Community Health Workers Make a Difference: Evidence of Program Impact on Improving Maternal, Newborn, and Child Health Behaviors in Northern Nigeria

Northern Nigeria’s infant and child mortality rates have been stagnant or rising since 2005. In 2009 we became part of a partnership program to improve maternal, newborn, infant and child care in four Northern Nigeria states. Control Local Government Areas received less-intense statewide policy changes, while the intervention zones received these state policies plus integrated interventions at primary health care posts and development of a community-based service delivery (CBSD). We assessed changes in maternal, newborn, and child health (MNCH) care and services among women with births in the previous five years by comparing data from surveys of 6,345 women in 2009 and 3,320 women in 2011. Chi-square and t-tests document significant improvements in several maternal newborn, infant, and childcare practices. We found that pregnant women with antenatal care visit during the most recent pregnancy increased from 25% to 46%, 58% and 62% in the control, low intensity and high intensity areas, respectively. In general, the greatest improvements in MNCH care are seen among women in the communities with more interactions and potentially more intense CBSD activities. Regressions showed the differential impact of these interventions by social and economic vulnerability, with less impact in the most vulnerable communities.