Quality of Care in Nigeria

As part of Government’s stewardship role and accountability to its citizens in ensuring a healthy population which is crucial to national development, improving the quality of care has been identified as a key priority in its effort to reduce maternal and newborn mortality.

The technical updates from participation at the launch of the Network and other regional meetings of the Network coupled with technical support through missions from WHO Afro and Geneva, the implementation of the MNH quality of care has been a pathfinder to other health issues.

In domesticating the QoC MNH initiative, under the leadership of Government and with collaboration with sub-national level, Professional associations for  Obstetrics ,Paediatrics/Neonatal medicine and Midwifery   and Development partners (WHO, UNICEF,  USAID/ MCSP UNFPA and  Pathfinder International), a national strategy for improving quality of care for maternal, newborn and Child  health (MNCH Phase 1) was developed in 2018. Also WHO maternal and newborn health quality of care standards was adapted.

The Network: 39 Local Government Areas in Eleven (11) states and FCT have been selected to be the first wave learning districts. Within the Network, 113 health facilities which are reflective of the high MNH burden in the states and represent an equitable geopolitical spread have been selected as the learning sites for the Quality of Care Network. The quality of care aims identified includes:

Maternal health:

  • Improve the prevention and management of postpartum haemorrhage through the use of partograph, uterotonics drugs and AMSTL,
  • Improve the treatment of eclampsia with Magnesium Sulphate, reduce the occurrence of sepsis.
  • Foster respectful maternity care

Newborn health:

  • Increase the practice of skin to skin contact
  • Reduce birth asphyxia
  • Decreases the cases of sepsis through the use of chlorhexidine for umbilical cord care

We are taking a phased approach:  in  phase 1 quality aims for implementation at the learning sites –Maternal health: prevention and management of postpartum haemorrhage through the use of Uterotonics drugs and Active Management of Third Stage of Labour (AMTSL) and Newborn health: increase the practice of skin to skin contact to prevent hypothermia.

We will be supporting health workers at the health facilities to improve maternal and newborn health through quality improvement cycles, clinical mentoring and peer to peer learning.

Conclusion:  The journey in domesticating this initiative in a decentralized system of Government has been a learning curve with success stories and challenges.

Photo: A mother and her child wait to receive care at a UNICEF-supported mobile MNCH clinic in Farankasa village, Zamfara State, Nigeria. © UNICEF/Knowles-Coursin