Introduction
Maternal mortality in Nigeria is one of the highest in the world with an estimated 574 maternal deaths for every 100,000 live births, with the country contributing about 10% of global burden of maternal deaths, while child mortality rate is also high with 104.3 deaths per 1,000 live births(NDHS 2013).According to the WHO and UNICEF, every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.
The national burden of maternal and child deaths are a call for urgent and concerted action to further improve the survival chances of the country’s mothers and children.The vast majority of maternal and children’s deaths are preventable with improved access to more health facilities and skilled care providers, and simple remedies and solutions such as medicines, and vaccines, clean water, basic sanitation and electricity. High numbers of maternal and under-five deaths are a clear indication that many women and children are not receiving the basic health services that they need.
A good maternal and child health program needs a comprehensive, rigorous, relevant, and timely data which are essential for performance improvement. Though there are multiple data sources, data generated by national HMIS is the most wide-ranging and comprehensive. However, access to information by the public on the scale of maternal and child mortality has remained a significant binding constraint to holding the government and providers accountable for maternal and child deaths.
Accountability for Providers’ Performance is one of the six (6) success factors associated with reduced maternal mortality ratio (World Bank, Reducing Maternal Mortality, Marjorie Koblinsky). Other factors are high availability of skilled birth attendants located near home, especially where home births are traditional, high availability of birthing facilities, free or reduced cost for services and transport to the services for clients, strong government policy guiding the health programme, including maternal health programmes and formalized referral links among facilities and the providers, including community providers such as TBAs.
While there has been considerable attention on the other factors, Accountability for Government and Providers’ Performance which ought to be a topic agenda and in the front bannerhas not been sufficientlyfocussed.Consequently, Initiative for Health Accountability and Transparency (IHAT) is putting Public Accountability forMaternal and Child Mortalityin the spotlight using Data Analytics Visualisation and ensuring that the ugly situation get a great deal of public attention and political commitment.
Justification
Given the magnitude of maternal and child deaths, the public deserve the “Right to Information on Maternal and Child Deaths”. Therefore, the need for constant and regular public visibility of the burden of maternal and child deaths is most plausible, for holding the government and providers accountable.Our Quarterly National Health Barometer e - Newsletter and Infographic Videos will be used to bridge routine information gap and furnish appropriate evidence to inform Advocacy and Mobilisation of the public towards maternal and child mortality reduction.
Conceptual Framework
Against WHO and UNICEF estimates, available data on the NHMIS database (dhis2) is under-reported but sufficient to draw consciousness to the magnitude of maternal and child deaths.
To fulfil the purpose of promoting public accountability for maternal and child deaths and routinely connect the public with health situation and events, and enhance social accountability, the initiative will be premised on the following elements:
- Data Analytics Visualisation to be based on data on the NHMIS database (dhis2)
- Online Communication with the public and strategic stakeholders with the Barometer e – Newsletter and Infographic Videos through website/social media.
- Engaging and Prompting the Relevant Actors at all levels.
- Encouraging Insightful Actions of Government and Providers to address the challenges.
Specific Objectives
Data on the dhis2 of the National HMIS will be used to create and publish National Health Barometers e - Newsletter and Infographic Videos aimed at achieving the following objectives:
- To routinely connect the public with health situation and events based on the reported routine data
- To draw more consciousness to performance indicators, particularly of mothers and children's healthcare.
- To broaden public support and strengthen political commitment
4 To use the public for validation of reported data on maternal and child deaths
- To enhance surveillance of maternal and child deaths.
- To encourage data reporting and use by providers, states and LGAs.
- To enhance public and community support to improve maternal and child health
Programme Description
Based on the four elements of the conceptual framework, and working with the Federal Ministry of Health and relevant stakeholders, data on the National Health Management Information System (NHMIS) dhis2 database will be used to generate analytics visualization in our quarterly Barometer e – Newsletter and Infographic videos which will be widely disseminated using electronic and social media.
Through the medium of the Barometer e – Newsletter and the Infographic Videos, the number of maternal and child deaths, where they are happening and the major causes of the deaths will be highlighted and routinely communicated to relevant stakeholders including the government, health, political, traditional and community leaders, and the CSOs and the media who will be engaged and prompted for action.
In addition, there will be targeted advertorial on the social media focusing on select personalities such as political leaders and representatives, and the providers in highly burdened areas. This strategy will be aimed at linking the personalities with outcomes in their locality.
It is expected that the intervention will broaden public support and strengthen political commitment for maternal and child mortality reduction efforts, and activate insightful actions by the government, providers and the partners.
The Barometer will be used for anchoring public accountability for maternal and child mortality reduction campaign.
Be part of the great effort by following our Quarterly National Health Barometer e - Newsletter and Infographic Videos at https://www.youtube.com/channel/UCZ-v6IlaAf3K_XytY5-tXSg?view_as=subscriber
You Can Hold Your Leaders and Representatives Accountable for Avoidable Loss of Lives.
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NOTE:
Public Accountability for Maternal and Child Deaths Using Data Analytics Virtualization is a project at initial stage of development, in need of partner and financial support and innovative in terms of narration, content, animation and virtual reality.
With time, our focus will be expanded to include other maternal and child health key performance indicators.
Dr M. J. Abdullahi.
He is the Convener of Abuja, Nigeria based Initiative for Health Accountability and Transparency (IHAT)
