Like other countries with high maternal and newborn death rates, Nigeria has a mandate to reduce such mortality substantially by 2030. Sustainable Development Goal (SDG) 3 sets a target of reducing the global maternal mortality ratio to less than 70 per 100,000 live births and for all countries to reduce neonatal mortality to at least 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.
To achieve these SDG targets, it has become imperative for government and healthcare providers to have access to reliable data that will aid decision-making and assist in evaluating the distribution of health resources. Health issues, including maternal and newborn health (MNH), cannot be addressed adequately without a conscious effort to collect, document, measure and interpret data. As a highly populous developing nation and regional leader, Nigeria is in the spotlight.
By making information and data available to all stakeholders in an easy-to-understand and visually-engaging format, E4A-MamaYe has been supporting State Led Accountability Mechanisms (SLAMs) to influence positive change in MNCH. The scorecards track a number of health indicators through a simple traffic light format for easy reading, understanding and interpretation where green means Good Progress; yellow means Some Progress; and red means Insufficient Progress.
Scorecards: understanding data has never been so easy
In Nigeria, we work in Lagos, Bauchi and Gombe states, where we support SLAMs to package scorecards based on performance of selected indicators for Maternal, Newborn and Child Health (MNCH); Maternal and Perinatal Death Surveillance and Response (MPDSR); Stockout of Essential Life-saving Commodities; and Family Planning. These are made available to stakeholders in government, health facilities and civil society for decision-making, and to the public through mass media. Dr. Mohammed Dayyabu, Director of Planning, Research and Statistics in the Bauchi State Ministry of Health says:
E4A-MamaYe-supported MNCH and MPDSR scorecards make available relevant and useful data/facts that tickle the state government to wake up from its slumber and work towards the benefit of its citizenry.
Stakeholders, particularly government officials, say the scorecards are widely accepted because they use data from within the system. Data are gathered from different local government areas (LGAs) and then harnessed from the District Health Information System 2 (DHIS2), a global platform used for national health information systems. Data are then entered into a database held by the SLAM Evidence sub-Committee for analysis. The resultant findings are then disseminated to relevant stakeholders such as medical directors at the Ministry of Health, lawmakers, state Governors, civil society groups, opinion leaders, and media.
Discussing results to fill in the gaps
Core to the success of the scorecard is the discussion around it. The SLAMs work at bringing together representatives from government, civil society and the media to review, discuss and recommend solutions / interventions to address challenges arising from scorecard findings.
For example, the July-December 2017 MNCH scorecard in Gombe identified a major gap in data reporting resulting from poor quality of data in DHIS2. Based on this identified gap, the Gombe State Accountability Mechanism for Maternal and Newborn Health (GoSAM) advocated for the creation of a budget line for the state’s Health Management Information System (HMIS), which was included in the 2018 budget of the State Ministry of Health. GoSAM is committed to supporting the Ministry of Health to ensure timely release of the HMIS budget to improve the quality of MNCH data collection and reporting in all the 11 local government areas of the state.
After years of experience in producing scorecards, E4A-MamaYe has learned that efficient information management is essential to channeling resources effectively toward areas of need. Scorecards are essential tools for accountability. CSOs and other stakeholders can use them to hold governments accountable for their commitments on MPDSR and MNCH, to improve health services in their country generally and to contribute to implementing the SDG 3 target globally.