Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

Type Journal Article - BMC public health
Title Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014
Volume 15
Issue 1
Publication (Day/Month/Year) 2015
Background: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many
interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the
Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the
Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014.
Methods: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was
searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health
in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of
maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using
Nigeria Demographic and Health Survey data (1990–2013). This was supplemented by document analysis of
policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period.
Results: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and
the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and
post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal
evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent
reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope
observed in the period with a cluster of published studies (2004–2014). Fifteen intervention studies specifically targeting
under-five children were published during the 24 years of observation. A statistically insignificant downward trend in
the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies
and development of MNCH policies.
Conclusions: The development of MNCH policies, implementation and publication of interventions corresponds with
the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more
MNCH intervention research and publications of findings is required to generate local and relevant evidence.

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