REPORT ON THE MATERNAL NEWBORN AND CHILD HEALTH WEEK (MNCHW) IN NASARAWA STATE ON 11TH to 15TH NOVEMBER 2019

SUMMARY

The MNCHW is an approach organized to deliver an integrated package of preventive services that are cost effective, yet, result-oriented for improving Maternal and Child Health that are conducted in conjunction with routine services at health facilities. MNCHW is a simple one-time delivery mechanism that consolidates services that immediately demonstrate impact in terms of significantly increasing coverage levels of all the core preventive and curative interventions that allow a child to thrive and develop. It is a key element of efforts to achieve the fourth MDG, which is the reduction of child mortality. MNCHW provides an effective opportunity to deliver a core set of services for child survival through the existing health system. MNCHW is definitely a strategy to accelerate child Survival and Development with the ultimate goal of reduction in Child morbidity and mortality. Mothers and caregivers are expected to bring their children to the local health facilities during the week long activity.

THE IMPLEMENTATION 

In Nasarawa State, implementation of the second round of MNCHW held on 11th to 15th NOVEMBER 2019. The interventions used during this round of MNCHW include Vitamin A capsules, Deworming drugs and Nutrition screening (using MUAC tapes), others are the immunization antigens (BCG, OPV, DPT, HBV and MV). Pregnant women received ANC and Malaria control drugs (Iron Folate, TT, and SP) while women of child-bearing age were counselled on family planning and other household practices like basic hygiene, breast feeding and hand washing. It was a handful week for maternal, newborn and child health all aimed at improving survival and also to complements the existing routine service delivery.

BACKGROUND INFORMATION

Nasarawa State is located in the North central geo-political zone of the country along with Abuja, Plateau, Benue, Kogi, Kwara and Niger States. To the North East the State is bordered by Taraba State while to the North West it is bordered by Kaduna State.

The State has its capital at Lafia. There are Thirteen (13) Local Government Areas, Sixteen (18) Development Areas, Sixty (60) Health Districts, One Hundred and Forty Seven (147) political wards and Two Hundred and Ninety Four (294) fixed posts.

The State population for Geographic Information System (GIS) for 2017 is 5,684,188 while that for projected census population is 2,736,282

STATE PROFILE

Total Population (GIS 2017) = 5,684,188

• Vit. A Target Population             1,009,834

• 6-11 Months (20% OF 6-59MTS)               112,204
• 12-59 Months(80% OF 6-59MTS)               897,630
• Women Of Child Bearing Age (22% of Tot. Pop)               1,122,038
• Pregnant Women (5% of Tot. Pop)   280,509

• Total Number of Health Facilities     930
• No. Of LGAs               13
• No. Of Wards                 147
• No. Of MNCHW Posts  (2 per Ward)         326 
• Boundaries: Benue, Kaduna, Taraba, Kogi, Plateau States and FCT

PRE IMPLEMENTATION ACTIVITIES 

Advocacy and mobilization at state and local government levels were carried out to Line ministries and paramount traditional rulers in the state.

• LGA Planning meeting
• Social Mobilization activities
• Training of Health personnel
• Stake holders meeting 
• State level Training
• Training of Town Announcer and House Hold Mobilizers
• LGA and Ward level trainings

Microplanning Planning meeting with LGA NFP and ward Focal Person in order to have a workable work plan for a successful implementation of the second round of MNCHW. It was done in the 13 LGA with State supervisors in attendance

All trainings were focused on strengthening the capacity, skills and knowledge of health workers for effective service delivery towards a successful implementation of MNCHW with emphasis on the selected interventions and any new development. 2,233 personnel were trained for the MNCHW out of 1,956 were Health facility workers

441 town announcers were trained to effectively carry out community announcement for 10days (5 Days before implementation and 5days during intervention. 

735 House Hold Mobilizers were trained on how to give appropriate messages to caregivers and support them to access services in the Health facilities.

Social Mobilization Activities

• Advocacy to Paramount traditional Rulers(Emir of Lafia, Kwandare, Shadu, Doma e.t.c) and Chief Executives of the Media Houses (NTA & NBS) to solicit their support                                       
• Radio and TV discussion on MNCH week
• Production and airing of jingles relevant to MNCHW was done from 15th October to 15th November 2019
• Community dialogue and sensitization was conduction on 9th to 11th October in all 13 LGAs involving 588 People (4 person/147 wards) and 39 facilitators. This was carried out to create more awareness on Vitamin A and improve coverage for the MNCHW
• Announcements were carried out in mosques & churches to increase awareness between 10th-15th November
• Engagement of Town announcers in all Wards and LGAs between 10th-15th November

Distribution of Materials

• Distribution of Immunization Antigens, Vitamin A capsules, Albendazole, ANC drugs and other Materials was done on 9th November 2019

Implementation 

MNCHW in Nasarawa state was implemented on 11th-15th   November 2019 in all the 13 LGAs of the state. The activity was flagged off by the wife of the Executive Governor Hajiya Silifat A.A. Sule in Lafia LGA. 

The MNCHW was supported by 234 LGA team members in the 13 LGA with minimum of two health facilities per ward and some having up to 3, in 326 Health Facilities with 120 Health worker covering 60 Hard to Reach Area. 

COLLABORATION/ FUNDING

• STATE: Supervisors’ Allowance,and other logistics N41,123,190
• UNICEF: N2,154,200

              (Also Allocated Vitamin A, Technical Support, and Supervision

• USAIDs (Technical Support, and Supervision)
• SOML N7,578,546

INTERVENTIONS GIVEN DURING MNCHW

• Immunization 
• Vitamin A Supplementation, 
• De-worming
• Nutrition Screening using MUAC Tapes
• ANC:- Iron, Folic acid, S.P
• Birth registration
• HIV Testing and Counselling (HCT)
• Health Promotion on Key Household Practices
  • Exclusive Breastfeeding, ORS
  • Hand Washing
  • Family planning

RESULTS OF INTERVENTIONS:

Vitamin A Supplementation

DEWORMING

MUAC SCREENING

IRON FOLATE

HIV TESTING SERVICES

BIRTH REGISTRATION

ISSUES/CHALLENGES

• Non-tallying of interventions by HWs
• Some MUAC strips were wrongly calibrated
• Poor MUAC screening by some HWs
• Inadequate BR materials
• Shortage of commodities few days into implementation

OPPORTUNITIES

• SOML, UNICEF AND Vitamin Angels provided Vit. A
• Vitamin Angels provided Anti natal Vitamins and Albendazole

PLANS/RECOMMENDATIONS

• Going forward the state will take actual stock of commodities available at the health facilities before distribution of  commodities during MNCHW

• Supervision Plan: LGAs to ensure ALL HFs & teams provide DIPs for implementation shown to SS during Ward Level trainings & displayed at PHC Dept before implementation
• DEVELOP DPs for each HF, & TAs during training & show to SS (done by WFPs, OICs)
• Document & track children with MUAC Red to ensure link to service, & Follow UP each DAY at ERM until they are linked to care
• When LGA Chairman supports with MNCHW funds the money should be used for other needs.
• Develop drug distribution plan for health facilities before the next round of MNCHW (Feb. 2020)
• All data for MNCHW interventions must be appropriately entered into HMIS registers
• INFORM HWs @ LGA & Ward LT  2 wear uniforms during implementation
• Provide hand washing materials @ ALL levels of training for demonstration
• Drug Distribution will be made according to wards & then given to LGAs
• Ardos and Wakilis should be invited for community sensitization/ dialogue going forward in the next round of MNCHW. 
• WFPs MUST use Signed distribution list for HFs receiving commodities (To be cross-checked by SS @ ERM & used to determine payment)
• Integrate follow-up visit of MNCHW M-red into routine follow-up.
• Constitute a team to visit Karu LGA to develop a mitigation plan for state to come up with a separate and more specific plan for Karu LGA next round of MNCHW 
• TBA obi should be captured in the state report.

NOVEMBER 2019 MNCHW

ABREVIATION

1. MDG Millennium Development Goal
2. MNCHW Maternal, Newborn and Child Health Week
3. NAHI Nutrition, Agriculture and Health Initiative
4. NFP Nutrition Focal Persons
5. SOML Saving One million Lives
6. USAIDs Unites States Agency for International development