Photo credit: © Dahiru Ribadu for IDEAS
Community involvement is vital for making progress towards universal coverage of health services for mothers and newborns. Yet communities cannot work in a vacuum if universal coverage is to be achieved. In the Nigerian context, state government engagement is also important to ensure community health services are embedded in the health system and in the state’s health budget. This engagement creates an enabling environment for scale-up and sustainability. These are the interim conclusions of two studies conducted under the IDEAS project[ii], one quantitative and one qualitative, that evaluated a Village Health Worker scheme in Gombe State, northeast Nigeria.
Over the last 10 years, there has been little change in the maternal mortality ratio in Nigeria, and it remains high at 814 per 100,000 live births in 2015[iii]. In largely rural Gombe State, contributing factors include limited uptake of and access to health services, which hamper universal coverage. Moreover, low adult literacy rates (63.9 in any language and 34.5 in English[iv]) restrict community participation for health, particularly among women.