PAS coalition in Kaduna state has asked for increased awareness, social mobilization for the RMNCH+N services, and increased access to hard-to-reach area for routine immunization distribution in order to increase coverage in the state. The coalition also called for enhanced policy, planning, and institutional framework, enhanced funding for predictable financing, and adequate and timely release of funds in the state. This was disclosed during the RMNCH+N week in Kaduna

The Maternal and Child Health Week (MNCHW) was introduced amongst other measures, as a priority and strategic action to accelerate the reduction of child mortality and improvement of maternal health. This intervention was primarily intended to improve access to essential, quality maternal and child health services, consistently with the objectives of the 2007 Integrated maternal and Child Health Strategy. MNCHW was launched in Nigeria in 2009, as a bi-annual campaign-style programme designed to deliver key child and maternal health interventions and to revitalise health care systems. It is a week-long event organized by the National Primary Health Care Development Agency (NPHCDA), State Primary Health Care development agencies (SPHCDA), and the State Ministries of Health (SMOH). 

The week was organised to deliver an integrated package of highly cost-effective and curative services/interventions like antenatal care in order to strengthen the routine PHC services. The NPHCDA describes the week as ‘a simple one-time delivery mechanism that consolidates services that are likely to immediately demonstrate impact in terms of significantly increasing coverage levels of core preventive and curative interventions that can improve the health of mothers and children. The programme has the potential of significantly increasing coverage of key maternal and child health interventions through efficient social mobilization that creates awareness and participation. This can only be possible through effective partnership, adequate and timely release of funds and complete commitment by the state government. The objectives and related outcomes of the maternal week are consistent with the priorities of Nigeria, and still relevant. 

 

Pre-Implementation Activities Carried Out:

MNCHW CONTEXT SPECIFIC	BUDGET ITEM
Planning Meetings	Stakeholders, Micro-planning, work-plan development, advocacy meetings, review and planning meetings at state level
Training State level	LGA, Ward levels and health workers
Supplies and   Logistics	Wipes Scissors, supplies for other interventions e.g., Deworming, Iron folate procurement
Social mobilization	Town announcement, Radio jingle /TV, Community dialogue, Rallies/ banners
Monitoring and evaluation	LGA, State, Federal
Data coordination	Rapid SMS, Printing of data tool, LGA Operation room, State Operation room,

 

Objective of the Kaduna State MNCHW

The specific objectives of MNCH Week focused on the reduction of maternal, perinatal, infant and childhood mortality and morbidity and the promotion of reproductive health and the physical and psychosocial development of the child and adolescent within the family. 

 

Component of the Kaduna State MNCH Week

The MNCHW components include family planning and reproductive health services, maternal, new-born, and child health services; health communications; health commodities and supplies; and health systems strengthening. The health services are provided to mothers (women in their child bearing age) and children. The targets for MCH are all women in their reproductive age groups, i.e., 15 – 49 years of age, children, school age population and adolescents.

 

MNCHW Financing

While there exists an information gap on the actual cost of implementation of MNCHW in Kaduna state in 2021, review of budget planning indicates that two third of the total funding is being contributed by the states and LGAs budget.

 

Implementation of the MNCHW

The implementation of the MNCHW in Kaduna state was conducted in all the 274 PHCs in the state. Some of the bottlenecks experienced during the MNCHW include; low rates of MNCHW attendance due to security situation, issue of distance travel to the MNCHW delivery point, stock-outs/not receiving the intervention on time, negative experiences on visiting health facilities by caregivers, late disbursement of funds and logistic material and inadequate HR to manage/provide service during the MNCHW. 

As part of the effort to proffer solutions and evaluate some of the bottleneck experience during the MCHNW, the Kaduna State Primary Health Care Development Agency (SPHCDA) held the state RMNCAH+N TWG meeting at I-care women and youth center on the 24, June 2021. The objective of the RMNCAH+ N TWG meeting is to take update on mid-year RMNCH+N 2021 AOP review, review the level of implementation of RMNCH+N activities of April- May 2021 from the 2021 AOP and discuss the best way to achieve implementation of Q3 activities from the 2021 AOP. Participants for the meeting were drawn from UNFPA, FHANI, SPHCB, GIWAC~PAS, LGHA, State coordinators of reproductive health at LGA and ward level, director of community health SPHCB, SMOH and CSO organization, a total number of fifty-six participants participated in the meeting.  Twenty-four males and thirty-one females. The goals of the RMNCAH+ TWG is to Strengthen coordination between malaria and RMNCH+N programs, mobilize and leverage on existing resources to increase demand and uptake of RMNCH Services and improve quality of malaria-related RMNCH+N services.

Thematic Area of the RMNCH+N TWG meeting discussion Focuses on;

• Status of implementation of RMNCH+N activities from April -May 2021
• Funding sources for the planned activities 
• Amount and proportion of funding from government and partners for the implemented RMNCH+N activities i.e.  MNCHW 
• Amount and proportion of funding from government and partners for non-implemented RMNCH+N activities i.e.  MNCHW 
• Proportion of RMNCH+N activities type

Recommendations

• Increased awareness and acceptance -Branding -social mobilization for the RMNCH+N services
• Increased access by increasing HF conducting MNCHW -outreach in hard-to-reach area -Routine distribution
• Enhanced policy, planning and institutional framework
• Enhanced funding for predictable financing 
• Advocacy for adequate and timely release of fund 

Next Step

Kaduna PAS coalition will monitor the recommendations to ensure full implementation.