Government to evaluate impact of Midwives Service Scheme

By Ngozi Oboh


The federal government is worried that despite the introduction of the Midwives Service Scheme (MSS) in 2009, maternal and neo-natal deaths are still on the increase in Nigeria.

This has informed the need for an impact evaluation of the scheme to ascertain its relevance or otherwise in the Nigerian health sector, said Emmanuel Abanida, the acting Executive Director of the National Primary Health Care Development Agency (NPHCDA).

Mr Abanida who disclosed this on Thursday in Abuja at the MSS impact evaluation meeting stated that it is worrisome that Nigeria has one of the highest child mortality rates in the world and the worst maternal mortality rate in Africa.

"Five hundred women die out of every 100,000 as a result of giving birth to children," he said. "Averagely close to about 200 infants out of 10,000 given birth to die within the first five years. The impact evaluation is done to ensure that what MSS is designed to achieve, it is achieving it."

He added that the proposed MSS impact evaluation will examine the impact the scheme has on antenatal clinic utilisation, access to skilled attendance at birth and, quality of maternal and child health services.

"At the end we are going to find out if it is really giving us reduction in death of women that are giving birth. Are we really having reduction in death of infants? Are we really having reduction in number of children that are being maimed as a result of things that can be prevented? Are the health facilities doing more than what they are supposed to do before the MSS programme was introduced? It is like assessing for meaningful results," he said.

The survey according to Mr Abanida commenced yesterday with the meeting of the stakeholders and will be concluded in two years.

The evaluation is expected to provide evidence on effectiveness, distributional effect and quality of care. This will not only help to understand the impact of the interventions through providing population-wide estimates and distributional outcomes but will inform on distributional impact on the community.


Mobilising experience

The Midwives Service Scheme was established to mobilise unemployed and retired midwives for deployment to selected primary health care facilities in rural communities in order to facilitate an increase in skilled attendance at birth and, consequently, a reduction in maternal, newborn and child mortality in Nigeria.

The MSS programme aims at recruiting, deploying and retaining midwives in primary health centres located in regions of high martenal mortality in order to guarantee the availability of 24-hour service.

Benjamin Uzochukwu, a Consultant Physician at the University of Nigeria Teaching Hospital, Enugu who leads the team of the evaluators said the outcome of the evaluation will be useful for policy decisions of the government.

"The obvious need for the impact evaluation is to help policy makers decide whether the programmes are generating intended effects; and to fill the gaps in understanding what works, what does not, and how measured changes in well-being are attributable to a particular project or policy intervention," Mr Uzochukwu said. "The benefits of impact evaluation are therefore long term and can have substantial spill over effects."

Their study area will include all the local government areas in the 36 states and FCT while the study population will include women of child bearing age in selected households; health workers in MSS and non-MSS primary health care centres and interviews with ante-natal care and family planning users in the primary health care centres.


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