Engendering maternal and child health care services in cross river state health agenda in Nigeria: what worked well in a pilot study

Abstract

Objective: This study assessed the performance of maternal and child health (MCH) services launched between 2009 and 2012, as a pilot program in two local government areas (LGAs) of Cross River State, Nigeria. Design: Interventions included: rebuilding existing staff capacity; regular supply of vaccines; improved work environment; enhancing community participation in promotion of MCH services; and strengthening the staff size by recruiting medical officers for supervision of activities and prompt response to complications. Methods: Through a 30 cluster sampling technique, a house-to-house survey approach was adopted to sample three categories of participants from 1,171 households at baseline and compare with performance of respondents from 1,299 households at end-line. Results: Results showed a 2.3% (from 11.2% to 8.9%) decrease in under-five mortality. Also, an 8% decrease in immunization rate was observed during the intervention year. There was significant improvement in the population of women who delivered babies at a health centre at baseline (30.7%) relative to the population who delivered during the intervention year (45.2%); showing a 15% impact attributable to the intervention programme. Results also show that the prevalence of diarrhea and malaria among under-fives reduced from 49% to 45% and 62.2% to 52.5% respectively. Primary health centre recorded the most increase in patronage from 21.9% at baseline to 40.7% at end-line. Conclusion: These results suggest the possibility of high rate of success for sustainable Development Goals (SDGs) pertaining to MCH in Nigeria if all stakeholders across the 774 LGAs provide the minimum inputs required to enhance the Primary Health Care (PHC) services.