Abuja, 7 November, 2019 - Primary Healthcare Centres (PHCs) in the Federal Capital Territory (FCT) are stepping up efforts to improve the quality of care (QoC) given to new mothers at their facilities. Maternal mortality is an issue of concern in Nigeria. Every year, at least 58,000 Nigerian women die while giving birth, and at least 800 women die in every 100,000 live births. (WHO/UNICEF/UNFPA ).

“I’m happy with the way the midwife treated me throughout my labour,” says Mrs Chinyere Eze who delivered a baby boy at the Bwari General Hospital recently. “They were very professional and I’m glad I didn’t have any complications,” she adds. 

To record more postnatal success stories like Mrs Eze’s, with a mission to improving QoC provided to Nigerian mothers; health workers from 10 Health facilities, including seven PHCs and three Secondary health facilities gathered in Abuja on 23 October 2019 to compare notes and discuss the best way to tackle issues of poor maternal health. With Supports from the World Health Organization (WHO), 35 trained healthcare providers attended the peer-to-peer learning session on improving maternal, newborn and child quality of healthcare.

Speaking during the session, Mr Akila Udoji, the Officer in Charge of the Karu PHC expressed gratitude to WHO and the Federal Ministry of Health (FMoH) for introducing the QoC programme and building capacities of health workers. 

“QoC has really changed the way we give pre and postnatal care in Nigeria,” says Mr Udoji. 

“Based on training sessions, for instance, we’ve learnt the importance of things such as ‘skin to skin contact’ between mother and child immediately after childbirth as it goes a long way to keep babies warm, increase bonding and the experience of care. In essence, the QoC initiative has instigated a behavioural change generally in the way we handle new mothers. We are happy with this initiative”, he said. 

Successes recorded in 10 health facilities
Dr Iniobong Ekong, the focal person for FCT QoC implementation stated that the initiative has been successfully rolled-out in 10 health facilities in  Nyanya, Bwari and Kwali General Hospitals, and Karu, Gbagalape, Kuchigoro PHCs (Abuja Municipal Area Council); Kogo and Ushafa PHC (Bwari Area Council); and Dabi-Bako and Kwali Central PHC (Kwali Area Council).

“Frontline health workers in these facilities were trained on a new approach to care which involves identifying problems and proffering local solutions that will reliably deliver better care for mothers and new-borns around the time of birth without seeking significant additional resources”, said Dr Ekong. 

“Quality improvement(QI) approaches have also been adopted in preventing hypothermia in new-borns by ensuring immediate skin-to-skin contact for at least one hour after delivery, immediately drying them as well as measuring and recording their temperature exactly 1 hour after birth. As a result, on the average across the facilities, hypothermia has remarkably reduced from 95% down to 19%. In addition, the proportion of women receiving uterotonics within 1 minute of delivery (used to prevent post-partum haemorrhage) has also increased from 0% at baseline (no records kept previously) to 66.6%”, he added. 

In order to ensure improvements are sustained, WHO supported the facilities to hold monthly meetings and regular QI coaching visits. The facilities also partake in quarterly-peer-to-peer experience sharing meeting. Data collated at the second meeting (23 October 2019) indicate marked improvement across all the facilities, with all of them having remarkable results to show and share how it was done. This represented an improvement from the initial quarterly meeting where only 4 out of 10 facilities had shown improvement. In addition, Government is providing infrastructural upgrade and equipment to these facilities to support their QI aims. 

Improving quality of care at the PHCs
“WHO is working to ensure maternal mortality becomes an issue of the past in Nigeria,” says Dr Muyiwa Ojo, WHO focal person for Maternal Health. “Furthermore, WHO set up an initiative called QOC Quality, Equity and Dignity (QED), with a network of countries aimed at promoting Safe, Timely, Effective, Efficient, Equitable and people centred healthcare. It is imperative that all health facilities in Nigeria provide care that takes into account the preferences and aspirations of individual service users, provide highest level of quality and the cultures of their communities”. WHO continues to provide technical support to the Federal and states ministries of Health on implementation of maternal, newborn and child health QoC. 

Maternal mortality was top of the agenda at the WHO-supported sixty-second National Council on Health. During the opening of the of the council in Asaba, Delta State, Nigeria’s  Minister of Health, Dr Osagie Ehanire declared that stakeholders must work together to ensure that maternal deaths is reduced by over 90 per cent (less than 3 000 maternal per year) by the year 2030. At the meeting, the National Strategic plan for MNH QoC was approved for use in the country. 

WHO is committed to ensuring Nigeria achieves this goal in line with its mandate of promoting universal health coverage and propelling the sustainable development goals (SDGs). As a strategic partner, WHO Nigeria will continue to support the Nigerian government to strengthen the health system towards better health outcomes for women and children.

Technical Contacts:
Dr Joy Ufere; Email: uferej [at] who.int (uferej[at]who[dot]int); Tel: +234 803 979 5143