Submission ID 116806
| Issue/Objective | Nigeria is one of the most populous nation in Africa, with a population exceeding 200 million people, of which a significant proportion consists of children under five years of age. Despite rapid urbanization and economic growth in certain sectors, the country continues to face substantial challenges in improving the nutritional and health outcomes of its youngest and most vulnerable populations. A particularly critical issue is the high rate of malnutrition among children under five, manifesting predominantly as stunting, wasting, and underweight. The 2018 Nigeria Demographic and Health Survey (NDHS) reported that 32% of children under five in Nigeria were stunted, while 6.5% were wasted, and 25% were underweight. These alarming statistics highlight the urgent need for comprehensive, multi-sectoral interventions targeting child nutrition and health. In Oyo State, located in southwestern Nigeria, the malnutrition crisis mirrors the national trend. According to the Nigeria Food Consumption and Nutrition Status Survey, 42% of children under five are stunted, 25% are underweight, and 9% are wasted. The effects of malnutrition on children are profound, impacting not only their physical growth but also their cognitive development and overall well-being. Stunting, caused by chronic undernutrition, has long-term implications, affecting school performance, productivity in adulthood, and increasing the risk of chronic diseases later in life. Wasting, on the other hand, represents acute malnutrition and is associated with a higher risk of mortality, particularly in young children. These outcomes are exacerbated by factors such as poor maternal nutrition, poor breastfeeding practices, inadequate knowledge of appropriate complementary feeding, food insecurity, and limited access to healthcare services, particularly in rural areas. In response to these challenges, the Nigerian government, in collaboration with various national and international organizations, has implemented several initiatives to combat malnutrition and improve child health outcomes. One of such initiative is the Maternal, Newborn, and Child Health (MNCH) Week, which is organized by the National Primary Health Care Development Agency (NPHCDA), State Ministries of Health and State Primary Health Care Boards. MNCH Week is a bi-annual event that delivers an integrated package of essential maternal, newborn, and child health services, including immunization, growth monitoring, Vitamin A supplementation, deworming supplementation, malnutrition screening, nutritional counseling, Family Planning and antenatal care (provision of SP for IPTp, (IFA/MMS) Iron Foli Acid/Multiple Micronutrient Supplement) etc. The aim of this initiative (MNCH Week) is to strengthen routine primary healthcare services by providing cost-effective, high-impact interventions that are easily accessible to vulnerable populations. Notable nutrition programmes in the State are bi-annual Maternal Newborn and Child Health Week where over 2,885,747 children were supplemented with vitamin A, out of which 2,057,974 benefitted from deworming in 2023 and 2024. During the programme, 261,528 pregnant women were provided with iron folate and 246,616 pregnant women were provided with SP drugs. Other interventions included distribution of 7,887 family planning, 5,078 Birth Registration were done, BCG coverage were 9,283, Penta coverage were 17,988, HBV coverage were 7,843, Measles coverage were 10,794, LLIN were 599, Yellow fever coverage were 9,156, Tetanus Diphtheria coverage were 15,297, Health Promotion coverage were 494,315 and MUAC screening were 1,335,526. The significance of MNCH Week lies its ability to reach a large number of children and mothers within a short time frame, providing them with essential health services that might otherwise be unavailable or difficult to access. In Oyo State, MNCH Week has been instrumental in addressing the nutritional and health needs of children under five, particularly in underserved and rural areas. However, while the program has been widely implemented, there is limited empirical evidence on its direct impact on the growth and health outcomes of children under five in Oyo State. This study seeks to fill this gap by investigating the impact of MNCH Week on the growth of children under five across seven health zones in Oyo State. By examining both quantitative and qualitative data, this study aims to provide a comprehensive understanding of the program's effectiveness in reducing malnutrition and improving child health outcomes, as well as identifying any barriers to its successful implementation. The health sector has facilitated the emergence of a healthy work force mainly contributed to by a combination of curative, preventive, and rehabilitative health programs. The State government has gone ahead to renovate and equip Ring Road State Hospital and 299 PHC centers in order to increase the accessibility to healthcare. The curative programs include availability of healthcare facilities in both rural and urban areas across private and public sectors. These curative services are ably supported by programmes such as State supported Health Insurance Scheme (Oyo State Health Insurance Agency-OYSHA), "T'omoT'iya" (Maternal, new-born, child health and nutrition initiative), Free Health Missions and PHC under One Roof. Objective: The primary objective of this study is to evaluate the impact of Maternal, Newborn, and Child Health (MNCH) Week on the growth and health of children under five across seven health zones in Oyo State, Nigeria. Specifically, the study seeks to assess how MNCH Week has contributed to the reduction of malnutrition rates-particularly stunting and wasting-and the overall improvement in health outcomes for children in these regions. Additionally, the study aims to explore potential challenges in the delivery and uptake of MNCH Week services, particularly in rural and underserved communities, and to provide recommendations for enhancing the effectiveness and reach of the program. |
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| Methodology/Approach | This study employed a mixed-methods approach, combining both quantitative and qualitative data to assess the impact of MNCH Week on child health outcomes in Oyo State. The research focused on seven health zones within the state, comprising 33 Local Government Areas (LGAs). These health zones include urban, peri-urban, and rural areas, offering a diverse representation of the population and healthcare access across the state. The mixed-methods approach was chosen to provide a comprehensive analysis, allowing for the triangulation of data and a deeper understanding of both the numerical trends and the lived experiences of the program's beneficiaries. Quantitative Data Collection: The primary source of quantitative data was the District Health Information System (DHIS 2), a national health information repository that collects data from health facilities across Nigeria. For this study, data on children aged 0-59 months who participated in MNCH Week activities from 2020 to 2023 were extracted from the DHIS 2. The key indicators analyzed included: • Weight-for-age: A measure used to assess whether a child is underweight for their age. • Height-for-age (stunting): A measure used to assess chronic undernutrition. • Weight-for-height (wasting): A measure used to assess acute malnutrition. • Immunization coverage: The proportion of children who received age-appropriate vaccines during MNCH Week. • Vitamin A supplementation: The percentage of children who received Vitamin A during MNCH Week. These indicators were chosen because they represent key measures of nutritional status and child health, and are routinely collected as part of MNCH Week activities. The data were aggregated monthly by health facilities, validated at both the local and state levels, and entered into the national database. This process ensured the accuracy and reliability of the data used in the study. Qualitative Data Collection: In addition to the quantitative data, exit interviews were conducted with 14 parents (two from each of the seven health zones) whose children participated in MNCH Week. The interviews were designed to gather qualitative insights into the parents' experiences with the program, their perceptions of the services provided, and any challenges they faced in accessing the services. These interviews provided a valuable context for understanding how the program was perceived by its beneficiaries and helped to identify potential barriers to participation, such as long waiting times, distance to healthcare facilities, or a lack of awareness about MNCH Week activities. Data Analysis: The quantitative data were analyzed using descriptive statistics to summarize the key findings, such as the prevalence of stunting, wasting, and underweight, as well as immunization and Vitamin A supplementation coverage. A multivariate analysis was conducted to examine the relationship between MNCH Week interventions and child health outcomes, controlling for potential confounding factors such as age, gender, and geographic location. IBM SPSS Statistics software was used for the data analysis, ensuring robust statistical testing and the identification of significant associations between the variables. For the qualitative data, thematic analysis was employed to identify common themes and patterns in the responses from the exit interviews. Thematic analysis is a widely used method for analyzing qualitative data, allowing researchers to systematically code the data and identify recurring themes that provide insights into the experiences and perceptions of the participants. |
| Results | The results of the study provided compelling evidence that MNCH Week interventions have a positive impact on the growth and health of children under-five in Oyo State. The quantitative analysis revealed significant improvements in several key health indicators among children who participated in MNCH Week activities compared to those who did not. Stunting and Wasting: Children who participated in MNCH Week showed a significant reduction in the prevalence of stunting and wasting. Specifically, the multivariate analysis demonstrated that children who received growth monitoring, malnutrition screening and nutritional counseling during MNCH Week were 30% less likely to be stunted (p < 0.05) and 25% less likely to be wasted (p < 0.05) compared to non-participants. These findings highlight the critical role that MNCH Week plays in addressing both chronic and acute malnutrition, particularly in regions where access to regular healthcare services may be limited. Immunization and Vitamin A Supplementation The study also found significant increases in immunization coverage and Vitamin A supplementation among children who participated in MNCH Week. Immunization coverage during MNCH Week reached 90%, with the majority of children receiving all age-appropriate vaccines. This is a notable achievement, given the challenges associated with reaching rural and hard-to-reach populations in Oyo State. Similarly, 85% of children who participated in MNCH Week received Vitamin A supplementation, which is crucial for boosting immune function and promoting healthy growth. Parental Perceptions The qualitative data from the exit interviews revealed that parents generally had positive perceptions of MNCH Week and its impact on their children's health. Many parents reported that the growth monitoring and nutritional counseling provided during MNCH Week helped them better understand their children's nutritional needs and how to address them. However, some parents, particularly those in rural areas, mentioned challenges such as long waiting times at healthcare facilities and difficulties in accessing the services due to the distance from their homes. |
| Discussion/Conclusion | MNCH week has a tremendous positive impact on the diet of children under five in Oyo State, Nigeria, contributing to improved health outcomes and reduced stunting prevalence when compared with past years without the conduct of the week. The findings of this study provide strong evidence that Maternal, Newborn, and Child Health (MNCH) Week was an effective intervention for improving the growth and health outcomes of children under five in Oyo State, Nigeria. The program significantly reduced the prevalence of stunting and wasting, improves immunization and Vitamin A supplementation coverage, and offers valuable growth monitoring and nutritional counseling services to parents. These outcomes were particularly important in a context where malnutrition and poor access to healthcare remain significant challenges. However, while the program has achieved notable successes, there are still several areas where improvements can be made. Addressing the challenges faced by parents in rural areas-such as difficulties in accessing healthcare facilities and long waiting times-will be crucial to ensuring that the benefits of MNCH Week are equitably distributed across the population. Additionally, increasing awareness of MNCH Week activities and engaging with local communities to promote participation will be essential to expanding the program's reach and impact. Based on the results of this study, it is recommended that the Nigerian government and other stakeholders continue to support increasing funding and expand MNCH Week interventions, particularly in underserved and rural areas. Enhancing the delivery of services during MNCH Week, such as by improving the efficiency of healthcare facilities and ensuring that they are adequately resourced, will be critical to sustaining the program's success in reducing malnutrition and improving child health outcomes in Oyo State and beyond. |
| Presenters and affiliations | Abiodun Akeem Akande Department of Health Planning, Research & Statistics, Oyo State Ministry of Health Olutayo Amos Akindoyin Department of Health Planning, Research & Statistics, Oyo State Ministry of Health Yomi Michael Taiwo Department of Nursing Services Abubakar Olayinka Department of Planning, Research and Statistics Ayodeji Rotimi Fakunle Deputy Director, Administration University College Hospital |
