Public health interventions, barriers, and opportunities for improving maternal nutrition in Northeast Nigeria.
BACKGROUND
Efficacious strategies to improve maternal nutrition and subsequent maternal, neonatal, and child health exist, but their utilization and application at scale is limited.


OBJECTIVE
This study explored the gaps, barriers, and opportunities for maternal nutrition policy and programming in Nigeria, a country with a disproportionate share of the global burden of maternal and child mortality


METHODS
Research was conducted in three phases in four Local Government Authorities in Taraba State. Phase 1 consisted of a desk review of policies, programs, and sociodemographic and health indicators pertinent to maternal nutrition. In-depth interviews were conducted with key informants in state and local ministries of health as well as international nongovernmental organizations and community- and faith-based organizations. Phase 2 utilized in-depth interviews and focus group discussions with community leaders, health promoters, and mothers. Phase 3 consisted of key informant interviews with federal policy and program leaders in government ministries and nongovernmental organizations.


RESULTS
Nutrition, especially maternal nutrition, is not prioritized and is poorly funded in both the governmental and the nongovernmental systems. Perceived weak advocacy for nutrition and its role in economic development and the lack of coordination among governmental and nongovernmental actors were said to contribute to low prioritization. Dependence on health facilities as the primary platform for delivering maternal nutrition is problematic, given severe resource constraints and perceived community barriers, including cost, distance, and poor quality of care.


CONCLUSIONS
Advocacy for maternal nutrition that improves understanding of its consequences for health and economic development could hasten prioritization, coordination, and investment in maternal nutrition at the national, state, and local levels. Innovative, multisectoral strategies that move beyond facility-based platforms are needed to reduce the burden of maternal undernutrition in Northeast Nigeria.
Rollins School of Public Health, Emory University, Atlanta, Georgia 30317, USA. awebb3@emory.edu
Amy Webb
AW
Girard
Cynthia
C
Dzingina
Oladele
O
Akogun
John B
JB
Mason
Deborah A
DA
McFarland
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D017144:Focus Groups; D006284:Health Plan Implementation; D006292:Health Priorities; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D044342:Malnutrition / Q000178:diet therapy / Q000503:physiopathology / Q000517:prevention & control*; D008427:Maternal Health Services / Q000379:methods*; D039382:Maternal Nutritional Physiological Phenomena; D008875:Middle Aged; D009549:Nigeria; D018673:Nutrition Policy; D011247:Pregnancy; D055815:Young Adult