Improving maternal and neonatal outcomes in low-income communities in lagos state, Nigeria: an overview of the mamabase pilot program

Le résumé fourni par la source

Nigeria accounts for nearly one-fifth of global maternal deaths, with disproportionately high mortality among women living in low-income communities. Structural, financial, and sociocultural barriers continue to limit access to skilled maternal healthcare, in low-income settings in urban Lagos State. The MamaBase pilot program was implemented by the Maternal Reproductive Health Research Collective (MRH Collective) in 2024. The program was designed to address demand-side barriers to maternal health service utilization through a community-centered, data-driven approach, and was implemented across low-income communities in all 20 Local Government Areas of Lagos State, Nigeria. and. This prospective observational study describes the MamaBase pilot programme and presents early findings from its implementation. MamaBase employed a multicomponent approach that included community outreach and health education, active identification and enrollment of pregnant women by community health extension workers (CHEWs), linkage to nearby public primary healthcare facilities, and continuous follow-up throughout pregnancy and up to six weeks postpartum. Real-time data collection and monitoring of maternal health service utilization was done. Conditional cash incentives were provided to encourage early antenatal care (ANC) registration, completion of at least four ANC visits, and facility-based delivery, alongside targeted financial support for selected clinical needs. A total of 7,883 pregnant women were enrolled across the state. At enrollment, 47% of women were registered for ANC; this increased to 84% during program participation. Among women with available visit data, 58.5% attended four or more ANC visits. The majority of participants delivered in health facilities, most commonly public primary healthcare centers. The MamaBase pilot demonstrates the feasibility of a large-scale, community-centered maternal health intervention in low-income urban settings. Integrating demand-generation strategies, financial incentives, CHEW-led follow-up, and digital surveillance may strengthen maternal service utilization and reduce inequities in access to skilled care. Lessons from this pilot may inform the design and scale-up of similar community-based maternal health programs in other resource-constrained urban settings.

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