Impact of community engagement programs on reaching the most vulnerable women in Northern Nigeria

Sally E. Findley, Columbia University and ICAP-NY
Henry V. Doctor, World Health Organization (WHO) EMRO
Godwin Afenyadu, PRRINN-MNCH

MCH outcomes in Northern Nigeria are among the worst in the world, often the worst for low status women. We assessed the impact of an intervention integrating critical health system and community-based improvements, with several targeting vulnerable women. Analysis of baseline to endline survey data (2009-2013) showed that the proportions of women making antenatal care visits and who delivered with a skilled birth attendant doubled, with the greatest changes in communities with high intensity community engagement activities. Infant, and child mortality also declined the most in these communities. Women who made more ANC visits were significantly more likely to be literate, have a well-maintained home and a cell-phone, have help with children, speak up at ceremonies, know danger signs, make clinic visits, satisfied with improvements in the clinic, and higher frequency of participation in CE activities. Additional efforts will be needed to reach the most vulnerable.