Changes in Maternal and Child Health Care Behaviors: Early Evidence of the Impact of Community-Based Programs in Nigeria

Sally E. Findley, Columbia University
Omolara T. Uwemedimo, Columbia University
Henry V. Doctor, Columbia University
Cathy Green, Health Partners International
Fatima Adamu, PRRINN-MNCH
Godwin Afenyadu, PRRINN-MNCH

PRRINN-MNCH Program aims to reduce the high maternal and child mortality rates in the four northern Nigerian states of Jigawa, Katsina, Yobe, and Zamfara through improved emergency obstetric services together with strengthened primary care, health governance, human resources, health information utilization and community engagement. We conducted random household surveys using DHS-comparable questions to women with pregnancies in the past 5 years, at baseline in 2009 (n=5,041) and two years post-implementation in 2011 (n=3,075). From baseline to follow-up, antenatal care rates increased, 32.6% to 50.7%. Breastfeeding within 24 hours rose to 63%, and immunization and other child health care practices increased. These changes were greater in program than non-program areas. The infant mortality rate dropped from 90.0 to 45.4 in the intervention communities, and to 82.1 in non-program communities. This early look at the impact of the program suggests that PRRINN-MNCH is beginning to have significant impact.