Monitoring of Maternal, Newborn and Child Health Week (MNCHW), 2013
Funded by: UNICEF “A” Field Office, Enugu
Implemented by: Economic and Social Empowerment of Rural Communities (ESERC)
Project Duration: 2013
Geographical Coverage: Isi-Uzo, Igbo Etiti, and Aninri Local Government Areas (LGAs), Enugu State, Nigeria
Project Background and Context
Maternal, Newborn and Child Health Week (MNCHW) is a nationally coordinated strategy designed to accelerate the delivery of high-impact, life-saving health interventions to women and children, particularly in underserved and hard-to-reach communities. The initiative supports Nigeria’s commitments to reducing maternal and child morbidity and mortality and aligns with global priorities such as the Millennium Development Goals (MDGs 4 and 5), which focused on reducing child mortality and improving maternal health.
Despite improvements in health policies and service delivery in Nigeria, maternal and child health indicators in many rural and semi-urban areas remain poor due to factors such as limited access to quality healthcare, low utilization of health services, inadequate health infrastructure, weak health systems, and socio-cultural barriers. MNCHW was therefore designed as an outreach-driven platform to deliver integrated health services directly to communities, ensuring that pregnant women, newborns, and children under five receive essential preventive and promotive health services.
In 2013, with funding support from UNICEF “A” Field Office, Enugu, the Economic and Social Empowerment of Rural Communities (ESERC) was engaged to monitor the implementation of MNCHW activities in Isi-Uzo, Igbo Etiti, and Aninri LGAs of Enugu State. The monitoring exercise aimed to ensure quality service delivery, adherence to national guidelines, accountability, and equitable access to MNCH services across the target LGAs.
Project Goal and Objectives
Overall Goal
To ensure the effective, transparent, and high-quality implementation of the 2013 Maternal, Newborn and Child Health Week in selected LGAs of Enugu State, thereby contributing to improved maternal, newborn, and child health outcomes.
Specific Objectives
• To monitor the delivery of MNCHW interventions in Isi-Uzo, Igbo Etiti, and Aninri LGAs.
• To assess compliance with national MNCHW guidelines and UNICEF-supported standards.
• To evaluate the availability and utilization of essential MNCH commodities during the campaign.
• To document challenges, gaps, and best practices observed during implementation.
• To provide evidence-based feedback and recommendations to UNICEF and relevant government stakeholders for improved MNCH programming.
ESERC’s Role and Implementation Strategy
ESERC served as an independent civil society monitoring partner, bringing community-level insight, technical expertise, and accountability-focused oversight to the MNCHW process. The organization adopted a participatory and field-based monitoring approach, working collaboratively with Local Government Health Authorities, health workers, community leaders, and caregivers.
Implementation Strategy Included:
• Deployment of trained ESERC monitoring teams to MNCHW service delivery points.
• Use of standardized monitoring checklists aligned with national MNCHW guidelines.
• Direct observation of service delivery processes.
• Engagement with health workers, caregivers, and community members.
• Documentation of findings for reporting and advocacy purposes.
Key Interventions and Activities Monitored
During the MNCHW 2013 exercise, ESERC monitored a wide range of integrated maternal, newborn, and child health interventions delivered across health facilities and community outreach sites in the three LGAs.
1. Maternal Health Interventions
• Distribution of Iron and Folic Acid supplements to pregnant women.
• Administration of Tetanus Toxoid (TT) immunization to women of reproductive age.
• Health education and counselling on:
– Antenatal care (ANC) attendance
– Skilled birth attendance
– Nutrition during pregnancy
– Birth preparedness and complication readiness
2. Newborn Health Interventions
• Promotion of early initiation of breastfeeding.
• Counselling on exclusive breastfeeding for the first six months.
• Education on essential newborn care, including hygiene and thermal care.
• Identification and referral of newborns with danger signs.
3. Child Health Interventions
• Administration of routine childhood immunizations in line with the national immunization schedule.
• Distribution of Vitamin A supplements to children aged 6–59 months.
• Deworming of eligible children.
• Growth monitoring and nutrition screening.
• Health education for caregivers on infant and young child feeding (IYCF) practices.
4. Community Mobilization and Demand Creation
• Engagement of community leaders and volunteers to mobilize caregivers.
• Use of community sensitization strategies to increase turnout.
• Monitoring of community participation and caregiver awareness.
Monitoring Methodology
ESERC employed a combination of qualitative and quantitative monitoring tools, including:
• Direct Observation:
Assessment of service delivery quality, infection prevention practices, client flow, and adherence to protocols.
• Commodity Tracking:
Monitoring availability and proper utilization of MNCHW commodities such as vaccines, supplements, and consumables.
• Key Informant Interactions:
Discussions with health workers, LGA health officials, and community mobilizers to understand implementation dynamics.
• Beneficiary Feedback:
Informal interactions with mothers and caregivers to assess satisfaction, understanding of health messages, and perceived barriers.
Key Observations and Findings
• MNCHW services were widely accepted by communities, with high turnout of women and caregivers, particularly in rural settlements.
• Health workers demonstrated strong commitment, despite challenges such as long working hours and limited personnel.
• Community mobilization efforts significantly improved awareness and participation.
• Some service delivery points experienced logistical challenges, including occasional stock-outs and limited space for service provision.
• Variations were observed in data recording practices, highlighting the need for continuous capacity strengthening.
Outcomes and Contributions
The monitoring exercise contributed to:
• Improved accountability and transparency in MNCHW implementation.
• Identification of operational gaps requiring immediate and long-term attention.
• Strengthened collaboration between UNICEF, government stakeholders, and civil society.
• Enhanced documentation of MNCHW processes and community experiences.
Lessons Learned
• Community-based monitoring enhances service quality and responsiveness.
• Early and sustained community mobilization is critical for high MNCHW uptake.
• Adequate logistics planning is essential to avoid service disruptions.
• Continuous supervision and mentoring improve adherence to MNCH guidelines.
Recommendations
Based on the monitoring findings, ESERC recommended:
• Strengthening logistics and commodity supply chains ahead of MNCHW.
• Increasing the number of trained health workers at service delivery points.
• Improving data collection and reporting systems.
• Sustaining community engagement beyond MNCHW campaigns.
• Integrating MNCHW lessons into routine primary healthcare services.
Conclusion
The monitoring of the Maternal, Newborn and Child Health Week (MNCHW) 2013 in Isi-Uzo, Igbo Etiti, and Aninri LGAs demonstrated the critical role of civil society in promoting accountability, quality service delivery, and community participation in public health programmes. Through UNICEF’s support and ESERC’s independent monitoring, the MNCHW initiative contributed meaningfully to improving access to essential maternal, newborn, and child health services in Enugu State.
The exercise reaffirmed that sustained investment in integrated outreach platforms, coupled with strong monitoring and community engagement, is essential for improving maternal and child health outcomes and strengthening Nigeria’s primary healthcare system.
