Impact of alternative community engagement strategies on improved maternal and child health behaviours and outcomes among the most vulnerable in northern Nigeria

  • Sally E. Findley Columbia University Medical Centre
  • Henry V. Doctor World Health Organization
  • Godwin Y. Afenyadu Nassarawa GRA, Kano
Keywords: heath systems research, community engagement, maternal and child health, Nigeria


Low-status women typically have poorer maternal and child health outcomes. In northern Nigeria, we piloted alternative models for engaging vulnerable women and facilitating an improvement in their maternal health outcomes.  We assess the net impact of an integrated health system improvement model focusing on ensuring emergency obstetrical services for clusters of affiliated primary health care clinics, on the relative additional impact of alternative community engagement (CE) strategies.  Analysis of baseline to endline survey data (2009-2013) showed that proportions of women making antenatal care (ANC) visits and who delivered with a skilled birth attendant doubled.   Maternal and infant mortality also declined.  Greater improvements with more ANC visits and skilled birth attendance were associated with being   non-poor, owning a cell-phone, being less socially excluded, being satisfied with improvements in the clinic, and participating more in CE activities. Efforts to increase participation in CE activities can further enhance outcomes for the vulnerable women

Author Biographies

Sally E. Findley, Columbia University Medical Centre
Mailman School of Public Health15
Henry V. Doctor, World Health Organization
Regional Office for the Eastern Mediterranean, Department of Information, Evidence and Research, Health Information and Statistics
Godwin Y. Afenyadu, Nassarawa GRA, Kano
Women for Health Nigeria