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ORIGINAL ARTICLE
Open Access

Female Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern Nigeria

Charles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu and Alastair Ager
Global Health: Science and Practice March 2015, 3(1):97-108; https://doi.org/10.9745/GHSP-D-14-00117
Charles A Uzondu
aPartnership for Reviving Routine Immunization in Northern Nigeria–Maternal Newborn and Child Health Initiative, Kano, Nigeria
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Henry V Doctor
aPartnership for Reviving Routine Immunization in Northern Nigeria–Maternal Newborn and Child Health Initiative, Kano, Nigeria
bColumbia University, Mailman School of Public Health, New York, NY, USA
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Sally E Findley
bColumbia University, Mailman School of Public Health, New York, NY, USA
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Godwin Y Afenyadu
aPartnership for Reviving Routine Immunization in Northern Nigeria–Maternal Newborn and Child Health Initiative, Kano, Nigeria
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Alastair Ager
bColumbia University, Mailman School of Public Health, New York, NY, USA
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  • For correspondence: aa2468{at}columbia.edu
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    Consultations with community members helped shape the design of the pilot community-based service delivery program.

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    Figure 1.

    Number of Health Post Visits per 100 Population, Kadawawa Intervention Community (Before and During the Intervention) and Kafin Baka Control Community, Northern Nigeria

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    Figure 2.

    Antenatal Care Attendance Rates per 100 Pregnant Women, Kadawawa Intervention Community (Before and During the Intervention) and Kafin Baka Control Community, Northern Nigeria

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    Figure 3.

    Number of Facility-Based Deliveries by Skilled Birth Attendants, Kadawawa Intervention Community (Before and During the Intervention) and Kafin Baka Control Community, Northern Nigeria

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    “Gender-sensitive” motorcycles that did not expose women's legs while riding were approved by traditional rulers for use by the female community health workers.

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    Table 1. Selected Demographic Characteristics for Kadawawa (Intervention) and Kafin Baka (Control) Communities in Nigeria at Baseline
    No. (%)
    KadawawaKafin Baka
    Population15,9546,748
    Population under 1 year old638 (4%)270 (4%)
    Women of reproductive age2,712 (17%)1,485 (22%)
    Pregnancies at any given time789 (5%)337 (5%)
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    Table 2. Summary of Pre-Intervention Qualitative Study Findings in Jigawa State, Nigeria
    ThemeFindings
    Barriers hindering pregnant women from accessing health care• Women have to seek approval from an authority figure to access health care.
    • Weak women were perceived to deliver at the hospital and strong women at home.
    • Community members lacked knowledge about pregnancy danger signs.
    Barriers at the community health facility level• Poorly equipped health facilities: “We have to give birth on cement floors because there is only one bed …”
    • Limited access to drugs: “We need medicines, we need our hospitals to be repaired …”
    • Limited access to health personnel, especially female personnel: “The male CHEWs are afraid of touching us …”; “[Female CHEWs] should be available in the facility at all times, not coming from time to time …”
    • No emergency transport to Jahun General Hospital: “The roads are bad and the hospital a long distance away … transportation is too high [costly] and if the only available car has gone to the market, that is all …”
    Barriers at the referral facility level• Perceived negative outcomes to delivering at Jahun General Hospital: “If CHEWs referred us to Jahun General Hospital, we will not really be happy to hear that …”
    • Feeling insulted and harassed by staff at Jahun General Hospital: “They ignore us and call us villagers …”
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Global Health: Science and Practice: 3 (1)
Global Health: Science and Practice
Vol. 3, No. 1
March 01, 2015
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Female Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern Nigeria
Charles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu, Alastair Ager
Global Health: Science and Practice Mar 2015, 3 (1) 97-108; DOI: 10.9745/GHSP-D-14-00117

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Female Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern Nigeria
Charles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu, Alastair Ager
Global Health: Science and Practice Mar 2015, 3 (1) 97-108; DOI: 10.9745/GHSP-D-14-00117
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