Evaluation of a Community-based Intervention to Improve Maternal New-born and Child Health Coverage in the Rural and Hard-to-reach Communities of Adamawa State Nigeria

Abstract

The healthcare inequities in hard-to-reach (HTR) areas of developing countries, such as Nigeria, have significant implications for disease prevention and control, particularly in maternal and child health. The aim of this study is to look at how well mobile outreach and health facility outreach programs work to improve health outcomes in rural, underserved, and hard-to-reach (HTR) areas in Adamawa State, Nigeria. The focus is on key indicators of maternal, newborn, and child health. The key interventions include antenatal care (ANC), family planning, routine immunization, vitamin A supplementation, deworming of children under 5 years, and Diarrhea treatment. The study applied a cross-sectional design using before-and-after assessments to assess the outcome of the mobile outreach interventions using quantitative health facility-level data from the District Health Information System (DHIS 2.0) on the intervention. Following a successful intervention, the coverage of these indicators prior to and following the intervention was compared using the data. The study shows a cumulative improvement in ANC (21%), institutional delivery (18%), and Penta 3 coverage (28%). Mobile and hard-to-reach strategies utilizing community health workers and volunteers from the LGA, and health facilities can be effective in improving coverage of MNCH services and hold promise for better maternal and child survival in rural, HTR, and under-resourced parts of Adamawa State, Nigeria, and Sub-Saharan Africa at large. In addition, the mobile outreach interventions have contributed to improving MNCH services in hard-to-reach communities, so scaling up the strategy is highly recommended. Keywords: Hard-to-reach, Interventions, Outreach, Communities, Adamawa State, Nigeria.