CHAI supports Ministries of Health in our partner countries to drastically reduce maternal and neonatal deaths by scaling up the integrated MNH approach over an accelerated timeline.
The impact of CHAI’s MNH program can be most clearly seen in three states in Northern Nigeria. Nigeria accounts for the largest proportion of maternal deaths (19.1 percent), neonatal deaths (12.5 percent), and stillbirths (11.6 percent) worldwide. In 2014, working in partnership with the Nigerian Federal Government and the state governments of Kaduna, Kano, and Katsina, and funded by the Norwegian Ministry of Foreign Affairs, CHAI initiated the MNH program across a population of approximately 10 million people. Within six months of field-level intervention implementation, dramatic results were achieved to reduce maternal and newborn deaths across these three states.
An independent external evaluation in November 2016 verified that the following significant and sustained reductions were achieved within 12-18 months within the focus geographies:
• Maternal mortality: 37% reduction;
• Neonatal mortality: 43% reduction; and
• Stillbirth: 15% reduction.
The evaluation concluded that “the CHAI Maternal-Neonatal Health Program accomplished impressive, rapid and, to date, sustained reductions in newborn mortality, maternal mortality, stillbirth, perinatal mortality and a combination of stillbirth and newborn mortality equivalent to or beyond those observed in other efforts to improve neonatal and maternal survival.”
A separate, second independent external evaluation agreed with these findings, concluding that the program was “relevant at all levels”, that the stated reductions “most likely… understates the achievements of the programme” and “is considered to provide good value for money provided that the lessons gained are brought forward and used in future programmes.”
Continuing this level of sustained impact will not only lead to significant results across the three focus states in Nigeria, but can also serve as a model for other countries and partners with the comprehensive MNH approach now being rolled out in other countries where the need for an effective and efficient approach towards MNH is great. In Ethiopia for instance, CHAI responded to a Federal Ministry of Health request to scale the program up in 40 woredas (districts) in in 2017, covering an estimated population of 5 million people. Targeting woredas with some of the highest maternal and neonatal mortality burden in Ethiopia, the program aims to reduce maternal and neonatal mortality rates by 30% and 40% respectively. This builds on previous work, supported by the RMNCH Trust Fund, to roll out an institutionalized midwife mentoring program in 278 health centers located in 100 hard-to-reach districts across Ethiopia. Institutional delivery, antenatal care, and postnatal care increased throughout the course of 2015 by 42 percent, 61 percent, and 38 percent, respectively, in those sites supported by the mentoring program.
The sustainable systems established through CHAI’s MNH program ensures further lives are saved beyond the project implementation period. Continuing this level of sustained impact will not only lead to significant results, but can also serve as a model for other countries and partners looking to implement an effective, efficient and sustainable approach towards maternal and neonatal mortality reductions.