Asides from our clients’ initiatives, BH supports promising systems-directed initiatives that are positioned to deliver sustainable change and improve people’s lives.
Maternal & Reproductive Health Research Collective
MamaBase
Let’s Keep Mothers Alive.
According to the World Health Organization (WHO), the maternal mortality rate (MMR) in Nigeria is 1047 (per 100,000 live births). Studies have shown that poor access to high quality antenatal (ANC) and postnatal care (PNC), poor uptake of primary care and low utilization of skilled health personnel(1), including hostilities between midwives and traditional birth attendants (TBAs) are contributing to the high MMR in Nigeria (2). Other barriers to accessing obstetrics care include unavailability of transport services to reach the health facilities and a poor referral system (3,4). These issues are further exacerbated by the lack of good-quality data on maternal and child health (5,6,7). Incomplete and inconsistent data is a barrier to the use of secondary data for evaluation of services and programmes, and for evidence basedpolicy decision making and research (8). Electronic health (eHealth) solutions have the potential to improve quality of healthcare by addressing many inefficiencies and shortcomings embedded in health systems. However, many low and middle income countries (LMIC) including Nigeria, lack standardized and comprehensive national registries or registration systems that provide background data on Maternal & Child health disease and outcomes. A number of eRegistries or electronic records have been developed for LMIC’s however, many remain fragmented and in pilot phase without nation-wide implementation. Most do not have a link to any health service outcomes or improve provision of services.
A comprehensive tracking system including community-based reporting, investigation and review processes to augment official registration of maternal and child deaths as well as births, is important to identify death-specific factors and to classify associated barriers to maternal and child care. These factors are crucial to provide better understanding for the design and implementation of interventions to reduce maternal and child mortality (9,10). Availability of a seamless, sustainable, and secure data information exchange at all levels of healthcare is crucial in delivering high quality healthcare in a safe and cost-effective manner.
Our goal is to create a digital online-offline registry and database system for real-time surveillance of maternal and child health outcomes at the community level in Nigeria through;
(i) Development, launch and implementation of a maternal & child health eRegistry platform that captures women at the community level and across all PHCs
(ii) Coordinated referral and linkage system to care across all levels of the healthcare system
The primary outcome will be reduction of maternal mortality rate, by providing improved services, collecting data and evidence to better understand which populations of households, pregnant women, mothers, and newborns are most susceptible to poor health outcomes and why. This includes understanding care pathways and identifying and addressing the barriers that prevent these women and newborns from receiving high-quality care, as well as adequate nutrition during pregnancy and immunization in the first five years of life.
In the maternal and child health context, primary data on health interventions is created when a woman is booked for antenatal care, and data on her health and the services she receives is subsequently added, retrieved and reported from her personal file over a continuum of community and facility services. In many low resource settings, paper registers and patient folders are pervasive and make timely review and analysis of data cumbersome. Manual extraction of data from paper files also leave room for human error and subsequently lead to poor quality data and underutilized health information. Our goal is to create a system that can seamlessly collect, triangulate and verify maternal health data while linking mothers and their babies to care across different levels of the health system. Within every state where we work, we will prioritize supporting the State Ministry of Health and Government to digitize the core data collection tools for maternal, newborn, and child health at the community level. In the design of the registry we will work with the government to generate unique ID numbers for women and their offspring within the community to ensure that the data collected from women and frontline health workers can subsequently be linked to individual level patient data from primary health care facilities where they seek care (primary health centers, private clinics, health posts, TBA). The registry data will enable the government and other researchers to evaluate facility and non-facility outcomes, including patient reported experiences and outcomes of pregnancy and childbirth as well as support the development of referral and/or linkage to care systems across the community, PHC, and secondary facility levels. Further expansion to other states will be discussed and carried out based on success of the initial pilot and funding availability.
A registry based on systematic and uniform data with predefined health outcomes and determinants, including care provision. Establish an efficient data management platform where all information relating to the women all through the pregnancy period is captured and can be accessed by stakeholders. Enrolls and follows up on pregnant women and their newborns up to 90 days postpartum. . The project will focus on clinical care, research and surveillance through the following;
(i) Identifying and registering all pregnant women in indigent communities in Lagos State
(ii) Create unique iDs
(ii) Link these women to public primary health facilities in their communities
(iii) Develop content for maternal health messages to be shared with registered women throughout the period of their pregnancy and engage with women routinely on the quality of service they receive at the health facilities
Sites: 57 LCDAs across 325 PHC’s in Lagos State for the initial pilot. Then expanded to six other state sites to include Ogun, Kano, Kaduna, Oyo, Edo and Delta states and eventually all 36 states.
MRHR Collective is a Maternal and Reproductive Health organisation established to reduce the rate of pregnancy-related illness and death, and improve the reproductive health of Nigerian women. We are passionate about the overall well-being of Nigerian women, because we believe that supporting women’s reproductive health is a key part of creating a safer, more prosperous world for every person. Through research, advocacy, training and direct intervention programmes, we work with our partners to provide comprehensive solutions for Nigerian women.
