What are the barriers to attendance to the MNCHW and how can these be reduced

Maternal Neonatal and Child Health Weeks programme (MNCHW) was launched in Nigeria in 2009, as a bi-annual campaign-style programme designed to deliver key child and maternal health interventions and to revitalise health care systems. The work was a collaborative project between the London School of Hygiene & Tropical Medicine, Food Basket Foundation International and Oxford Policy Management.

There was very low awareness of the MNCHW programme amongst women who had not attended MNCHW, amongst husbands and amongst social mobilisers. Even though knowledge of the MNCHW interventions and their health benefits was relatively high amongst the women who had attended MNCHW and government officials, it was low across other interviewee strata. Further, all interviewee strata, except government officials, confused MNCHW with other health programmes that were being implemented in the area.

Conclusions:

• the low awareness of MNCHW and its health benefits need to be addressed to improve attendance. Child health was highly valued by all interviewee strata. Therefore, an overall recommendation, which can be acted on immediately, therefore, is to combine health education with social mobilisation in order to increase knowledge of MNCHW and its health benefits across all stakeholders
• the MNCHW strategy should be reviewed. MNCHW delivers multiple complex interventions requiring skilled staff, which severely limits the number of facilities through which it can be delivered. The overall recommendation, which can be acted upon in the intermediate to long term, therefore, is to modify the current MNCHW strategy from delivering a complex set of interventions, requiring skilled staff, to delivering a simple set of interventions that does not require highly skilled staff. This change would allow an increase in the number of health facilities and outreach posts through which MNCHW is delivered in order to address the MNCHW access barrier