Evidence to improve maternal and newborn health in Ethiopia, North-Eastern Nigeria and Uttar Pradesh, India

IDEAS is a 5 year measurement, learning and evaluation (MLE) project funded by the Bill & Melinda Gates Foundation. The goal is to find out what works, why and how for maternal and newborn health (MNH) programmes in Ethiopia, North-East Nigeria and Uttar Pradesh, India. The project aims to (1) build local capacity for MLE, (2) measure efforts to increase the coverage of critical interventions through enhancing interactions between families and frontline workers, (3) explore scale-up of MNH innovations, (4) investigate the impact on survival of MNH innovations implemented at scale, and (5) promote best practice for policy. IDEAS will test the theory that improved newborn & maternal survival can be achieved at scale by enhancing interactions between families and frontline workers so that the coverage of critical interventions is increased. An innovative component of IDEAS is to use the District Evaluation Platform approach which generates an implementation strength score to measure the scale-up of MNH innovations across the 3 geographies.

Results from early data collection by IDEAS will be presented, with a focus on measuring the coverage of critical interventions and existing interactions between families & frontline workers in NE Nigeria prior to the widespread implementation of Foundation funded MNH innovations. In May 2012 a linked household, frontline worker and health facility survey using cluster sampling was implemented across Gombe State. Forty enumeration areas were selected with probability proportional to size and all households within those clusters surveyed. All household heads and resident women aged 13-49 were interviewed to investigate the frequency and quality of interactions between families and frontline workers, the baseline coverage of critical interventions for mothers and newborns, and how equitably interactions and interventions were distributed. Frontline workers and primary level health facilities were surveyed to capture supply side indicators of service quality.

These results will provide important demand and supply side evidence about maternal and newborn health care in an area with a very high mortality burden, and will form the basis for understanding future priorities in NE Nigeria.