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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.


Early childhood: Coverage of breast feeding and DPT3 vaccination by LGA, 2012 and 2014.
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pone.0129129.g004: Early childhood: Coverage of breast feeding and DPT3 vaccination by LGA, 2012 and 2014.

Mentions: None of the 20 LGAs met 90% coverage in the proportion of births supervised by skilled birth attendants at baseline and at follow-up (Fig 3A). However, coverage had increased in 8 LGAs at follow-up over baseline; there was no change in 3 LGAs. In another 9 LGA, SBA coverage had actually dropped by the follow-up. In benchmarking the LGA performances with the national and the estimated State coverage, 3 LGAs had performed above the national average of 39% at the baseline and follow up. In another 6 LGAs, performance levels at follow-up fell between at state average of 22.5% and the national coverage of 39% and 11 LGAs fell below the state average coverage. With respect to the coverage of postpartum care for mothers, while it remained poor at baseline and at follow-up, 10 LGAs recorded a higher percent at follow-up in the number of mothers who received postpartum examination within 4 days after birth. Eight LGAs that had zero coverage at baseline had shown some marginal improvements at follow-up (Fig 3B). The percentage of newborns who were breastfed within 8 hours of birth substantially increased from baseline in 15 of the 20 LGAS, reduced in 2 LGAs, and remained unchanged in 3 LGAs (Fig 4A). One LGA (Ganjuwa) already had a follow-up coverage up to the 90% UN target.


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)

Early childhood: Coverage of breast feeding and DPT3 vaccination by LGA, 2012 and 2014.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0129129.g004: Early childhood: Coverage of breast feeding and DPT3 vaccination by LGA, 2012 and 2014.
Mentions: None of the 20 LGAs met 90% coverage in the proportion of births supervised by skilled birth attendants at baseline and at follow-up (Fig 3A). However, coverage had increased in 8 LGAs at follow-up over baseline; there was no change in 3 LGAs. In another 9 LGA, SBA coverage had actually dropped by the follow-up. In benchmarking the LGA performances with the national and the estimated State coverage, 3 LGAs had performed above the national average of 39% at the baseline and follow up. In another 6 LGAs, performance levels at follow-up fell between at state average of 22.5% and the national coverage of 39% and 11 LGAs fell below the state average coverage. With respect to the coverage of postpartum care for mothers, while it remained poor at baseline and at follow-up, 10 LGAs recorded a higher percent at follow-up in the number of mothers who received postpartum examination within 4 days after birth. Eight LGAs that had zero coverage at baseline had shown some marginal improvements at follow-up (Fig 3B). The percentage of newborns who were breastfed within 8 hours of birth substantially increased from baseline in 15 of the 20 LGAS, reduced in 2 LGAs, and remained unchanged in 3 LGAs (Fig 4A). One LGA (Ganjuwa) already had a follow-up coverage up to the 90% UN target.

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.