INTEGRATED MATERNAL,

NEWBORN AND CHILD

HEALTH STRATEGIES

PRESENTERS
Ogunleye Olushola
Olaitan U04MD1012
Iyalla Ada Joy
U04MD1021
Abubakar Magaji
U04MD1023
Mohammed Dauda
U04MD1039
Pindar Wakawa Yakubu
U04MD1056

Onyeacho David
Obiorah U04MD1063
OUTLINE
Overview of Maternal, Newborn
and Child Health; Situation
Analysis
Why we need an Integrated
Maternal, Newborn and Child
Health Strategy
IMNCH Strategy
Strategic Approaches, Objectives
and Organisation of Maternal,
Newborn and Child Health
Services
IMNCH Continuum of Care
Partnership for Maternal,
Newborn and Child Health

OVERVIEW OF
MATERNAL,
NEWBORN & CHILD
HEALTH
OGUNLEYE OLUSHOLA OLAITAN
U04MD1012

INTRODUCTION
Each year, millions of
women, newborns, and
children die from
preventable causes.
While the interventions
that could save their
lives are widely known,

they are often not

available to those
most in need.

PRESENT STATUS OF
MATERNAL & CHILD
HEALTH: WORLDWIDE
A look at the statistics worldwide
shows that each year:
More than 60 million women deliver at
home without skilled care.
About 530,000 women die from
pregnancy related complications, with
some 68,000 of those deaths resulting
from unsafe abortion.
About 4 million babies die within the
first month of life (the newborn
period), and more than 3 million die as
stillbirths.

Over 10 million children under the age

of 5 die.
Moreover, nearly all (99 percent)
maternal, newborn, and child deaths
occur in low- and middle-income
countries.

PRESENT STATUS OF
MATERNAL & CHILD
HEALTH: NIGERIA

The country loses 2,300 under-five year olds

and 145 women of child-bearing age
everyday.
Over one million Nigerian children will die
before their fifth birthday this year, a figure
that represents about 10% of the global total.
Annually, an estimated 52,900 Nigerian
women die from pregnancy-related
complications out of a total of 529,000 global
maternal deaths.
A womans chance of dying from pregnancy
and childbirth in Nigeria is 1 in 13.

24% of deaths in under-fives take place in

the first month of life.

In Nigeria alone, over a quarter of a

million (284,000) babies die every year:
about 700 newborns die each day.
Nigeria ranks the highest in Africa in
terms of the number of neonatal deaths
and the third highest in the world: 8%
percent of the worlds total.
The majority of these deaths are
preventable by improving existing care.

NIGERIAS GLOBAL
RANKING
NIGERIAS RANKING IN
AFRICA
MILLENNIUM
DEVELOPMENT GOALS
(MDGs)

In the year 2000, 189 nations of the

world met and agreed on 8 Millennium
Development Goals.
Two of these goals are to reduce
under-five mortality by two-thirds
(MDG4) and to reduce the maternal
mortality by three-fourths (MDG5),
between 1990 and 2015.
Specifically for Nigeria these goals
are:
A 2/3 reduction in U5MR from 230/1000 live
births in 1990 to 77/1000.
A 3/4 reduction in maternal mortality ratio
from 1000/100,000 in 1990 to 250/100,000 in
2015.

These goals are closely associated

with MDG1, MDG6 and MDG7.

Problems with
Achievement of the
MDGs in Nigeria

Nigeria is not on track to achieve

its health-related millennium
development goals.
The U5MR showed a marginal
reduction between 2002 and
2007, of about 10%, compared
to about 50% in countries such
as Ghana and Mozambique.
Diarrhoea continues to account
for 16% of U5MR.
The tragedy behind this lack of
progress is that 63% of the
U5MR and up to 75% of newborn
deaths could be avoided.
Unabated, HIV/AIDS is likely to
impact negatively on the overall
achievement of MDGs 4 and 5.

SITUATION ANALYSIS:
MORBIDITY AND
MORTALITY PATTERNS
MATERNAL MORBIDITY
AND MORTALITY
The maternal mortality
ratio in Nigeria is
estimated to be
800/100,000 live
births. NE:
1,549/100,000 live
births; SW:
165/100,000 live births

(an almost 10 fold

difference).
Marked urban-rural
variation in maternal
mortality: 351/100,000
(urban) to
828/100,000 (rural).
NEWBORN MORBIDITY
AND MORTALITY
The neonatal mortality
rate according to the
NDHS 2008 is 40 per
1,000 births,

compared to 48 per
1000 births as
indicated by NDHS
2003.
The highest neonatal
rates were also
observed in the NE
and NW zones of the
country. The lowest
rates were seen in the
SE zone.
CHILDREN UNDER FIVE
YEARS

The Nigeria DHS 2008 indicated

an IMR of 75/1000 live births
and U5MR of 157/1000 live
births, compared to the results
from the NDHS of 2003 which
indicated an IMR of 100/1000
live births and an U5MR of
210/1000 live births.
Analysis of recent trends show
that Nigeria is making only
marginal progress in reducing
these rates.
There was a 2.6 fold difference
the magnitude of U5MRs
between the highest and lowest
risk regions.

KEY DETERMINANTS OF
MATERNAL, NEWBORN AND
CHILD MORTALITY
Inadequate coverage and low
quality of essential obstetric
care.
Access:

Financial access: Poverty has

significant implications for health and
development.

Low income households

Rural areas
Women
Increasing health care costs

Physical access: Distance from the

place of dwelling to a health care
facility.
Access to information: Access to mass
media is likely to affect womens
knowledge and use of health facilities
in pregnancy and delivery, and

consequently the occurrence of

maternal morbidity and mortality.

Socio-cultural factors:

A number of socio-cultural beliefs and

practices in Nigeria limit the ability of
women to take independent decisions
about their own lives, including the
decision to seek appropriate health
care.
Gender disparity exists in almost every
sphere of life in Nigeria, to the
disadvantage of women.

WHY WE NEED AN
INTEGRATED
MATERNAL
NEWBORN AND
CHILD HEALTH
STRATEGY

IYALLA ADA JOY

U04MD1021
The health and
wellbeing of the
mother is inextricably
linked with the health
and survival of the
child.
It is increasingly
recognized that
conditions during
pregnancy and

delivery are major

determining factors in
the survival of the
mother and child.
Globally, countries
with the highest
maternal deaths also
have very high
neonatal mortality
rates.
Most newborn deaths
in Nigeria occur within
the first week of life,

reflecting the intimate

link between the
survival of the
newborn and the
quality of maternal
care.
More than 51% of such
deaths occur between
days 0 and 3
confirming the fact
that delivery by skilled
birth attendants will
dramatically reduce

maternal and newborn

mortality rates.
Maternal death,
stillbirths, and
newborn deaths are
strongly linked to
deliveries which take
place at home, without
properly trained skilled
birth attendants or in
health centres which
are not equipped or
staffed to handle

obstetric or neonatal
emergencies.
In addition, the
socioeconomic and the
long term health
status of the mother
contributes
significantly to the
mortality and
morbidity of mothers
and their children.
Maternal and neonatal
mortality are often the

result of a badly
managed pregnancy
and home delivery
without a skilled birth
attendant.
The Integrated
Maternal, Newborn and
Child Health Strategy
involves the
reorganization and
reorientation of the
health system to
ensure the delivery of

a set of essential
interventions which
will provide a
continuum of care for
women, neonates and
children.
In conclusion,
integrating maternal
newborn and child
healthcare services
provides an
opportunity for the
health sector to

eliminate unhelpful
dichotomies that stifle
funding and lead to
confusion and
ultimately cost lives.
IMNCH STRATEGY
ABUBAKAR MAGAJI
U04MD1024

IMNC STRATEGY
Vision and Mission
Goals, Target And
Indicators
Analysis of Selection of
Intervention

Priority Areas for

Action
Critical links in MNCH
Continuum
Vision
To make Nigeria a country where
Pregnancy and delivery do not
pose a threat to the lives of the
mother and newborn
Where children are healthy and
able to grow and develop to their
full potential thereby
contributing to the nations
socio-economic development

Mission

To deliver integrated
high-impact and cost
effective maternal,
newborn and child
health interventions at
high population
coverage to achieve
the MDG 4 and 5
Goals
To reduce maternal,
neonatal and child
morbidity and

mortality in line with

MDG 4 and 5
Targets
75% reduction in
maternal mortality
from 1000/100000 live
birth in 1990 to
250/100000 live birth
in 2015
66% reduction in the
mortality rate in under
5 from 230/1000 live

birth in 1990 to
77/1000 in 2015
Indicators
Maternal mortality
ratio
Proportion of birth
assisted by skilled
birth attendants
Contraceptive
prevalence rate
Under 5 mortality rate
Infant mortality rate

% of 1year olds fully

immunised against
measles
Neonatal mortality
rate
The guiding principles
Continuum of care
Integration:
Implementation of proposed
priority interventions at various
levels of the health system in a
coherent and effective manner
that is responsive to the needs
of the mother, the newborn and
the child
Women and child right

Right- based planning will be

incorporated in MNCH
interventions to ensure the
protection of the most
vulnerable

Guiding principle cont

Equity
Emphasis on ensuring
equal access and
universal coverage to
quality care to
enhance maternal
MNC survival

 Multisectoral
collaboration
Contributions from
other sectors will help
in achieving health
development issues
6. Partnership
Emphasis on
developing new
partnerships and
strengthening existing
ones to ensure that
MN & CH interventions

are fully integrated in

national, state and
LGAs
Intervention
There are three
delivery modes
Family- oriented,
community- based
Population- oriented
outreach services
Individual orientated
clinical services

Packages of
intervention for family
and community
A. Family preventive/
WASH services like

Use of ITN by under 5

children
Use of ITN by pregnant
women
Use of safe drinking water
Use of sanitary latrine
Hand washing with soap by
mothers
Condom use

Contd

B. Family neonatal
care
Clean delivery and
cord care
Putting to breast
within 30mins of
delivery
Universal extra
community based
care of low birth
weight infants/ referral
for very low birth
weight
Infant and child feeding

Exclusive
breastfeeding for
children 0 6 months
Continued
breastfeeding for
children btw 6 23
months
Adequate
complementary
feeding from 6 months
Supplementary
feeding with
moderately

malnourished
children(<2SD)
Contd
D.
Community
management of illness
Oral rehydration
therapy
Zinc for diarrhoea
management
Vit A treatment of
measles
Anti malaria treatment

2. Population oriented
key interventions
A Preventive
healthcare for
adolescent and adult
Family planning

B - Preventive
healthcare during
delivery
Antenatal care
Tetanus immunization
Deworming in pregnancy
Detection and treatment of
asymptomatic bacteriuria

Detection & mgt of syphilis

in pregnancy
Prevention and treatment of
iron deficiency anaemia
IPT for malaria
ITN for pregnant women
through ANC

Contd
C
HIV/AIDS
prevention and care
Voluntary confidential testing
and counselling (VCCT) and
treatment with Nevirapine
Infant feeding counselling
Condom use

Cotrimoxazole prophylaxis for

HIV +ve mothers and infants
with advanced disease

Contd
D. Preventive
healthcare for infants
Measles vaccine
BCG vaccine
TT vaccine
OPV vaccine DPT vaccine
HBV vaccine
Vit A- supplementation
ITN for <5 through NPI

3. Intervention at
health facility level

A Clinical primary level

skilled maternal and
neonatal care
Skilled delivery care
Resuscitation of
asphyxiated neonates
at birth
Maternal steroids for
preterm labour
Antibiotics for
preterm /prelabour
rupture of membrane (
P/PROM )

Detection and
management of
preeclampsia (MgS04)
Management of
neonattal infection at
PHC level.
Intervention cont
B. Management of
illnesses at primary
clinical level.
Antibiotics for
pneumonia

Antibiotics for
diarrhoea and enteric
fever
Vit A. treatment for
measles
Zinc for diarrhoea mgt
Oral rehydration
therapy for diarrhoea
management.
Artemisinin based
combination therapy
for children.

Artemisini based
combination therapy
for pregnant women
Combination therapy
for mother and infants
for PMTCT
HIV treatment of
mothers and children
with ARDs
Intervention cont
C.
Clinical first
Referral illness mgt.

Basic Emergency abst

& neonatal Care
Mgt of severely sick
children
Clinical mgt of
neonatal jaundice
Universal emergency
neonatal care
Mgt of complicated
malaria
D. Clinical Second
Referral illnesses mgt.

Comprehensive
emergency obs and
neonatal care
Other emergency
acute care
Mgt of complicated
AIDS.
STRATEGIC APPROACHES,
OBJECTIVES AND
ORGANISATION OF
MATERIAL, NEWBORN
AND CHILD HEALTH
SERVICES

Mohammed Dauda

U04MD1039
STRATEGIC APPROACHES,
OBJECTIVES AND
ORGANISATION OF
MATERIAL, NEWBORN AND
CHILD HEALTH SERVICES
A- STRATEGIC APPROACHES
1.ADVOCACY
2. STRENGETHING OF THE HEALTH SYSTEM
3.EMPOWERING FAMILIES AND COMMUNITIES
4.ORGANISING OPERATIONAL PARTNERSHIPS
5.MOBILIZATION OF RESOURCES

B-STRATEGIC OBJECTIVES
I

IMPROVE ACCESS TO GOOD QUALITY

SERVICES
PRIORITY ACTIONS
Harmonize the ward minimum health care in line
with IMNCH strategy
Establish a minimum package for IMNCH and RH
services 2 and 3 levels

Review national policies and protocols

Upgrade and re-organized health services.

Accessed training needs, train, retrain, and update
in-service training programmes.

Strengthening pre services education in health

training institution.

Introduce performance improvement techniques,

and supportive supervision.

Introduce motivational packages for service

providers.

Institutionalized bi annual MNCH week.

Subsidized or free MNCH services.

Engaged and motivate project health facilities

Expand PHC facilities/ services in underserved areas

Deploy doctors and midwives under NYSC Scheme

to underserved areas.

Provide outreach from the PHC facility level to

community and households.

II. ENSURE ADEQUATE

PROVISIONS OF MED. SUPLLIES
AND DRUGS, RH COMMODITIES,
ITNs OTHER BASIC EQUIPMENT.

PRIORITY ACTIONS

Assess and strengthen the supply chain

system.
Update, disseminate and enforce compliance
with the essential drug list.

Strengthen capacity for forecasting and

procurement of MNCH commodities.

Institute budget line and ensure timely release

of adequate funds.

Train key staff in logistic mgmt. of MNCH

commodities

Revitalize the drug revolving fund

Support local production of essential drugs and

other MNCH commodities.

Advocate for removal of tariffs on key MNCH

commodities

Build capacity for maintenance and installation

of med. Equipment.

III. STRENGTHEN INDIVIDUAL,

FAMILY AND COMM. CAPACITY TO
TAKE NECESSARY MNCH ACTIONS
AT HOME TO SEEK HEALTH CARE
IN A TIMELY MANNER.

PRIORITY ACTIONS
Institute and support community education on
MNCH issues.

 Promote counseling services at household

levels.
Strengthen community and ward development
committees.
Build capacity of community resource persons
and care givers for early recognition of
warning signs of Obs. and neonatal
complication.
Train other resource persons for emergency
response and preparedness for MNCH
conditions.
Advocate for increased community resources
and investment in MNCH services.
Institutionalized community based MNCH
services.
Promote male involvement to improve
households health care seeking behavior.
Facilitate women empowerment.
Develop the capacity of community groups and
associations to appreciate and assume their
roles as partners in the improving MNCH and
RH services.

IV. IMPROVE CAPACITY FOR

ORGANISATION AND
MANAGEMENT OF MNCH
SERVICES
PRIORITY ACTIONS

Strengthen the skills and capacity of

programme managers and health
management teams.

Integrate MNCH programmes into relevant

development policies and programme in order
to improve resources.

Develop IMNCH advocacy and other relevant

tools to reduce MNC- mortality ; improve
commitment of national, political, community
and religious leaders

Institute a system to officially register

maternal and peri-natal death to improve and
correct health system.

Strengthen the link btw local govt health

system and communities through formation
and reactivation of community/ ward dev.
Communities.

Support and promote the use of registers in all

facilities through training supervision and
regular feedback.

V. ESTABLISH A FINANCING
MECHANISM THAT ENSURES
ADEQUATE FUNDING,
AFFORDABILITY, EQUITY, AND

EFFICIENT USE OF FUNDS FROM

THE VARIOUS SOURCES
PRIORITY ACTIONS
Advocate for increase in the allocation to
health.
Allocate sig. proportion of the total health
budget to IMNCH
Improve networking and the co-ordination of
the resources for IMNCH services from donors
and global initiatives; GFATM, GAVI,PEPFAR,
Improve financial management, establish
monitoring system and enforce physical
discipline.
Establish financial mechanism that protect the
poor and vulnerable groups.
Improve the working arrangement between
public and private sectors.

VI .STRENGTHEN
SUPERVISION, MONITORING
AND EVALUATION SYSTEM TO
REPORT ON PROGRESS
TOWARDS ACHIEVING MCH
MDGS
PRIORITY ACTIONS

Strengthen health information system.

Establish baseline data; define the minimum

set of indicators, coverage and impact targets

Establish and build capacity for MNC mortality

review system which links comm. to all levels

Develop tools and guidelines to strengthen the

system capacity for supportive supervision,
documentation and regular reporting.

Promote the use of integrated supervision

tools to track the progress in implementation
of MNCH interventions.

Conduct regular review and planning meetings

LGs, state and other stakeholders to monitor
progress.

VII. ESTABLISH AND SUSTAIN

PARTNERSHIPS TO SUPPORT
IMPLEMENTATION OF IMNCH
STRATEGY.

PRIORITY ACTIONS
Conduct advocacy at all levels to promote
partnership for IMNCH.
Establish the national partnership for MNCH.

Built capacity and involve relevant NGOs with

comparative advantage in specific areas of
intervention.

Build capacity of private sector service

providers, teaching and research institutions
to support implementation.

Intensify public/private partnership with

corporate organization in their respective
areas of operation.

C .ORGANISATION OF
MATERNAL, NEWBORN AND
CHILD HEALTH SERVICES
-At local government level
A. Role of household and community
.Ensure the health of the mother, newborn and
child.
. Address the element of self care.
B. Role of PHC
. Focused ANC, PMTCT, early diseases detentions
and treatment.
.Early detention and timely referral of
complications in pregnancy.
. Normal delivery .
.Postnatal care for mother and newborn.
. Early initiation of exclusive breastfeeding,
continued breastfeeding with timely complimentary
feeding.
.Full immunization and growth monitoring

. Integrated mgnt of childhood illness.

Role of primary referral centers.
.Offer basic emergency Obs and neonatal and child
care

At state levels
Role of secondary health care facility
. Offers comprehensive emergency Obs and
newborn care.
. Surgical procedures, including CS.
. Safe blood transfusion.
. Assisted vaginal delivery.
At National Level
.FMOH and its agencies are to step up their
stewardship role to improve service coverage
and quality
. National PHC fund will play a role in making
increased revenue available for IMNCH
implementation.

IMNCH CONTINUUM OF
CARE

PINDAR WAKAWA
YAKUBU
U04MD1056
Definition
This is the core
principle which
underpins the IMNCH
strategy to save
mothers,neonates and
children whose lives
and health care needs
are intrinsically related

It has two
dimensions:
It connects essential
MNCH interventions
throughout
adolescence,pregnanc
y,child
birth,postnatal,newbor
n periods & into
childhood
It is also a seamless
linkage btw the
family,community &

health facility assuring

appropriate care in
each phase
Concept of IMNCH
continuum of care
It is based on the
assumption that the
health & well-being
of mothers,newborn
& children are
closely linked &
should be managed
in a unified way to

improve health &

survival.
Critical links in MNCH
continuum/priority
areas of action
Focused antenatal
care
Intrapartum care
Emergency obstetric
& new born care
Routine postnatal
care

 Infant & young child

feeding
Malaria prevention
Routine immunization
Prevention of motherto-child transmission
of HIV
Integrated
management of
childhood
illnesses(IMCI)
Water, sanitation &
hygiene

Focused antenatal care

The outcome of each
pregnancy and
wellbeing of the
newborn child depends
on qualitative (ANC)
The goals of focused
ANC are to promote
maternal and newborn
health survival
through:

Early detection &

treatment of problems
and complications
Birth preparedness
and complications
Readiness and
Basic health
promotion through
sound nutrition and
preventive measures
FAC Contd

To have the desired

impact, IMNCH must
increase pt. access
and uptake to ANC
services
Increase awareness
about health services
in the community,
community specific
advocacy

Balance the deployment &

retention of staff through
policies

Intrapartum care

Priority interventions
include:
Skilled birth
attendance
Supportive care &
pain relief
Monitoring the
progress of labour with
a partograph
rd
Active mgt of 3 stage
of labour neonatal
resuscitation

Emergency obstetric &

newborn care(EmONC)
Training of doctors &
nurses/midwives in
expanded life saving
skills
Provision of
equipment,supplies
&drugs required for
EmONC
A functional two-way
referral system
Routine postnatal care

Detection of
complications &
treatment
Infection prevention
Advice on danger
signs
Identification & mgt of
low birth weight babies
Newborn care
Neonatal
interventions that
need to be scaled up
will include:

Access to skilled care

during pregnancy,
childbirth & the
immediate postnatal
period at community &
PHC facility levels
Capacity building of
staff for optimal
newborn care e.g
newborn
resuscitation,early
initiation & exclusive
breast-feeding,keeping

the neonate
warm,hygienic cord
e.t.c
Timely & appropriate
care-seeking for
infections &
monitoring of low
birth-weightinfants
Water sanitation and
hygiene
Targeted at mothers &
primary care-givers

Low-cost water
treatment methods
Construction of
laterines(VIP) & safe
disposal of excreta
Promotion of Hand
washing;bf
preparing/eating
food,after
defaecation,after
cleaning up a faecessoiled infant
Prevention of malaria

Use of insecticide
treated nets(ITNs)
Intermittent preventive
treatment of
malaria(IPT)
Modalities include;
Free or subsidized ITN
distribution on a
regular basis
Integrating ITN &IPT
into the National
programme on

immunization, ANC,
IMCH.
Infant and young child
feeding(IYCF)
Exclusive breastfeeding in the first six
months of life
Adequate
micronutrient intake
Integration of IYCF
with other child health
services;

Baby friendly
initiatives
Growth monitoring &
promotion
Institutionalizing
routine immunization
Provision of tetanus
toxoid to pregnant
women in ANC
Childhood
immunization at
community &PHC
facilities

Health campaigns &

outreach to most
difficult-to-reach areas
Integration of other
child survival
interventions into EPI
Reach every
ward(REW) strategies
Prevention of motherto-child transmission
of HIV(PMTCT)
Integrating PMTCT
interventions into

ANC,nutrition
programmes,reproduct
ive health services
Modalities;
VCT
Antiretroviral
prophylaxis treatment
Counseling on infant
feeding options
Family planning
Mgt of common
childhood illnesses &

care of HIV-exposed
children
Integrated mgt of
childhood
illnesses(IMCI)
addresses common
childhood illnesses in
an holistic manner.
Modalities;
Oral rehydration
therapy

Zinc supplementation
in the mgt of diarrhoea
& pneumonia
Effective & antibiotic
treatment of
pneumonia,dysentry &
neonatal infections
prompt & effective
treatment of malaria
Cotrimoxazole to HIV
exposed & HIV-positive
children

Repositioning family
planning
Family planning could
reduce maternal
mortality by 20%
2yrs birth interval
increases infants
survival 2x
It is one of the
fundamental pillars of
safe motherhood
Repositioning FP
entails;

Advocacy & improved

access to
information,increasing
the number of delivery
points
Maximizing all
opportunities for
addressing the FP
needs of men &
women
Family planning cont..d
Training community
resource persons

Provision of
equipments
Building consensus
among
stakeholders(religious
leaders & men),
Addressing the family
planning needs of
vulnerable
populations-young
people, displaced
persons, refugees in
war/conflicts

Sustained financing
Rolling out the IMNCH
strategy
IMNCH strategy is not
another vertical
programme, but a
strategy to integrate
an existing range of
interventions to;
Improve the use of
resources
Expand health care
coverage

Help Nigeria achieve

MDG 4 & 5 by 2015
Partnership for maternal,
NEWBORN and child health

Onyeacho David
Obiorah
U04md1063
The partnership

Its a global initiative

of 170 member
countries dedicated to
ensuring that all
women, neonates &
children remain
healthy &thrive.
Launched in 2005 as
many countries were
not on track to
attaining the targets
for improving maternal

health & reducing child

mortality.
Dr. Francisco Songane
was appointed director
of the partnership in
2006.
Aims:
Primary aim is to
support countries to
reduce newborn &
child mortality and
improve maternal
health.

To expand the proven

and cost-effective
interventions to reach
those in need.
To support countries
to implement their
own roadmaps for
accelerating the MDGs
4&5.
To ensure coordination
&joint programming
among stakeholders.

To mobilize
&maximize the use of
resources.
To promote synergies
& avoid duplication of
interventions.
Stakeholders
Governments
International
Agencies:
USAID,UNAIDS,UNFPA,
UNICEF,

WHO, DFID, PATHS,

World Bank.
Non governmental
organisations.
Health care
professional
organisations.
Academic & research
institutions.
Civil society
Global partnership:
GAVI

Existing interventions
are effective
The existing packages
of interventions for
reduction of newborn,
child mortality &
improving maternal
health are proven to
be practicable and
cost-effective only if
they can be expanded
and religiously
implemented:

Contd
Ensuring access to
voluntary family
planning could reduce
maternal deaths by
20-35%; & child
mortality by 20%.
Skilled attendance
during delivery would
reduce maternal
deaths by about 75%.
Exclusive
breastfeeding up to 6

months would save

1.3m children per year.
Routine immunization
could avert the death
of over 2m children
annually.
Despite these proven
interventions
200m women
currently lack access
to contraceptives.
Only 58% of women in
developing countries

deliver with assistance

of a midwife or doctor.
Only 3% of HIV
pregnant women are
offered drugs for
PMTCT(2005)
270m children have
no access to
healthcare services of
any kind.

27m children have not

been fully immunised
in 2004
The partnership in
Nigeria
Nigeria launched its
own national
partnership for MNCH
in March, 2007.
The successful
implementation of this
strategy is based on
the MOH at all levels

to work together with

international
development partners.
The framework
include:
national partners
international
partners
National partners
FMOH/Agencies:
Dept. of public health

Dept. of hospital
services.
Dept of food & drugs
National AIDS & STI
control programme
National malaria
control programme.
Family health division
NAFDAC
NPHCDA
NACA
NPC
Nat. planning comm.

Medical institutions
Line ministries:
education
women affairs
infom. &
comm.
transport. Etc.
National partners
contd
Private Sector:
Banks
Industries
NGOs: CHAN, FOMWAN

International Devpt.
Partners:
WHO
UNICEF
DFID/PATHS
USAID
UNFPA
WORLD BANK
CONCLUSION
only a focused and
coordinated effort
by all

stakeholders can
bring
change to the
health of
our mothers,
newborns
and children in
their
remotest areas
REFERENCES
Federal Ministry of Health, Nigeria. The
Maternal Newborn Roadmap, 2005.
Federal Bureau of Statistics: Nigerian
Demographic Health Survey, 1999.
Nigerian Demographic and Health Survey,
2003 (National Population Commission and
ORC Macro, Calverton, MD, 2004).

RE Black, SS Morris, J Bryce. Where and why

are 10 million children dying every year? The
Lancet 361 (9378) 26 June 2003.
Nigeria Federal Ministry of Health, 2003,
National HIV/AIDS and Reproductive Health
Survey (NARHS): Abuja, Nigeria: Federal
Ministry of Health 2003.
Federal Ministry of Health, Abuja, Nigeria.
Integrated Maternal, Newborn and Child
Health Strategy, 2007.
Erin Sines, Anne Tinker, and Julia Ruben. The
Maternal, Newborn, Child Health Continuum of
Care, Population reference Bureau, March
2006.