Evidence-based strategies lower maternal mortality

Nigeria Health Watch, WHO, and others offer maternal health care.

Nigeria's 914 maternal deaths per 100,000 live births are 19% of worldwide maternal fatalities.

WHO: 154 15-45-year-old Nigerian women die daily from pregnancy and childbirth-related causes. Northern Nigeria has the world's highest maternal death rate.

58,000 Nigerian women die from pregnancy and delivery complications, costing $1.5 billion.

The Nigeria Health Watch has spent 18 months promoting maternal health via MSD for Mothers-supported initiatives.

Nigeria Health Watch promotes healthcare via action and communication.

MSD for Mothers aims to prevent maternal mortality with $500 million.

On 1 June 2022, Nigeria Health Watch MD Vivianne Ihekweazu said:

"We'll summarise the findings and offer methods to improve maternal health in Nigeria.

"We've worked with you to promote ideas and evidence from MSD for Mothers partner programs that aim to help Nigeria achieve the SDG goal of a worldwide MMR of less than 70 per 100,000 live births by 2030."The project's six topics were quality of care deficits, quality assurance, private sector capabilities, affordability, and digital support/technology.

She said Evidence for Change intends to emphasize the need of adopting a quality-of-care approach to providing maternal health care in Nigeria via MSD for Mothers-supported programs.

This workshop will finish with key learnings and new solutions from our programs. Ihekweazu said having Nigeria's key players present helps them understand health care issues. Ihekweazu mentioned the Kaduna State Ministry of Health, PHIMA, PCN, ANPMP, and AGPNPN as significant players.

 The Nigerian Maternal  Database aims to reduce maternal and perinatal mortality, which was 576 per 100 000 live births and 77 per 1000 in 2013. (NDHS).

Ify Babatunde-Yusuf reported on Ezekwe. She stated many women risk danger.

She advocated keeping a full, accurate, standard medical record throughout labor, delivery, and early postnatal period.

Every health institution should have a data collection, analysis, and feedback system, said Ezekwe.

QED project process indicator: Creating facility-based routine data gathering systems for maternal and perinatal mortality and near-miss.

Nigeria is one of nine first-wave nations adopting Quality of Care to minimize maternal and newborn mortality.

She stated the WHO Quality, Equity, and Dignity (QED) campaign is one way to achieve the SDGs.The doctor said reducing MMR to two-thirds of 2010 baseline levels depends on affordable, accessible, acceptable, quality treatment in an enabling environment that respects human rights.

The SDGs seek to end maternal and neonatal mortality by 2030, according to WHO.

Ezekwe stated the MPD-4-QED Program is for referral-level hospitals, mothers hospitalized within 42 days after birth or abortion, and their babies.

Ezekwe said program success needs ownership at various levels, including hospital management and government, and transfer to FMoH is happening.

She said operations' (including financial) skills must be improved to host the website, interface with DHIS2, and match with hospitals' EMRs.

Ezekwe stated FMoH won't pay stipends, thus data collecting needs new strategies. Attrition (reposting/relocating skilled data collectors and hospital coordinators) and stipend cuts reduce data collection. New workers need training, she added.

She stated doctor strikes and COVID-19 impacted hospital patronage.

"Change Evidence" "topic What are the reported data, outcomes, and effects? How do they prove sustainability, scale-up, or adoption? The biggest, according to Ezekwe.

First-year: 69,055 live births, 4,498 stillbirths, 1,090 neonatal deaths. 1 percent of vital status data was missing as of May 31 for 213,584 mothers (and newborns).

The investigation improved treatment, she claimed. Example: labor monitoring and companionship.

Prospective monitoring of maternal and perinatal data, including quality of care indicators, is crucial for meeting WHO QED program goals and the third SDG targets at the country level, says a public health physician.

Ezekwe advised launching a statewide database project in nations with comparable medical record architecture as Nigeria to discover policy-altering solutions. With more facility births and digitization of national health management systems, this approach may be extended, she added.

Ezekwe said the WHO works with public and private sector partners to help doctors. Professor Isaac F. Adewole initiated the effort in April 2019.

Six private hospitals joined public ones.

SOGON and AFEMSON discussed maternal and baby care using program data.

"A Nigerian IT business was hired to construct and operate the web-based platform, educate collaborators, and increase the FMoH ICT Department's ability to maintain it."

The Honourable Minister of Health (HMH) authorized MPD-4-QED as a platform for combining MPDSR and QoC at tertiary institutions.

Ezekwe said MPDSR seeks the President's permission.

MDSR probes maternal deaths. It studies maternal fatalities to enhance treatment and avoid future deaths.

mDoc optimizes self-care for those with frequent and chronic health needs by merging quality improvement, behavioural science, data, and technology.

mDoc's high-tech, the high-touch approach helps Nigerians with chronic sickness. Using behavioral science, quality improvement methods, data, and technology, they provide integrated chronic and routine care.

remarked Abiakam "NudgeHubsTM and community ambassadors; MQNTM physician and patient tele-education.

NaviHealth.aiTM helps people locate good treatment.

Our geo-coded directory finds healthcare.

"Patients should be reviewed. They boost confidence. NaviHealth.ai leverages NAMC's quality dimensions (safety, timeliness, effectiveness, equality, efficiency, and patient-centered care).

Abiakam stated mDoc helps breast cancer patients self-care and offers pharmaceutical finance via Rupe-Flexi.

CompleteHealthTM helps HER2+ breast cancer patients afford treatment.

Abiakam stated the purpose of delivering virtual care to women of reproductive age under RICOM3 is to minimise MMM from indirect causes by employing a QoC approach to promote prevention, early identification, and treatment of indirect causes of MMM connected with PE/E. (WRA).

She noted indirect MMM factors that elevate PE/E and early CVD risk are treatment targets.

Abiakam declared they have 40 hospitals and clinics in four LGAs/districts in two "states" (20 each state).

Women-centered QoC decreases PE/E-related indirect MMM.

Abiakam said the initiative delivers onsite skills-based training, virtual sessions, supportive supervision and mentorship, and work aids and guidelines.

She stated the organisation discovers quality gaps, defines improvement targets, creates QoC measurements, helps QI teams test modifications (PDSA), and tracks progress toward goals. HMIS makes decisions.

Abiakam claimed ladies have WhatsApp/SMS help. "Tele-ECHO self-care sessions for ladies," she stated.

Abiakam said all chosen coaches share wins and learn from colleagues.

Self-efficacy grew 41% to 84% between baseline and follow-up, as did digital literacy and health literacy.

54% BP improvement, 63% BP control are good early numbers. We employ numerous strategies to enhance digital and health literacy, she added.

Abiakam stated CompleteHealthTM reached 67,000 women of reproductive age, primarily in Lagos and Abuja, 74% of 18-to-49-year-old women, and 69% of smartphone-owning women.