubMed

Affiliation: JSI Research & Training Institute, Inc., -Targeted States High Impact Project (TSHIP), Bauchi, Bauchi State, Nigeria.

ABSTRACT

Background: Improving maternal and child health remains a top priority in Nigeria's Bauchi State in the northeastern region where the maternal mortality ratio (MMR) and infant mortality rate (IMR) are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs) 4 and 5.

Methods: At baseline (2012) and then at follow-up (2013), we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA) of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS) technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated.

Results: For several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up.

Conclusions: Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic considerations need to be given to the design of strategies that address the demand for health services.

No MeSH data available.


Related in: MedlinePlus

Coverage levels of selected indicators across the continuum of care, 2012 & 2014: Bauchi state coverage range (minimum and maximum) and average.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4472677&req=5

pone.0129129.g001: Coverage levels of selected indicators across the continuum of care, 2012 & 2014: Bauchi state coverage range (minimum and maximum) and average.

Mentions: The coverage estimates of the indicators for the continuum of care at baseline (2012) were all lower than the national-level estimates (obtained from the 2008 and 2013 NDHS [9, 10]) and much lower than the MDG-recommended coverage level of 90% [4] (Table 1). Breastfeeding practices were defined differently in the study and the DHS and the Countdown 2015, and the ensuing estimates were therefore not comparable. The demand for FP satisfied was 7.8% (95% CI: +/- 0.7%) in 2012 compared to follow-up (2014) estimate of 6.1% (95% CI: +/- 1.0%) and the national average of 15%. The demand for FP satisfied had declined by 1.7 percentage points by 2014 from the baseline coverage. Although the estimated coverage of at least four antenatal visits in pregnancy at baseline was also below the 2008 national average of 45%, it increased from a baseline level of 28.4% (95% CI: +/- 1.6%) to 45.5% (95% CI: +/- 2.6%) in the 2014 follow-up survey. Deliveries supervised by a SBA increased by only 1.5 percentage points from the baseline level of 22.5% (95% CI: +/- 1.4%) to 24.0% (95% CI: +/- 1.4%) both of which were lower than the national average of 39%. There was a three-percentage point increase in the percent of women who had received postnatal care within 4 days of delivery from baseline of 7.4% (95% CI: +/- 0.6%) to 10.4% (95% CI: +/- 0.9%) by the follow-up survey in 2014. The coverage of newborns that were breastfed within 8 hours of birth increased by 19 percentage-points from a baseline of 25% (95% CI: +/- 1.6%) to 43.8% (95% CI: +/- 2.5%) in the follow-up. DPT3 vaccination coverage dropped by 2.8 percentage-points from a baseline of 13.1% (95% CI: +/- 1.0%) to 10.3% (95% CI: +/- 0.6%) in the follow-up period. Access to antibiotic treatment for acute pneumonia increased by only one percentage-point from 18.8% (95% CI: +/- 1.0%) at baseline, to 19.8% in the 2014 follow-up. As shown in the range plots in Fig 1, at the aggregate state level, only marginal increases in the average coverage were recorded for most of the indicators in the continuum of care. The exceptions were coverage for four or more antenatal visits and exclusive breastfeeding (in 24 hours before the study) which recorded significant increases. This implies that a few LGAs achieved over 80% coverage in these indicators (Fig 1). We disaggregated coverage by LGAs. In general, the coverage of all the indicators was widely distributed around the average estimates reflecting the large differences between LGAs in the attained coverage estimates. While some LGAs had low coverage rates, others had achieved significantly high coverage at baseline and or follow-up.


Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria.

Abegunde D, Orobaton N, Sadauki H, Bassi A, Kabo IA, Abdulkarim M - PLoS ONE (2015)

Coverage levels of selected indicators across the continuum of care, 2012 & 2014: Bauchi state coverage range (minimum and maximum) and average.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4472677&req=5

pone.0129129.g001: Coverage levels of selected indicators across the continuum of care, 2012 & 2014: Bauchi state coverage range (minimum and maximum) and average.
Mentions: The coverage estimates of the indicators for the continuum of care at baseline (2012) were all lower than the national-level estimates (obtained from the 2008 and 2013 NDHS [9, 10]) and much lower than the MDG-recommended coverage level of 90% [4] (Table 1). Breastfeeding practices were defined differently in the study and the DHS and the Countdown 2015, and the ensuing estimates were therefore not comparable. The demand for FP satisfied was 7.8% (95% CI: +/- 0.7%) in 2012 compared to follow-up (2014) estimate of 6.1% (95% CI: +/- 1.0%) and the national average of 15%. The demand for FP satisfied had declined by 1.7 percentage points by 2014 from the baseline coverage. Although the estimated coverage of at least four antenatal visits in pregnancy at baseline was also below the 2008 national average of 45%, it increased from a baseline level of 28.4% (95% CI: +/- 1.6%) to 45.5% (95% CI: +/- 2.6%) in the 2014 follow-up survey. Deliveries supervised by a SBA increased by only 1.5 percentage points from the baseline level of 22.5% (95% CI: +/- 1.4%) to 24.0% (95% CI: +/- 1.4%) both of which were lower than the national average of 39%. There was a three-percentage point increase in the percent of women who had received postnatal care within 4 days of delivery from baseline of 7.4% (95% CI: +/- 0.6%) to 10.4% (95% CI: +/- 0.9%) by the follow-up survey in 2014. The coverage of newborns that were breastfed within 8 hours of birth increased by 19 percentage-points from a baseline of 25% (95% CI: +/- 1.6%) to 43.8% (95% CI: +/- 2.5%) in the follow-up. DPT3 vaccination coverage dropped by 2.8 percentage-points from a baseline of 13.1% (95% CI: +/- 1.0%) to 10.3% (95% CI: +/- 0.6%) in the follow-up period. Access to antibiotic treatment for acute pneumonia increased by only one percentage-point from 18.8% (95% CI: +/- 1.0%) at baseline, to 19.8% in the 2014 follow-up. As shown in the range plots in Fig 1, at the aggregate state level, only marginal increases in the average coverage were recorded for most of the indicators in the continuum of care. The exceptions were coverage for four or more antenatal visits and exclusive breastfeeding (in 24 hours before the study) which recorded significant increases. This implies that a few LGAs achieved over 80% coverage in these indicators (Fig 1). We disaggregated coverage by LGAs. In general, the coverage of all the indicators was widely distributed around the average estimates reflecting the large differences between LGAs in the attained coverage estimates. While some LGAs had low coverage rates, others had achieved significantly high coverage at baseline and or follow-up.

Bottom Line: For several of the indicators, a modest improvement from baseline was found.However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level.Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015.

View Article: PubMed Central - PubMed

Affiliation: JSI Research & Training Institute, Inc., -Targeted States High Impact Project (TSHIP), Bauchi, Bauchi State, Nigeria.

ABSTRACT

Background: Improving maternal and child health remains a top priority in Nigeria's Bauchi State in the northeastern region where the maternal mortality ratio (MMR) and infant mortality rate (IMR) are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs) 4 and 5.

Methods: At baseline (2012) and then at follow-up (2013), we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA) of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS) technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated.

Results: For several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up.

Conclusions: Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic considerations need to be given to the design of strategies that address the demand for health services.

No MeSH data available.


Related in: MedlinePlus