Boosting Newborn Health in Northern Nigeria: Can Community Health Workers Make a Difference?
"A look at how community health initiatives are improving newborn care and survival rates in Northern Nigeria, addressing critical health disparities."
In Northern Nigeria, infant mortality rates have been significantly higher than in the southern states, creating an urgent need for effective interventions. Recognizing this disparity, a partnership program was launched in 2008 aimed at enhancing maternal, newborn, and child health (MNCH) to reduce infant and child mortality across three Northern Nigerian states.
The MNCH program focused on integrated interventions at primary healthcare posts and community-based service delivery (CBSD) using networks of community volunteers and community health workers (CHWs). These dedicated individuals educated women on critical danger signs for themselves and their infants, promoting timely and appropriate responses aligned with the World Health Organization's Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy.
Before scaling up these interventions across the region, it was essential to evaluate the effectiveness of different approaches. This involved comparing a low-intensity volunteer model against a more intensive CBSD approach that utilized CHWs, ensuring that the most impactful strategies were prioritized for wider implementation.
How Community Health Initiatives Impact Newborn Care
A detailed study was conducted using stratified cluster sample household surveys at baseline (2009) and follow-up (2011) to gauge changes in newborn and sick child care practices. The surveys focused on women who had given birth in the five years prior to each survey (baseline: n = 6,906; follow-up: n = 2,310). Follow-up respondents were categorized by the intensity of CHW interventions in their communities:
- ‘High-intensity’ intervention: Encompassed community volunteer activities along with CBSD provided by a CHW, offering one-on-one advice and support.
Conclusion: Strengthening Community-Based Healthcare
The study confirms the effectiveness of community-based approaches utilizing community volunteers and CHWs in enhancing newborn and sick child care. Interestingly, the low-intensity approach, which relied on community volunteers, proved equally effective as the more intensive CBSD approach with CHWs in several key newborn and sick child care indicators, particularly in delivering appropriate home care for children with fever or cough. These findings highlight the critical role of community engagement and support in improving health outcomes, paving the way for more focused and effective healthcare strategies in Northern Nigeria.