The State of Maternal Health in Nigeria

CHDS Research Fellow Daniel Erim has recently had two articles published which focus on contextualizing decision science models to reflect the state of maternal health in Nigeria. The first is a survey of Nigerian healthcare facilities which assess the availability of maternal health services and identifies determinants of access. The second examines the benefits and cost-effectiveness of individual and integrated packages of interventions targeted to prevent pregnancy-related deaths. “By focusing my analyses within specific geographical areas, I have been better able to evaluate the benefits of different policies aimed at promoting and increasing the availability of maternal interventions within those locations,” Daniel said.

Daniel, in close conjunction with CHDS programmer Zachary Ward, has also been assisting in the creation of an updated version of the main maternal decision science model. Within the context of his work in Nigeria, Daniel is eager to use the new model’s capability to simulate discrete health care facilities, each of them with unique characteristics. “The new ability to model how EmOC quality, distance from a facility, and demographic characteristics may affect one’s choice of which healthcare facility to deliver in, should allow us to model a much richer and more complete picture of the decision making process faced by pregnant women in Nigeria,” he said.

As part of his research, Daniel took part in a geographic information systems (GIS) training through the Harvard Center for Geographic Analysis. As Daniel explained, “One of the benefits of decision science is that through its interdisciplinary nature, it provides the flexibility to explore different tools that may open up new opportunities for analyses.” GIS will be utilized not only as way to provide highly contextualized inputs for the model, but also as an avenue for knowledge translation (KT), allowing modeled results to be presented to audiences in an innovative fashion. As part of CHDS’ continued efforts to provide first-rate, audience-specific KT, Daniel has spent considerable time engaging health executives and policy makers in Nigeria. He also travelled to Nigeria, presenting to experts in the field and networking with current and future in-country collaborators. “I am most excited for what comes next,” he said. “There are many research questions that can be answered using our decision analytic techniques. The potential ability to access the benefits of increasing the number of healthcare facilities; estimating the financial capital needed for scale up of EmOC services; the benefits of PMTCT and IPT services; and the spill over benefits for neonates, should keep us busy for some time to come.”