title: Monitoring maternal, newborn, and child health interventions using lot quality assurance sampling in Sokoto State of northern Nigeria.
abstract: BACKGROUND
  Maternal mortality ratio and infant mortality rate are as high as 1,576 per 100,000 live births and 78 per 1,000 live births, respectively, in Nigeria's northwestern region, where Sokoto State is located. Using applicable monitoring indicators for tracking progress in the UN/WHO framework on continuum of maternal, newborn, and child health care, this study evaluated the progress of Sokoto toward achieving the Millennium Development Goals (MDGs) 4 and 5 by December 2015. The changes in outcomes in 2012-2013 associated with maternal and child health interventions were assessed.
  
  
  METHODS
  We used baseline and follow-up lot quality assurance sampling (LQAS) data obtained in 2012 and 2013, respectively. In each of the surveys, data were obtained from 437 households sampled from 19 LQAS locations in each of the 23 local government areas (LGAs). The composite state-level coverage estimates of the respective indicators were aggregated from estimated LGA coverage estimates.
  
  
  RESULTS
  None of the nine indicators associated with the continuum of maternal, neonatal, and child care satisfied the recommended 90% coverage target for achieving MDGs 4 and 5. Similarly, the average state coverage estimates were lower than national coverage estimates. Marginal improvements in coverage were obtained in the demand for family planning satisfied, antenatal care visits, postnatal care for mothers, and exclusive breast-feeding. Antibiotic treatment for acute pneumonia increased significantly by 12.8 percentage points. The majority of the LGAs were classifiable as low-performing, high-priority areas for intensified program intervention.
  
  
  CONCLUSIONS
  Despite the limited time left in the countdown to December 2015, Sokoto State, Nigeria, is not on track to achieving the MDG 90% coverage of indicators tied to the continuum of maternal and child care, to reduce maternal and childhood mortality by a third by 2015. Targeted health system investments at the primary care level remain a priority, for intensive program scale-up to accelerate impact.
authors.affiliation: United States Agency for International Development - John Snow Inc. Research and Training, Inc. - Targeted States High Impact Project Nigeria; dabegunde@tshipnigeria.org.
authors.forename: Dele
authors.initials: D
authors.lastname: Abegunde
authors.affiliation: United States Agency for International Development - John Snow Inc. Research and Training, Inc. - Targeted States High Impact Project Nigeria.
authors.forename: Nosa
authors.initials: N
authors.lastname: Orobaton
authors.affiliation: Jhpeigo - Targeted States High Impact Project Nigeria, Bauchi, Nigeria.
authors.forename: Kamil
authors.initials: K
authors.lastname: Shoretire
authors.affiliation: United States Agency for International Development - John Snow Inc. Research and Training, Inc. - Targeted States High Impact Project Nigeria.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: United States Agency for International Development - John Snow Inc. Research and Training, Inc. - Targeted States High Impact Project Nigeria.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Mohammed
authors.affiliation: United States Agency for International Development - John Snow Inc. Research and Training, Inc. - Targeted States High Impact Project Nigeria.
authors.forename: Jumare
authors.initials: J
authors.lastname: Abdulazeez
authors.affiliation: United States Agency for International Development - John Snow Inc. Research and Training, Inc. - Targeted States High Impact Project Nigeria.
authors.forename: Ringpon
authors.initials: R
authors.lastname: Gwamzhi
authors.affiliation: United States Agency for International Development - John Snow Inc. Research and Training, Inc. - Targeted States High Impact Project Nigeria.
authors.forename: Akeem
authors.initials: A
authors.lastname: Ganiyu
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data; D046688:Child Mortality; D002675:Child, Preschool; D005193:Family Planning Services; D005260:Female; D014943:Global Health; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D055810:Lot Quality Assurance Sampling / Q000379:methods*; D008297:Male; D008428:Maternal Mortality; D000068101:Maternal-Child Health Services; D009549:Nigeria / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards; D011314:Preventive Health Services / Q000592:standards; D015397:Program Evaluation
keywords: Nigeria; lot quality assurance sampling; maternal; monitoring and evaluation; newborn and child health