CHIPs Plus(+) Intervention

We aim to expand access and increase utilization to high quality, affordable reproductive maternal and newborn care information and services, influence the behaviors of the thousands of inhabitants in rural communities, through strengthening the availability of information and services on reproductive maternal and child health, and risk communication on COVID 19 from sources that these community members trust in the Niger-Delta region of Nigeria. The content for engagement will be developed using human-centered design (HCD)

Adolesent girls and young women (AGYW) are even more vulnerable and are at a higher risk of death because of conditions such as anemia, obstructed labor, and fistula. They are also less likely to use skilled maternal health services than mothers over age 20. Access to adequate health service is a major barrier to improved maternal mortality. Barriers to accessing health care amongst many include; User fees, distance to facility, lack of transportation to the facility, and human resource for health and currently access to facilities due to fear and stigma of the novel COVID19. Besides, pregnancy-related complications are the leading cause of death among young women aged 15-19 years. AGYW are at particular risk for maternal conditions such as anemia, obstructed labor, and fistula. They are also less likely to use skilled maternal health services than mothers over age 20., Availability of essential medicines, and availability of trained human resources for health to deliver the services is still a challenge. These supply-side challenges have been frequently enumerated as contributing factors to low coverages in Nigeria and high maternal mortality. Yet weak demand for antenatal care and delivery services, and poor community linkage for these services remain significant demand-side constraints.

Corona Management System (CMS) intends to roll out a Private-sector managed model for the Community Health Influencers, Promoters, and Services (CHIPS) agents who are trained to deliver door to door health education and health promotion, mobilize communities on critical health issues, and provide basic health services like ANC, FP, Malaria testing and treatment. The model will engage the CHIPs agents to market RMNCH commodities, family planning commodities i.e Oxytocin, Misosprotol, provide Home base ante-natal care services using Hand-held pregnancy scans, and provide immunization, Malaria testing/treatment services, and integrated management of childhood illnesses for women in rural communities. The CHIPs agent will be supported by a Higher cadre health worker (Doctors and Nurse-Midwives) providing backend support. A mobile phone driven information system will also be developed that allows community members to subscribe, get comprehensive RMNCH and COVID information, and also provide supportive information to the CHIPs. These will be deployed using an enterprise model, funded in a pre-paid model/aligned into community-based health insurance schemes in the Niger-delta region by 2022. 

Our proposed idea will put girls and women living in rural and humanitarian communities at the center of the intervention, to understand these women as users of health services more closely and to leverage a participatory approach to co-design solution that ensure the availability of services at different community homes while improving the health-seeking behaviors of women particularly young mothers during and after the COVID-19 Pandemic. Our idea will also work with these women and CHIPs agent to ideate and iterate, towards increasing access to antenatal and postnatal services including immunization for new-borns, Malaria testing, and treatment, integrated management of childhood illnesses, increase utilization of family planning services and strengthen the capacity of CHIPs to mobilize and increase demand for RMNCH. The community engagement meetings will be led by positive deviants to facilitate social and behavior change to increase utilization of RMNCH services and to prevent the spread of COVID19 

Evidence suggests that improved access to adequate health care holds great potential for improved maternal and child survival. 

In Nigeria, survey reports show that 46% of Nigerians admit that health workers are their trusted source of information on health, with an additional 27% endorsing community mobilizers and community leaders, as their trusted source of information on health. This includes information on family planning, and other sexual and reproductive health issues, as well as information on vaccination, and water, sanitation, and hygiene practices. These survey outcomes have remained relatively consistent from Q4 2017 when quarterly micro surveys were instituted by the National Primary Healthcare Development Agency (NPHCDA).

This idea is different because it incorporates a human-centered design into designing a private-sector enterprise model. It also targets women especially young women, community health volunteers (CHIPs+) in rural communities, and humanitarian settings. The intervention builds on existing evidence on the roles of community health volunteers and positive deviance in spurring social and behavior change. The idea uses a mobile phone driven information that enables community members to subscribe, get comprehensive RMNCH and COVID information, and also provides supportive information to the CHIPs It also dovetails into the current National strategies in Nigeria to rapidly improve access to RMNCH information and services in humanitarian settings.

Our idea will test the hypothesis that women especially young women will demand RMNCH services, immunization services, Malaria testing/treatment, as a right if they are engaged using private-sector enterprise models through a human-centered process of increasing knowledge, and the increasing availability of services, and trust-building. We expect our solution to succeed because it builds on documented evidence and best practices of community engagement and demand generation, whilst innovatively introducing a composite design model.

Internet of things 

Software and mobile applications 

Big Data

GIS

mobile phone driven information that enables community members to subscribe, get comprehensive RMNCH and COVID information, and also provides supportive information to the CHIPs

We expect our solution to succeed because it builds on documented evidence and best practices of community engagement and demand generation, whilst innovatively introducing a composite design model.

Over the timeline of the grant, key outputs that we intend to achieve include:

• 2,000 providers in our target geographies with increased capacity on mobilize and increase demand for reproductive, maternal and child health, with at least 1,000 of the providers identifying as women
• 2,000 providers in our target geographies with increase capacity to mobile and increase demand for COVID information, Malaria testing, and treatment, integrated management of childhood illnesses, increase utilization of family planning services, with at least 1,000 of the providers identifying as women
• At least 80% of trained providers providing  reproductive, maternal and child health services, with at least 800 of those providing services identifying as women
• At least 80% of trained providers providing  COVID information, Malaria testing, and treatment, integrated management of childhood illnesses, increase utilization of family planning services, with at least 800 of those providing services identifying as women
•  A mobile phone driven information system developed
• 2,000,000 women and girls will have enhanced access to antenatal, postnatal, delivery and immunization health service and provide basic health services like family planning, Malaria testing and treatment, and integrated management of childhood illnesses for women
• 2,000,000 women and girls will have enhanced access to COVID-19 information

Over 3-5 years, with increased capacities of providers serving our target geographical location, we anticipate that:

• 2,000,000 women and girls will increase demand and utilization of RMNCH services
• influence the behaviors of the thousands of inhabitants in rural communities, through strengthening the availability of information and services on reproductive maternal and child health, and risk communication on COVID 19

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We plan to reach 500 CHIPs and 500,000 Adolecent mothers and women

As with many projects there are number of threats that might undermine the validity of the proposed design.  These include lack of support from government partners and gatekeepers; poor cooperation by management of Health facilities due to suspicion on the use of data; inadequate budget; heavy rains that could make certain location  physically in accessible;  Given the innovativeness of this project, there might be unforeseen costing that could delay the process. 

To mitigate against lack of support and cooperation from government MDA and health facility management, the team will hold project familiarity meetings prior to commencement of the project to ensure that all stakeholder understand the purpose of the study and project overall. 

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4 full time staff

5 Vollunteers

Dr. Chijioke Kaduru, Program Director Chijioke Kaduru is our Health Division Lead for CMS. He holds a Master of Public Health degree, a Bachelor of Medicine and Bachelor of Surgery degree and a Bachelor of Science degree, working in public health for over ten years, with seven of those years working in Ghana and Nigeria. He is a Public health Physician who works on providing Sub-National Health Systems Strengthening technical assistance to the States we support, driving the conceptualization, implementation, monitoring and evaluation of State-led interventions in Malaria, Routine Immunization and Reproductive Health. He also focuses on strengthening Communications for Development systems at sub-national level. He has worked as a Technical Assistant on the World Bank/GAVI supported National strategy for immunization and primary healthcare systems strengthening, as part of the drive to end polio, strengthen routine immunization and improve primary healthcare services

Mr. Koko Aadum, Procurement and Logistics Koko Aadum is the Innovation specialist, and head of procurement and logistics for this joint venture. He holds degrees in electrical electronics engineering, with a Master’s Degree in Information and Communications Technology (ICT) for Development. He has worked for the last five years deploying ICT solutions to strengthen procurement and logistics management in Health. He currently provides leadership on our technology-driven innovations in the improving procurement for Reproductive, Maternal, Newborn and Child Health commodities and supplies

Community Theatre for Immunization in Bayelsa and Rivers States (2019 to Present)

Funded by Grand Challenges Explorations, an Initiative of the Bill and Melinda Gates Foundation (US$100,000 for year 1)

We currently using this fund to empower caregivers to seek and fully utilize immunization services, by engaging caregivers and communities on Vaccine Preventable Diseases, Immunisation and Social Determinants of Health, using community theater that showcases real stories. Communities are engaged to take the lead in identifying some of the demand side challenges, such as Adverse Events Following Immunisation, awareness on the Routine Immunisation schedule, awareness on the availability of Immunisation sessions and knowledge about Vaccine Preventable Diseases. These topics form the foundational issues around which the community drama that is developed.

The pathways for scale will focus on the deployment of this approach in humanitarian settings, as a component of the response and recovery strategies implemented by government and partners, and also in the potential to deploy this as a population, health and environment strategy for building community resilience for the wider benefit of women and girls. The sustainability of our solution lies in the innovative model that empowers community platforms like the CHIPS to be the driver of change. This will ensure we are not reinventing the wheel but working with the Government to sustain the platform through the revenue generated from annual fees associated with the marketing of RMNCH commodities, and FP commodities and also through scale-up grants

Financial Barrier is the main challenge. if we have access to funding we will be able to use our solution to impact the lives of adolescent mothers and women at large

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Our solution aim to expand access and increase utilization to high quality, affordable reproductive maternal and newborn care information and services, influence the behaviors of the thousands of inhabitants (Adolescent girls and women) in rural communities, through strengthening the availability of information and services on reproductive maternal and child health, and risk communication on COVID 19 from sources that these community members trust in the Niger-Delta region of Nigeria. The content for engagement will be developed using human-centered design (HCD)

Our solution aim to expand access and increase utilization to high quality, affordable reproductive maternal and newborn care information and services, influence the behaviors of the thousands of inhabitants (Adolescent girls and women) in rural communities, through strengthening the availability of information and services on reproductive maternal and child health, and risk communication on COVID 19 from sources that these community members trust in the Niger-Delta region of Nigeria. The content for engagement will be developed using human-centered design (HCD)

Our solution aim to expand access and increase utilization to high quality, affordable reproductive maternal and newborn care information and services, influence the behaviors of the thousands of inhabitants (Adolescent girls and women) in rural communities, through strengthening the availability of information and services on reproductive maternal and child health, and risk communication on COVID 19 from sources that these community members trust in the Niger-Delta region of Nigeria. The content for engagement will be developed using human-centered design (HCD)