The USAID-funded Targeted States High Impact Project (USAID|TSHIP) works to strengthen health care delivery in Bauchi and Sokoto states. The objective is to increase the use of high-impact integrated maternal, newborn, and child health (MNCH), and family planning and reproductive health (FP/RH) interventions. This summary looks at data from 2010 to 2015 and documents how the Government of Bauchi and USAID helped save the lives of 38,137 women and newborns.

1. Final Dissemination Meeting
July 7, 2015
ADVANCING MATERNAL, NEWBORN,
CHILD HEALTH IN BAUCHI STATE:
The Progress So Far
2009-2015

2. From 2010 to 2015, the Government of
Bauchi and USAID helped
save the lives of
38,137 women and newborns.
Including:
706 newborn lives saved
618 lives saved due to CHX alone
46 maternal lives saved

3. Our Approach
Increase use of MNCH & FP services
Work in partnership with government, civil society, private
sector and the people of Bauchi State
Work with and through existing systems
Aim for sustainability from the get-go
Use lessons to advance MNCH across Nigeria

4. Sources: Nigeria Demographic and Health Surveys, 2008, 2013
168.8 million
Total Population
Nigeria Bauchi State
5.62 million
Total Population
8 children
per woman
5.5 children
per woman
0% decline-3.5% decline
In fertility rate
from
2008 to 2013
33%
of under-five deaths are neonatal
24%
Neonatal mortality rate
37 per 1000
births
43 per 1000
births

5. First 5-Year
Health Strategic
Plan Developed
and in Use

6. MATERNAL & NEWBORN
HEALTH

7. Bauchi State was second
in Nigeria to roll out
misoprostol &
chlorhexidine use at
scale.
24 national professional
associations, universities, media
and international NGOs
delegations visited to learn
about the approach.

8. Bauchi State misoprostol
coverage more than quadrupled,
saving maternal lives.
2012
4.4%
2013
6.0%
2015
14.8%
% coverage of misoprostol
Sources: TSHIP LQAS (2012, 2013 2015)

9. The use of misoprostol is strongly
associated with a much lower
maternal mortality ratio.
16
in the
cohort who
received
Misoprostol
1547
in Bauchi
State
Maternal deaths per 100,000 live births
Sources: MMR for cohort of 42,168 women in TSHIP study (received miso) and MMR for Bauchi State from NPCDA)

10. Coverage of chlorhexidine in Bauchi
State increased more than 20-fold,
saving newborn lives.
2012
0.7%
2013
3.0%
2015
24.4%
% coverage of chlorhexidine
TSHIP LQAS: 2012, 2013, 2015

11. The use of chlorhexidine is strongly
associated with a
much lower neonatal mortality
rate. It dropped to less than 5
per 1000 live births
< 5
in the
cohort who
received
CHX
43
in Bauchi
State
Neonatal deaths per 1,000 live births
Sources: NNMR for cohort of 42,360 newborns in TSHIP study (received miso) and NNMR for Sokoto State from 2013 DHS

12. What Remains to be Done
Enshrine all women’s
access to
misoprostol/
uterotonics as a right;
newborns access to
CHX
Support/sustain
community-based
health volunteers’
system
Bauchi State needs
a Marshall Plan to
rapidly train 3000
community midwives.
At current pace, it will
take 200 years
Use insurance/
universal coverage to
make antenatal
care, delivery and
emergency obstetric
care work better

13. ADVANCES IN
CHILD HEALTH

14. Vitamin A coverage for children
rose more than three-fold from
2008 to 2015, saving young lives.
Sources: DHS (2008);TSHIP LQAS (2012,2013, 2015)
2008
12%
2012
5.2%
2013
32.4%
2015
42.6%
% coverage of vitamin A
Nearly 512,000
children were reached
with Vitamin A
capsules biannually
in 2014/15 child
health weeks.

15. The pace is now set to use the
polio vaccination platform to
urgently strengthen routine
immunization.
41.7%
58.0%
52.5%
10.4% 12.7% 13.5%
2012 2013 2015
Coverage - all polio vaccines only
Coverage - DPT3 vaccines
Zero polio cases
in Bauchi State
in
27 months.
Sources: 2012, 2015: TSHIP LQAS; 2013: DHS Children 12-23 months

16. Over 60%* of infants under 6 months
were exclusively breastfed in Bauchi
State, more than double the national
average in Nigeria.
53.4% 54.8%
61.3%
2012 2013 2015
Sources: 2012, 2015: TSHIP LQAS; 2013: DHS
*Based on 24 hour recall

17. What Remains to be Done
Accelerating progress
in routine
immunization—
improve quality, cold
chain maintenance
Increasing
predictable supply of
life saving
commodities—
zinc/ORS,
Amoxicillin DT
Exploring new
approaches to
community case
management
Intensify promotion
of exclusive
breastfeeding
through CBHV;
educate men on its
importance

18. ADVANCES IN FAMILY
PLANNING

19. In Bauchi State, the percent of women
and men who do not want to have
additional children has continued to
markedly increase.
2.3%
7.8%
6.4%
0.5%
5.2%
4.7%
2012 2013 2015
Men
Women
Sources: 2012, 2015: TSHIP LQAS; 2013: DHS

20. Bauchi State recorded a
contraceptive prevalence of
9.8% in 2015
Sources: DHS (2008, 2013)
7.8%
6.8%
9.8%
2012 2013 2015

21. ADVANCES IN RELATED
HEALTH SYSTEMS &
CROSS-CUTTING AREAS

22. Key Legislation and Policies
Strengthen Health System
 Gender policy passed
 Drug, Medical Consumable
Management Agency
established
 Health Research Ethical
Committee
established, functional
Passage of Law on Maternal
Deaths Notification and
Accountability is urgently
required

23. 54,000 members of
100-Women Groups on
the move in 20 LGAs

24. Internships: Investing in the Next Generation
of Leaders Matters
“The most successful aspect of my
internship experience is that I was
trained and moulded into an individual
ready for a successful career with vast
knowledge of office management
processes matching the required
demand of a standard organisation.”
Shehu A, Male
• Trained 100 young
graduate interns
• Average duration =
8 months
• 57 Males
• 43 Females

25. Key Lessons andWhat the State
Government Needs to Know/Do/Act
 Good governance saves lives
 Invest in community health system—
they connect health to the last mile—
it saves lives
 A Marshall Plan is needed to urgently
produce 3000 community midwives
 Supplies critical to accelerating MNCH to
save more lives

26. Nana Asma’u, Daughter of Sheikh
Usman Danfodio on Governance
“Rulers must persevere to improve affairs,
Do you hear? And you who are ruled, do not
stray: Do not be anxious to get what you want.
Those who oppress the people in the name
of authority will be crushed in their graves,
in the Hereafter, Be Sure of God’s Truth.”
Source: Nana Asmau. Be Sure of God’sTruth. (1854)

27. From 2010 to 2015, the Government
of Bauchi and USAID helped
save the lives of 38,137 women
and newborns.
Including:
706 newborn lives saved
618 lives saved due to CHX alone
46 maternal lives saved

28. THANKYOU
TSHIP Consortium:
JSI Research &Training Institute, Inc. (JSI),
JHPIEGO, Futures Group International,
PLAN and Management Strategies for Africa (MSA)
www.jsi.com
www.facebook.com/USAID.TSHIP
www.twitter.com/TSHIP_Nigeria