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WEST AFRICA: Stakeholders brainstorm in Abuja on Maternal Newborn and Child Health


A stakeholders meeting on how to move maternal new-born and child health evidence into policy in West Africa is under way in the Nigerian capital, Abuja.

Organized by the Federal Ministry of Health in collaboration with the West African Health Organisation (WAHO) and IDRC of Canda, the three-day event, under the theme: "Nigeria Maternal Newborn and Child Health Research Days," was formally declared open by Nigeria's Minister of State for Health, Dr, Osagie Ehanire.

The aim is to enhance the reduction of maternal and child mortality rate, through the development of more efficient, equitable and sustainable policies, strategies, implementation plans, monitoring and evaluation frameworks and better functioning systems, according to WAHO and FMOH officials.

The first two days which witnessed the opening session, technical sessions, group discussions and panel sessions, attracted about 90 participants made up of Key stakeholders in Maternal Newborn and Child Health (MNCH) like policy makers, researchers, CSOs and NGOs. Director-General of WAHO, Prof Stanley Okolo, Director of Family Health department FMOH Dr. Adebimpe Adebiyi, former governor of Ondo State His Excellency, Dr Olusegun Mimiko and the senior specialist representative of IDRC from Canada Dr Nafi Diop were also in attendance.

While the Director of department of Family health, FMOH, Dr Adebyi in her welcome remarks thanked all the participants of the workshop for coming, the DG of WAHO, Professor Okolo, in his opening remarks shared some of his experiences since he started work a few months ago, reiterating his desire to continue to support any project designed to impact the lives of Nigerians.

In his Key Address, "The Abiye Program," Dr. Mimiko showed the success of the program in Ondo State, South-West Nigeria as an example of putting an Evidence into Practice.

Mimiko explained that ABIYE was a safe motherhood program designed to reduce the burden of maternal deaths in Ondo State, having one of the worst figures in the country, launched on October 28, 2009 at Ifedore LGA to track every pregnant woman and bring qualitative and effective health care to them wherever they live, work or play. It was also conceived to develop sustainable equity-based health care services that will provide universal access, as well as implement equitable allocation of our limited resources premised on specific needs and performance driven principles and it has made tremendous impact on the lives of mothers and children in the state.

The overall objectives of the meeting, according to Dr Adeniran, Director/Head Child Health Division, is to move maternal, newborn and child health evidence into policy in order to enhance the reduction of maternal and child mortality rates, through the development of more efficient, equitable and sustainable policies, strategies, implementation plans, monitoring and evaluation frameworks and better functioning systems.

Specifically, the objectives are: To present the early findings of the Innovation for Maternal and Child Health in Africa (IMCHA) projects research and other MNCH interventions ; To discuss the use of the research findings/good practices in decision making in MNC) and; To discuss the organisation and the sustainability of the Nigeria Research days for MNCH.

The expected outcome include sharing of the Innovation Maternal Child Health Africa (IMCHA) research projects ongoing findings and other good practices, and discussion of the mechanism for the use of research findings in decision making and practice in MNCH. Others are discussion of the proposal for the improvement and the sustainability of the Nigeria Research Day for MNCH conference discussed and; issuance of a final communiqué, on the consensus recommendation around the use of results for decision making.

Presenting the status and vision of MNCH in Nigeria, Dr. Adeniran gave a situation analysis of Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) including Nutrition in Nigeria. She stated the government's vision on integrated RMNCAH, the priority interventions for Sexual Reproductive Health; maternal health; newborn care; infancy and child hood; adolescent health and; nutrition. she also identifed the funding opportunities for implementation of RMNCAH+ Nutrition to include: Basic health care provision fund; Saving one million lives initiative programme for results; Global Fund Financing Mechanism; NHIS and Development partners.

In a presentation on "Innovation for Maternal and Child Health in Africa (IMCHA) – West African Health Organization as a HPRO and Nigeria Perspectives," Prof. Sombie of WAHO stated that the Economic Community Of West African States (ECOWAS) is an inter-governmental regional body made up of 15 West African Countries with a mission to achieve the attainment of the highest possible standard and protection of health of the peoples in the region.

Dr. Sombie noted that WAHO presently has 5 priority areas: maternal, child & adolescent health; centres of excellence & quality standards; medicines & vaccines; prevention & control of communicable and non-communicable diseases; health information; health information. WAHO strategies and activities were also highlighted.

Another presentation was made by Prof. Jesse Uneke, an expert in knowledge transfer, on "Application of equitable impact sensitive tool (EQUIST) in evidence informed policymaking to improve Maternal and Child health outcomes in Nigeria." It emphasized the need for evidence based policy making considering that Nigeria have the highest number of policies in West Africa, while attributing the increase in MMR to the increased inequity between the rich and the poor.

Identifying EQUIST as a tool that helps in equity analysis and Cost effective analysis for health, programmes, Uneke said the tool is available online free

In the discussions that followed the various presentations, participants appreciated the ABIYE project and need for replication. Cost of care was noted to be minimal and decreased over time. Other high points of the discussions included the need for sustainability of health programs instead of being truncated mid-way by incoming government; Need for local evidence to enhance policy making; recommendation for Multidisciplinary research approach and the need to sustain this MNCH forum

Identifying strong research collaboration between countries as the way forward, participants also stressed the strength of the community.

The 2ND Technical session dwelt on IMCHA project – Scaling up care for perinatal depression for improved maternal and infant health (SPECTRA) in Oyo State, which was presented by Dr Bibilola D. Oladeji of University College Hospital Ibadan.

The overall aim is to study factors that may impede or facilitate the delivery of evidence-based interventions for perinatal depression by front-line clinicians using the WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) in routine practice.

They found that the trainings led to improved knowledge and attitude of health workers towards the detection of depression among pregnant women. The researchers also learnt the rudiments of stakeholder engagement which have yielded positive results.

They identified that there are no mental health indicators in the HMIS and this needs to be addressed.

Another presentation in 2ND Technical session on IMCHA project was "Video edutainment at the doorstep: Impact on infant and maternal outcomes in Toro, Bauchi State, Nigeria "by the Bauchi team led by Hajia Yagana Gidado

Prof. Friday Okonofua, in his presentation, " Increasing Women's Access to Skilled Pregnancy Care in Edo State Nigeria: Results achieved," stated that most maternal deaths occur because women do not attend ANC or present late, so evidence for revitalization is needed. The main aim of their study is to strengthen availability and access after finding out why women do not use the PHCs. The stakeholders were well engaged and the project enjoyed community ownership. Barriers to utilization were identified and good dissemination of study findings have been made. The team has rolled out interventions to address the access problems.

In the panel sessions that were held, the discussions centred on the need for improvement, What is missing? What can be improved? The key good practices identified with regards to relevance, effectiveness, efficiency.

Others were prospects of scaling up; How to get these results into policy and practice; Some of the lacuna from the study designs were identified and can be improved on; The idea of innovations in health were discussed; Multidisciplinary approach was recommended for better results; The good practices from the projects were identified; Issues around scaling up of the projects and getting the research results into policy and practice were also discussed; mThe need for sustainability was emphasized and; Community participation and stake holder engagement is key to sustainable PHC programs.

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