The BORN Study: Better Obstetrics in Rural Nigeria

Nigerian midwife

photo by DFID - UK Department for
International Development/Flickr.com

Maternal and infant mortality is an enormous problem in Nigeria, Africa's most populous country. More than 250,000 infants die in Nigeria each year, and the country accounts for almost 15 percent of maternal deaths across the globe.

Rural areas are especially at risk. Recent figures suggest that about one out of every 120 births in rural Nigeria results in maternal death, compared to about one out of every 285 births in urban areas.

In response to this troubling issue, the Nigerian government created the Midwives Service Scheme (MSS). The MSS set an ambitious goal to double the proportion of deliveries attended to by skilled birth attendants and to lower maternal and infant mortality in target areas by 60 percent by December 2015.

With the MSS operating for a few years, now is the time for a rigorous evaluation of the program. RAND's BORN Study will examine what impact the MSS has had on:

  • access to emergency obstetric care
  • use of skilled birth attendants
  • maternal and child health.

The Potential for Impact

Fifty-two percent of maternal deaths and 50 percent of deaths among children younger than five years old occur in sub-Saharan Africa. The BORN Study's findings regarding the MSS and its efficacy at lowering maternal and infant mortality could have wide-ranging impact on health in the region.

What's New

The BORN Study team led a two-day stakeholder workshop hosted by the National Primary Healthcare Development Agency in Abuja, Nigeria October 23-24, 2013.

On Day 1 of the workshop, the team discussed the BORN Study's objectives and design and received structured feedback from a wide range of stakeholders:

  • Community Health Practitioners Registration Board of Nigeria
  • Nursing and Midwifery Council of Nigeria
  • Federal Ministry of Health
  • National Bureau of Statistics
  • National Health Insurance Scheme
  • Office of the Senior Special Assistant to the President - Millennium Development Goals (OSSAP-MDG)
  • International agencies including UNICEF and USAID
  • Various donor-funded programs and non-governmental organizations, including:
    • Partnership for Reviving Routine Immunization in Northern Nigeria-Maternal Newborn and Child Health (PRRINN-MNCH)
    • Partnership for Transforming Health Systems (PATHS 2).

On Day 2, the team trained participants on data analysis and program evaluation to build research capacity and provided participants with tools to design their own evaluations.

What's Next

Data collection began in early 2014.

Visit us in the fall of 2014 for some preliminary results.