Report by Job Eronmhonsele, CPED, Benin City Nigeria
The Federal Ministry of Health in collaboration with the West Africa Health Organisation hosted a stakeholders’ engagement event on Moving Maternal, Newborn and Child Health Evidence into Policy in West Africa Project (MEP) on October 29th, 2015 at the Vines Hotel, Durumi, Abuja. Those in attendance includes directors at the state Ministry of Health in 17 states of Nigeria, Key officers at the Federal Ministry of Health Abuja, WAHO team including Dr. Keita, implementing partners (IPs) based in Abuja, key officers of some relevant government agencies including NACA, NGOs, CSOs, among others. The department of Family Health, Ministry of Health championed the organizing of the event in collaboration with WAHO consultant for the MEP project in Nigeria.
The event was organized to bring together relevant stakeholders to help determine the required capacity for evidence-based policy making so as to enable the Implementation Research Team (IRT) to channel appropriate interventional strategies to enhance capacity of policy makers on the use of research evidence for policy making in the health sector.
At the Event
The event which started at about 9:00am was introduced by Dr. Mrs. Adeniran of the department of Family Health, FMOH and followed with self introduction by all participants present. The Director, department of Family Health, FMOH Abuja, Dr. Wapada I. Balami, in his welcome address thanked everyone for honoring the invitation to attend the event and urged everyone to be open-minded to contributing to the success of the event. Dr. Wapada noted that a big gap still exists between policy makers and researchers and hopes that the event would be able to come up with concrete strategies to closing this gap.
The welcome address was followed by a presentation by Dr. Keita (WAHO), introducing the project “Moving Maternal, Newborn and Child Health Evidence into Policy in West Africa (MEP). According to Dr. Keita, the general objective of the project is to “improve the demand for, the production of, and the use of research findings in decision-making in maternal, neonata and child health programs and policies within the ECOWAS region”.
The specific objectives include:
- Conduct a situation analysis of the background to the production and use of research findings at national and regional levels in maternal, newborn and child health (MNCH) within the ECOWAS region,
- Strengthen WAHO’s capacity to promote the use of health research within the ECOWAS region,
- Promote the use of evidence to improve decision-making around MNCH within the ECOWAS region, and
- Strengthen the collaboration between MNCH researchers and decision-makers within the ECOWAS region.
Dr. Keita stated that the project would span from 2014 to 2020. In addition to the MEP project in West Africa, Innovating for Maternal and Child Health in Africa will provide support to seven research projects namely: promotion of integrated approach to care in pregnancy and childbirth, promotion of community education, promotion of results-based financing and equity of access to care, sponsorship of girls by individuals, management of postpartum depression, promotion of innovative and feasible interventions to improve mother and child health, among others. He also stated that MEP project is regional and that research activities is currently taking place in BENIN, BURKINA FASO, GHANA, MALI, NIGERIA and SENEGAL. According to him, the funding for the project is supported by Ministry of foreign Affairs, Trade and Development of Canada (MAECD), The International Development Research Centre (IDRC) and The Canadian Institutes of Health Research (CIHR).
Following Dr. Keita’s presentations four (4) other organisations who have been working in the areas of health research and evidence to influence policy also made presentations. The first was Professor Okonofua of WHARC who is currently a beneficiary of the MEP project in Nigeria. He made a presentation on the current state of the project which is being implemented in Edo state, Nigeria. Professor emphasized the need to do a thorough mobilization of stakeholders for the project including the permanent secretary (PS) and commissioner of the state ministry of health, the PS FMOH, Abuja, Policy/decision makers both at the federal, state and local level and all relevant agencies before implementation of the project. According to him, involving them from the inception of the project will make policy influence easier.
Professor Friday Okonofua noted that Nigeria has some of the highest rates of maternal and perinatal deaths in the World, about 750,000 children under the age of 5 years die each year, less than 10% of Nigerian women use contraceptives to prevent unwanted pregnancies, Less than 35% are attended to by skilled births attendants (doctors and midwives) at the time of delivery and Less than 50% of pregnant women have access to emergencies obstetric services. He was of the view that MCH services are largely preventive and can be handled by Nurses/Midwives at PHC level. However, “both demand and supply factors must be addressed if women are to use PHC for MCH services in Nigeria, otherwise, they will continue to use ineffective traditional methods or no method at all”, he concluded. He went further to enumerate the demand side to include: knowledge of the PHC, perceptions and beliefs about effectiveness of PHC versus traditional care, etc, while the supply side include: Availability, Geographic Accessibility, Affordability and Acceptability.
Following Okonofua’s presentation was a presentation by Dr. Bibilola Oladeji, Department of Psychiatry University of Ibadan (represented) entitled “Scaling up care for perinatal depression for improved maternal and infant health”. In her presentation, she noted that Depression is particularly common amongst women of child-bearing age and that during pregnancy, 10% of women are diagnosed with depression/anxiety disorder. “In the postpartum period the rates are up to 13% and In Low and Middle Income countries rates are higher”, she added. But, she however stated that ‘Early Identification’ and prompt interventions are known to reduce these negative consequences.
The third presentation was titled “Video Edutainment to the Doorstep Impact on Maternal and Child Outcome in Toro Lga, Bauchi State, Nigeria by Mrs. Hadiza Mudi”. Hadiza, noted that one of the very few studies of maternal mortality in Bauchi state reported 612 deaths in 12,062 un-booked deliveries, given a maternal mortality ratio of 5146. To reduce this problem, a project has been designed which include a universal home visits to engage pregnant women and their spouses in discussion through video edutainment and to follow up with them in order to ensure safe delivery in Toro LGA. She went further to enumerate how and when the project will be implemented in Bauchi. “The intervention targets women of child bearing age (15-49 years) especially during
CPED Staff, Job Eronmhonsele, making a presentation of group work during stakeholders’ engagement meeting in Abuja
pregnancy, their husbands and families”, she concluded.
While all the presentations mentioned above were just from a research project at the start or in their first phases, CPED presentation by Dr. Francis Onojeta, was more of knowledge sharing on evidence to influence policy and a showcase of how best to implement evidence-based research to bring about desired change. After mentioning the objectives of the research project on “strengthening health systems in Nigeria through equitable access to primary health care: the case of Delta state”, Dr. Onojeta emphasized the mechanism put in place to ensure successful implementation of the research project which began in 2013 to include setting up steering committee and management committee. He said a combination of these platforms has helped to generate robust evidence-based policy research. He added that engagement with policy makers and other relevant stakeholders is still on-going both at the state and local government level.
During the mid-day, Dr. Uneke, consultant for the MEP project in Nigeria, reported on the situation analysis of the process of knowledge transfer and use of evidence in policy making on mother and child health in Nigeria. Thereafter, he took participants through the design of policy briefs and while evidence informed stakeholders’ dialogue is important.
Other activities of the day included group work and discussion among partners and participants from the 17 states ministries of health represented.