Fostering Collaboration and Learning while Addressing Barriers to Uptake of Maternal Health Services in three Northern States

Breakthrough ACTION is USAID's flagship project for social and behavior change. In Nigeria, the project uses the community capacity strengthening approach (CCS) to build the capacity of communities to resolve their health-related challenges by identifying and addressing maternal, newborn, and child health plus nutrition (MNCH+N) practices and issues around the uptake and access to health services.

The project staff collaborates with external community groups called ward development committees (WDCs) and national, state, and local governments in adaptation, training, and coaching to facilitate the CCS approach. Each committee developed a Community Health Action Resource Plan (CHARP), which addresses barriers to uptake of antenatal care (ANC) attendance and facility-based delivery.

The project applied a CLA approach to overcome challenges identified in implementing the CHARP through rapid situational assessment, supportive supervision, after-action reviews, public recognition, experience sharing meetings, and a mid-term assessment. These activities help identify challenges and best practices and determine which WDCs were functioning well and why; they also help the project see which committees are not functioning well and why and which communities implemented their CHARPS as planned.

The project adjusted the approaches to include digital media for capacity building and supportive supervision in response to COVID-19 and other constraints. One-hundred seventy-three committees are participating in the intervention from Kebbi, Sokoto, and Bauchi states. Findings indicate that most WDCs continued to implement their CHARPs through the COVID-19 pandemic, which is a promising sign of sustainability. However, gaps exist around proper documentation and low female representation and participation.