This document summarizes maternal and child health activities in Gombe Field Office for the second quarter of 2015. Key points include: - Over 35,000 pregnant women and new mothers were visited with health messages. Referrals totaled over 17,500. - On average, 79% of estimated pregnant women and 49% of new mothers received at least one home visit. - The call center handled over 11,500 productive calls, with 75% referred for services. - Commodity sales met or exceeded targets for most products, though efforts are needed to improve sales of some items. - Recommendations focus on increasing postpartum home visits, referrals, call center capacity

1. 4, Bauchi Road, Adjacent
Deputy Governors Office, GRA,
Gombe, Gombe State.
Society for Family Health, Nigeria
…Creating Change, Enhancing Lives
GOMBE FIELD OFFICE
QUARTERLY FACT SHEET
Quarter 2:
Apr. – Jun., 2015

2. Focal LGAs 11
Estimated Population 2, 801, 892 [GR = 3.4]
Estimated Live birth 130, 568 [CBR = 46.6/1,000]
Estimated home deliveries [56% of total live
births: CS, 2014] 73, 118
Estimated Pregnancies 150,153
Estimated EmOC [15% live births: WHO] 19, 585
Maternal deaths 576/100,000 [NDHS 2013]
Maternal morbidity [at least 30 per 1 maternal
death: WHO] 17, 280
Number of TBAs 1,160
Number of FOMWAN volunteers 290
Number of ETS volunteers 392
Number of MNHC referral facilities 117
BACKGROUND

3. MATERNAL HEALTH HOME VISITS
 Identify pregnant women
and newly delivered
mothers at home
 Established and reach
contacts with appropriate
health education
messages.
 Revisit contacts with
health messages as
appropriate.
 Register contacts and
document in MIS forms.
 35, 295 contacts established with
newly identified pregnant women [29,
702] and newly delivered mothers
[16, 106] within 7 days of delivery.
 ALL [100%] newly identified contacts
established were reached with health
education messages in IPC sessions
at home.
 74% [N= 29,702] of all the pregnant
women identified by the FLWs were
revisited at least once during that
pregnancy.
 88% [N= 16,106] of all the newly
delivered mothers identified by the
FLWs were revisited at least once
within 28 days of delivery.
 XXX male involvement sessions were
conducted.
What we did Outputs/Results achieved

4. MATERNAL HEALTH HOME VISITS- DATA SPEAKS
On average, 79% of estimated pregnant women and
49% of all newly delivered mothers in Gombe between
April to June 2015 were visited at least once by either a
TBA or a FOMWAN volunteer
Score Card
Target for
Q2
Achieved %
Achieved
Score
Pregnant women
reached
37, 539 29,702 79
Pregnant women
revisited
29,702 22,032 74
New mothers reached 32, 643 16,106 49
New mothers
revisited
16,106 14,100 88
New visit Revisit New visit Revisit
Pregnant women New mothers
Apr-15 9,333 7,200 4,959 4,250
May-15 9,857 7,334 5,554 4,913
Jun-15 10,512 7,498 5,593 4,937
Cummulative 29,702 22,032 16,106 14,100
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
Key
<50% of target achieved
50%-79% of Target achieved
>80% of Target achieved

5. OBSTETRIC AND NEONATAL COMPLICATION -
REFERRALS
 Conduct IPC sessions to
target groups [pregnant
women and new mothers
with their neonates]
 Identify complications or
danger signs and women in
labor
 Place a call to the call
center/provide first aid
medical services in
appropriate cases
 Refer and accompany client
for skilled services as the
case may be.
 Fill and document referrals in
referral/MIS forms
 A total of 17, 584 referrals were made
by the TBAs, FOMWAN and ETS
volunteers.
 6,507 pregnant women with pregnancy
related danger signs/complications were
referred, accompanied or transported for
skilled services.
 7, 825 women in labor were referred,
accompanied and/or transported to
health facilities.
 2, 943 neonates with complications
were referred, accompanied or
transported by TBAs and ETS
volunteers to access health services.
 309 newly delivered mothers identified
with post natal complications were
referred, accompanied or transported for
skilled services in health facilities.
What we did Outputs/Results achieved

6. EMOC REFERRALS - DATA SPEAKS
43% [N- 18,280] of women expected to
deliver at home were either referred and
accompanied by TBAs or transported to
health facilities for delivery by ETS
volunteers.
0
1000
2000
3000
4000
5000
6000
Pregnancy
Complication
Women in Labor Neonatal Complication Post Natal
Complication
Cummulative
TBAs Apr-15
TBAs May-15
TBAs Jun-15
FOMWAN Apr-15
FOMWAN May-15
FOMWAN Jun-15
ETS Apr-15
ETS May-15
ETS Jun-15
Score Card
Target for
Q2
Achieved %
Achieved
Score
Women in Labor 18, 280 7, 825 43
Key
<50% of target achieved
50%-79% of Target achieved
>80% of Target achieved

7. DELIVERY AND DELIVERY RELATED
 Identify a woman in
labor with imminent
delivery
[defined as the unavoidable home-based
delivery that occur either at night or when the
head of the baby had appeared in the cervix].
 Use Clean delivery kit
to conduct delivery
 Refer mother and baby
to health facility for
post natal checks.
 2, 476 imminent deliveries were
conducted at home by the TBAs.
 2, 436 newborns were delivered
by the TBAs.
 54% [N= 2, 476] of all home
deliveries were conducted using
clean delivery kits.
 2, 352 neonates in the urban
were visited and seen at home
by the FOMWAN volunteers.
 95% [N= 2, 352] of all neonates
visited and seen at home by the
FOMWAN volunteers were
revisited in the first 7 days of life.
What we did Outputs/Results achieved

8. DELIVERY AND DELIVERY RELATED - DATA SPEAKS
24% of expected home deliveries that were not
referred by TBAs [N= 10,420] had imminent
deliveries where CDKs were used.
0
100
200
300
400
500
600
700
800
900
Apr-15 May-15 Jun-15
Apr-15 May-15 Jun-15
Imminent home
deliveries
808 853 815
Home deliveries with
CDK
305 451 570
Newborns delivered 798 833 805
Neonates seen [Urban] 749 787 816
6093
6093 6093
1940
2473 2534
808 853 815
305 451 570
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Apr-15 May-15 Jun-15
Imminent deliveries
with CDKs
Number with
imminent home
deliveries
Number referred to
health facilities
Estimated number of
home deliveries

9.  A total of 17, 693 callers
attempted calling the call
center.
 11, 541 calls were productive
calls [calls with full length
conversation].
 35% of all attempted calls
were non-productive.
 66% of all productive calls
were initiated and referred
by the FLWs.
 75% of all productive calls
were referred for skilled
services.
 2% of referred callers were
followed on with calls to
ascertain/confirm access to
services and satisfaction.
CALL CENTER
Segregation/Mo
nth
Apr.-
15
May-
15
Jun-
15TOTAL
Volume of
calls
Productive calls 3,771 4,288 3,482 11,541
Non productive
calls 395 3,518 2,239 6,152
Referrals by
volunteers
TBAs 1,861 2, 498 1,793 6,152
FOMWAN 343 490 597 1,430
ETS 4 14 2 20
PPMV 22 18 24 64
Referral to
Health facilities 2,856 3,125 2,623 8,604
Follow on calls 58 64 22 144

10. CALL CENTRE - DATA SPEAKS
79% of all productive calls were maternal health related and 12% were neonatal
health related.
0
200
400
600
800
1000
1200
April May June
1ST TRIMESTER
2ND TRIMESTER
3RD TRIMESTER
FAMILY PLANNING
GENERAL HEALTH
HIV/AIDS
LABOUR/DELIVERY COMPLICATIONS
LABOUR/DELIVERY GENERAL
MALARIA
MATERNAL COMPLICATIONS
MATERNAL GENERAL
NEWBORN COMPLICATION
NEWBORN GENERAL
POST-DELIVERY

11. HEALTH FACILITY INTERVENTION – HSS/PBI
 Identify facilities providing
basic EmOC
 Train/conduct refresher training
for staff on basic EmOC
including KMC, HBB Clean
cord care, AMTSL e.t.c.
 Train facility staff on data
recording, collation and
documentation using NHMIS
Version 2013 FMOH Health
facility registers
 Partner with facility as referral
facilities for Performance
Based Incentive [PBI]
 24% of public health
facilities identified and used
as MNHC referral sites.
 Trained 244 Health facility
staff [2/partner facility + 10
LGA M&E Officers] on data
capture, collation, recording,
documentation and
reporting.
 16% [2,390] increase in
clients volume accessing
MNHC services in health
facilities [N= 14,657]
What we did Outputs/Results achieved

12. HEALTH FACILITY INTERVENTION - DATA SPEAKS
16% [2,390] increase in clients volume accessing MNHC services in health
facilities [N= 14,657]
(200)
-
200
400
600
800
1,000
1,200
1,400
ANC Del./Lab PNC Preg. C Nb. C FP ANC Del./Lab PNC Preg. C Nb. C FP
PBI Records Self/Walk-in Clients
Akko
Balanga
Billiri
Dukku
Funakaye
Kaltungo
Kwami
Nafada
Shongom
Yamaltu Deba

13. ESMPIN COMMODITY SALE- DATA SPEAKS
Depo
Provera
Norister
at
Combin
ation 3
Cycle
Beads
IUCD Jadelle
Misopro
stol
Gold
Circle
Classic
Gold
Circle
Flex
ORS/Zi
nc
Lifestyl
e
Condo
m
PUR
Female
Condo
m
Postino
r-2
Target [Cartons/boxes] 60 75 60 6 9 6 15 330 45 30 6 30 15 15
Q2 Achieved 52 45 52 2 3 6 24 280 54 15 2 11 43 18
0
50
100
150
200
250
300
350
Depo…
Norist…
Combi…
Cycle…
IUCD
Jadelle
Misopr…
Gold…
Gold…
ORS/Z…
Lifesty…
PUR
Femal…
Postin…
87 60 87
33 33
100
160
85120
50 33 37
287
120
% Achieved
87% general performance on commodity sale.

14. ESMPIN COMMODITY SALE- SCORE CARD
Product
Q2 Target
[Cartons/boxes]
Q2
Achieved % Achieved Score
Depo Provera 60 52 87
Noristerat 75 45 60
Combination 3 60 52 87
Cycle Beads 6 2 33
IUCD 9 3 33
Jadelle 6 6 100
Misoprostol 15 24 160
Gold Circle Classic 330 280 85
Gold Circle Flex 45 54 120
ORS/Zinc 30 15 50
Lifestyle Condom 6 2 33
PUR 30 11 37
Female Condom 15 43 287
Postinor-2 15 18 120
KEY
<60% Of Quarterly Target Achieved
Between 60-80% Quarterly Target Achieved + improvement over Q1
>80 Quarterly Target Achieved
Out of stock throughout the quarter

15.  Both TBAs and FOMWAN volunteers need to re-double their efforts in
terms of home visits to newly delivered mothers within the first 7 days of
delivery – during such visits, the FLWs have the opportunity to further
communicate key post-delivery messages as well merits of exclusive
breastfeeding and demerits of immediate bathing.
 Efforts on maternal and neonatal health referrals by all the FLWs need to
improve while concurrently improving home visits to determine clients
that needs referrals for skilled services.
 There is need to increase the number of call center staff to effectively
manage all calls because the proportion of productive calls to non
productive calls is high and is interpreted as inability of an agent to
effectively manage all calls during a shift.
 Efforts in call center and ETS awareness creation should be intensified
and the message can be deployed to health facilities.
 Plans to improve sale of commodities achieving less than 60% targets
should be intensified without relenting efforts to target achieved. Effort
need to be intensified on cycle beads, IUCD, Lifestyle, PUR and
ORS/Zinc.
RECOMMENDATION/IMPLICATION FOR
PROGRAMMING