GOMBE MNHC PROJECTGOMBE MNHC PROJECT

11STST Quarter 2015 FactsheetQuarter 2015 FactsheetLarrydeel Maina

Society for Family Health, Nigeria…Creating Change, Enhancing Lives

INTRODUCTION

¢ Data collation and analysis are considered to be important component of data management. The collation and analysis of this fact sheet is based on routine management information system [MIS] data reported during the period under review. Routine data is collected from frontline workers [FLWs] comprising TBAs, FOMWAN volunteers, ETS, Call center and Health Facility performance Based Incentive [PBI] data.

¢ The monitoring and evaluation unit helps in tracking the progress of implementation of the project response to improve policies, programs and service delivery.

…Creating Change, Enhancing LivesSociety for Family Health, Nigeria

MNHC Focal LGAs 10 Estimated Population 2, 801, 892 Estimated Live birth 130, 568 Estimated home deliveries [CS -56%] 73, 118Estimated Pregnancies 150,153 Estimated pregnancy complications [EmOC] 19, 585Maternal deaths [Gombe State] 752 [based on 2013 NDHS 576/100,000]

Maternal morbidity [Gombe State] 22, 560 [at least 30 per 1 maternal death]

Number of TBAs 1,160 Number of FOMWAN volunteers 290 Number of ETS volunteers 392 Number of MNHC referral facilities 117

BACKGROUNDBACKGROUND

1,160 TBAs identified and reached 24, 341 new pregnant women and 13, 423 new mothers with key MNHinformation messages at home. 5, 411 women in labor, 3, 909 pregnant women and 2, 082 neonates withcomplications were referred and accompanied to health facilities. The number of home deliveries by TBAs is4, 537 and 2, 673 of all imminent home deliveries were conducted with CDKs. The number of newbornsdelivered by TBAs at home is 4, 448

290 FOMWAN volunteers visited 2, 798 new pregnant women and 2, 227 new mothers at home with key MNHinformation and messaging. They were able to refer 708 pregnant women with maternal healthcomplications and 177 neonates to access MNH services in health facilities in urban areas of Gombe State.They were able to provide 75 CDKs to pregnant women as birth preparedness strategy during home visits.

392 ETS volunteers were able to transport 577 women in Labor, 287 pregnant women identified to havematernal health complications, 76 neonates identified with complications and 75 new mothers with postnatal complications within 7 days to health facilities.

The call center received a total of 4, 345 productive calls from both within and outside the State. 1, 949 pregnantwomen, 216 women in labor/delivery cases and need maternal health information and services and 506women with post delivery complication called the call center for maternal health information and services.

…Creating Change, Enhancing LivesSociety for Family Health, Nigeria

FAST FACTS FAST FACTS –– at a glanceat a glanceFAST FACTS FAST FACTS –– at a glanceat a glanceTraditional Birth Attendants [TBAs] – Rural Strategy

Federation of Muslim Women Association of Nigeria [FOMWAN] – Urban Strategy

Emergency Transport Scheme [ETS]

Call Center

HOME VISITS [ACHIEVEMENT]¢ 1, 450 frontline workers [1,160 TBAs and 290 FOMWAN volunteers ]

established 47, 366 contacts with pregnant women and newly delivered mothers.

¢ 27, 139 pregnant women were identified and reached with pregnancy related health messages during home visit IPC sessions.

¢ 15, 650 newly delivered mothers were identified and reached with post delivery messages at home by the FLWs.

¢ 75% of all the pregnant women identified by the FLWs were revisited at least once during that pregnancy.

¢ 86% of all the newly delivered mothers identified by the FLWs were revisited at least once during the 1st 7 days of delivery.

Expected Number of contacts to establish

Total number of contacts established

Average numberof contacts established/week

TBAs 4 per week [55,680] 67, 053 5

FOMWAN 3 per week [10,440] 9, 385 3

HOME VISITS - DATA SPEAKS

New visit Revisit New

visit Revisit

Pregnant women New mothersJan-15 8574 6320 5476 4599Feb-15 9339 6939 5250 4550Mar-15 9226 6968 4924 4273

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

0 2 4 6 8

Achieved Target

New mothers

On average, 72% of estimated pregnant

women and 48% of all newly delivered mothers

in Gombe between January to March 2015

were visited at least once by either a TBA or a FOMWAN volunteer

Pregnant women

OOBSTETRIC AND NEONATAL COMPLICATIONREFERRALS

¢ A total of 13,227 referrals were made by the TBAs, FOMWAN and ETS volunteers.

¢ 4, 904 pregnant women with pregnancy related danger signs were referred, accompanied or transported to health facilities by the TBAs, FOMWAN and ETS volunteers.

¢ 5, 988 women in labor were referred, accompanied or transported to health facilities for skilled delivery.

¢ 2, 335 neonates with complications were referred, accompanied or transported by TBAs and ETS volunteers to access health services.

¢ 100% of estimated pregnant women with pregnancy related complications/danger signs in Gombe were either referred by the TBAs, FOMWAN or ETS volunteers and accessed EmOC services by skilled service providers.

Number referred, accompanied or transportedPregnancy complications Women in Labor

Neonatal complications

TBA 3, 909 5411 2082FOMWAN 708 177ETS 287 577 76TOTAL 4, 904 5, 988 2, 335

EMOC REFERRALS - DATA SPEAKS

0

500

1000

1500

2000

2500

Pregnancy Complication

Women in Labor

Neonatal Complication

TBAs Jan-15TBAs Feb-15TBAs Mar-15FOMWAN Jan-15FOMWAN Feb-15FOMWAN Mar-15ETS Jan-15ETS Feb-15ETS Mar-15

Jan-15

Feb-15

Mar-15

Jan-15

Feb-15

Mar-15

Jan-15

Feb-15

Mar-15

TBAs FOMWAN ETSPregnancy

Complication 104812771584 242 211 255 90 88 109

Women in Labor 134420342033 150 187 240Neonatal

Complication 594 704 784 59 65 53 23 30 23

0

500

1000

1500

2000

250033% of estimated home deliveries were either referred and accompanied by TBAs or transported to

health facilities by ETS volunteers.

DELIVERY AND DELIVERY RELATED

¢ 4, 537 imminent deliveries were conducted at home by the TBAs.

¢ 4, 448 newborns were delivered by the TBAs.¢ 59% [2, 673] of all home deliveries were conducted using

clean delivery kits.¢ 2, 166 neonates in the urban were visited and seen at home

by the FOMWAN volunteers.¢ 96% [2, 068] of all neonates visited and seen at home by the

FOMWAN volunteers were revisited in the first 7 days of life.

Number of delivery and delivery related

Jan -15 Feb-15 Mar-15Imminent home deliveries 2, 230 1,384 923Deliveries with CDK 1, 408 847 418Newborns delivered 2, 170 1, 367 911Neonates seen and visited 756 741 669

DELIVERY AND DELIVERY RELATED - DATA SPEAKS

Imminent home

deliveries

Home deliveries with CDK

Newborns delivered

Neonates seen

[Urban]Jan-15 2230 1408 2170 756Feb-15 1384 847 1367 741Mar-15 923 418 911 669

0

500

1000

1500

2000

250059% of imminent home deliveries were conducted

using clean delivery kits.

Dec-14 Jan-15 Feb-15 Feb-15 Mar-15

Imminent home deliveries

Home deliveries with CDKNewborns delivered

¢ A total of 6, 338 callers attempted calling the call center within the reviewed period.

¢ 4, 335 calls were productive calls [calls with full length conversation].

¢ 32% of all attempted calls were non-productive.

¢ 48% of all productive calls were initiated and referred by the FLWs.

¢ 75% of all productive callers were referred for skilled services.

¢ 4% of referred callers were followed on with calls to ascertain/confirm access to services and satisfaction.

CALL CENTERSegregation/Month

Jan-15

Feb-15

Mar-15TOTAL

Volume of calls

Productive calls 1,298 1,257 1,780 4,335

Non productive calls 835 615 553 2,003

Referrals by volunteers

TBAs 340 432 833 1,605

FOMWAN 176 131 173 480

ETS 6 1 1 8

PPMV - 1 4 5

Referral to Health facilities 864 967 1,406 3,237

Follow on calls - 33 81 114

CALL CENTRE - DATA SPEAKS

48% [2,698] of estimated number of maternal morbidities [5, 640] between January to March 2015 in Gombe accessed the call center for information

and services.

750 759

1189

1880 18801880

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Jan-15 Feb-15 Mar-15

Maternal morbidity AchievedMaternal morbidity Target0

100

200

300

400

500

600

700

800

900

1000

Indicator achieved Jan-15 Indicator achieved Feb-15Indicator achieved Mar-15

¢ Both TBAs and FOMWAN volunteers need to re-double their efforts in terms of home visits to newly delivered mothers within the first 7 days of delivery –during such visits, the FLWs have the opportunity to further communicate key post-delivery messages as well merits of exclusive breastfeeding.

¢ Despite the downward trend in imminent home deliveries conducted by TBAs, efforts on maternal and neonatal health referrals by all the FLWs need to improve while concurrently improving home visits to determine clients that needs referrals for skilled services.

¢ There is need to increase the number of call center staff to effectively manage all calls because the proportion of productive calls and non productive calls is marginal and is interpreted as inability of a staff to effectively manage all calls during a shift.

CONCLUSION/RECOMMENDATION