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Full-Text Articles in Public Health

Paidar: Private Sector Allied For Inclusive Delivery Of Accessible Reproductive Health, Population Council Pakistan Jun 2026

Paidar: Private Sector Allied For Inclusive Delivery Of Accessible Reproductive Health, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Pakistan continues to face critical challenges in increasing contraceptive use and reducing the unmet need for family planning (FP). While public-sector facilities remain key providers, a substantial proportion of healthcare seekers rely on private family physicians as their initial point of contact.

Recognizing this strategic opportunity, the PAIDAR study was designed to strengthen the role of private- sector male family physicians in FP service delivery. Implemented across six diverse districts of Punjab, supported by Health Care Commission Punjab and Department of Health and Population Punjab, the intervention enhanced providers' capacity to deliver quality FP counselling, contraceptive services, structured referrals, and …


Making Better Use Of Data For Improved Health Service Delivery In Punjab: Transforming Data Into Action Evidence, Population Council Pakistan Jun 2026

Making Better Use Of Data For Improved Health Service Delivery In Punjab: Transforming Data Into Action Evidence, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Strong health systems depend not only on collecting data, but on using it effectively for planning, monitoring, and decision-making. To strengthen evidence-based management across Punjab's health sector, the Population Council partnered with the Health and Population Department, Punjab, particularly the Health Information and Service Delivery Unit (HISDU), to improve the utilization of routine health information. This brief summarizes the collaboration's focus on three complementary areas: (1) Development of the ASET (Analytics for Service Efficiency and Tracking) platform to transform routine data into actionable information; (2) Strengthening the Capacity of Data Users through specialized training in data analytics, visualization, and use …


From Evidence To Action: Case For Further Investment In Family Planning For Faster Fertility Decline, Population Council Pakistan Jun 2026

From Evidence To Action: Case For Further Investment In Family Planning For Faster Fertility Decline, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

For over three decades, the Population Council Pakistan has generated evidence and supported governments in designing innovative approaches to address population and reproductive health challenges. Building on evidence around fertility transition, reproductive health, and the nationally endorsed Tawazun (balance) narrative, the Population Council supported the Government of Punjab through the FCDO-funded Delivering Accelerated Family Planning in Pakistan (DAFPAK) initiative and other strategic partnerships to implement scalable solutions for strengthening family planning services. This brief outlines five high-impact, proven interventions ready for institutional scale-up and provides an actionable path forward to transform routine health encounters into sustainable health system reforms.


Voucher Model For Family Planning: Empowering Poor Women And Expanding Access To Family Planning Services In Punjab, Population Council Pakistan Jun 2026

Voucher Model For Family Planning: Empowering Poor Women And Expanding Access To Family Planning Services In Punjab, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Pakistan continues to face significant inequalities in access to family planning (FP) services, with the poorest women bearing a disproportionate burden of unmet need. Financial constraints, transportation costs, limited mobility, restricted decision-making power, and inadequate access to quality services often prevent women from obtaining the family planning services they need.

To address these barriers, the Population Council, in partnership with the Benazir Income Support Programme (BISP) and the Punjab Population Innovation Fund (PPIF), designed and rigorously evaluated an innovative Family Planning Voucher Scheme.

The model linked social protection with reproductive health services, enabling poor women from Rahim Yar Khan (RYK) …


Creating Actionable, Culturally Appropriate Interventions From Survey Data: A Community-Driven Capstone Pilot Project, Nicole Placke Dec 2025

Creating Actionable, Culturally Appropriate Interventions From Survey Data: A Community-Driven Capstone Pilot Project, Nicole Placke

Capstone Experience: Master of Public Health

The Community-Driven Capstone Track is a pilot program designed as an alternative to the traditional capstone track. With this track, students are able to engage with community partners through an integrative learning experience. The goal is to address real organizational needs in a way that demonstrates the mastery of foundational and concentration competencies.

Unlike the traditional capstone track, the CDC offers flexibility in both project type and deliverables. Rather than one formal written report, students might produce a series of products or tools. Deliverables are decided collaboratively between the student, community partners, and the faculty committee to ensure they are …


Namai Zambia: Final Study Technical Report, Nachela Chelwa Mar 2025

Namai Zambia: Final Study Technical Report, Nachela Chelwa

Sexual and Reproductive Health, Rights, and Choices

No abstract provided.


Improving Acceptability, Use, And Continuation Of Iud In Bangladesh, Sharif M.I. Hossain, Abdullah Al Mahmud Shohag, Zakaria Hossain, Shongkour Roy, Ubaidur Rob Oct 2023

Improving Acceptability, Use, And Continuation Of Iud In Bangladesh, Sharif M.I. Hossain, Abdullah Al Mahmud Shohag, Zakaria Hossain, Shongkour Roy, Ubaidur Rob

Sexual and Reproductive Health, Rights, and Choices

Although the nonhormonal copper intra-uterine device (IUD) is the safest and cheapest long-acting contraceptive method, its use has been declining day-by-day in Bangladesh. Less than 1% of married women 15-49 years of age who currently use a contraceptive method use an IUD. Researchers conducted a quasi-experimental pre-post-test non-equivalent control group designed study to test a simple intervention intended to increase acceptance, use, and continuation of the IUD among married women of reproductive age (18 to 45 years) in Keraniganj, Savar, and Nawabganj Upazilas (sub-districts) in Bangladesh. The study was conducted in a real-life situation of Union Health and Family Welfare …


Translating Evidence Into Impact: Enhancing Health In Francophone West Africa And The Sahel, Population Council Mar 2022

Translating Evidence Into Impact: Enhancing Health In Francophone West Africa And The Sahel, Population Council

Research Utilization and Impact Briefs

Francophone West Africa (FWA) is a diverse subregion known for its strong national identities and regional collaboration. With high maternal and child death rates and low contraceptive prevalence compared to other parts of West Africa, Francophone countries have worked together to pursue common health and development goals, such as enhancing access to family planning/reproductive health; meeting the health, education, and employment needs of a growing population of young people; and addressing challenges such as climate change and conflict. Over the past three decades, the Population Council has worked to advance subnational, national, and regional efforts to improve health and promote …


Assessing Effectiveness Of A Person-Centered Group Anc-Pnc Model Among First-Time Young Mothers And Their Partners For Improving Quality And Use Of Mnch-Fp Services, Sharif M.I. Hossain, Shongkour Roy, Sigma Ainul, Abdullah Al Mahmud Shohag, A.T.M. Rezaul Karim, Ubaidur Rob Jan 2022

Assessing Effectiveness Of A Person-Centered Group Anc-Pnc Model Among First-Time Young Mothers And Their Partners For Improving Quality And Use Of Mnch-Fp Services, Sharif M.I. Hossain, Shongkour Roy, Sigma Ainul, Abdullah Al Mahmud Shohag, A.T.M. Rezaul Karim, Ubaidur Rob

Sexual and Reproductive Health, Rights, and Choices

This baseline report is part of an operations research project “Healthy Women, Healthy Families (HWHF): Shustha Ma, Shustha Poribar” led by Management Sciences for Health (MSH) in partnership with BRAC, SCOPE, and the Population Council. The project aims to improve quality and increase utilization of maternal, newborn, and child health (MNCH) and family planning (FP) services and information for young mothers-to-be, first-time mothers (FTMs) aged 15-24, and their partners in the urban municipality of Tongi, Gazipur District, Bangladesh, through a group antenatal care ANC-PNC approach. The objectives of this study are to establish baseline values of selected HWHF project …


Breakthrough Research—Social And Behavior Change Costing Community Of Practice Series Brief #4: Social And Behavior Change Costs Associated With Insecticide Treated Bed Net Distribution For Malaria Prevention, Breakthrough Research Nov 2021

Breakthrough Research—Social And Behavior Change Costing Community Of Practice Series Brief #4: Social And Behavior Change Costs Associated With Insecticide Treated Bed Net Distribution For Malaria Prevention, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

Breakthrough RESEARCH is gathering, analyzing, and sharing evidence on the costs and impact of social and behavior change (SBC) interventions to support the case that investing in SBC is crucial for improving health and advancing development. A review of the SBC costing literature identified 147 studies on SBC costs, methodological shortcomings, and knowledge gaps that can be addressed in new SBC costing studies. To address these gaps, Breakthrough RESEARCH issued the “Guidelines for Costing of Social and Behavior Change Health Interventions,” which lays out 17 principles for conducting high-quality costing studies. This brief complements the guidelines and highlights important issues …


Understanding Community Health Volunteer Incentive Preferences In Kenya, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health Oct 2021

Understanding Community Health Volunteer Incentive Preferences In Kenya, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

In Kenya, community health services are implemented through community health units. Community health volunteers (CHVs) who serve these units are chosen by the community and trained by community health extension workers. This brief summarizes qualitative and quantitative findings from the Frontline Health project’s discrete choice experiment study in Kenya, which aimed to understand incentive preferences of CHVs with the aim of improving motivation, performance, and retention of CHVs.


Identifying Factors That Support Community Health Worker Motivation, Job Satisfaction, And Retention In Haiti, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health Oct 2021

Identifying Factors That Support Community Health Worker Motivation, Job Satisfaction, And Retention In Haiti, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) play a critical role in Haiti’s health system, by connecting communities—particularly rural and hard-to-reach populations—to healthcare services. The Frontline Health project conducted a study to better understand the types of incentive structures that can best support the CHWs in Haiti and this brief summarizes those findings.


Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project Oct 2021

Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project

Reproductive Health

As the global health community demonstrates an increasing commitment to investing in community health workers (CHWs) to achieve universal health coverage in lower- and middle-income countries, the need to effectively measure community health system performance is paramount. Embedded in the Integrating Community Health partnership (2017–2021), with support from the Bill & Melinda Gates Foundation, the Population Council and Last Mile Health co-led the Frontline Health (FLH) project, a four-year research, policy, and advocacy initiative aimed at developing core metrics and CHW reform processes, advancing their adoption, and promoting institutionalization of robust community health policies. This brief describes the Population Council’s …


From Data To Action: Partnering With Governments On Evidence To Support Adolescents During The Covid-19 Pandemic, Emily Eunyoung Cho, Karen Austrian, Isabel Vieitez Martínez Oct 2021

From Data To Action: Partnering With Governments On Evidence To Support Adolescents During The Covid-19 Pandemic, Emily Eunyoung Cho, Karen Austrian, Isabel Vieitez Martínez

Adolescents and Young People

The Population Council’s Girl Innovation, Research, and Learning (GIRL) Center hosted a virtual webinar in October 2021, bringing together evidence from two country-level studies on the impact of the COVID-19 pandemic on adolescent lives in Kenya and Mexico. This document provides a recap of the webinar, in which government partners reflected on the government-research partnership behind these efforts and shared their perspectives on lessons learned and the future of evidence-based policy action to support adolescents.


Cost-Effectiveness Analysis Comparing Integrated And Malaria-Only Social And Behavior Change Programming In Nigeria: Initial Costing Data, Avenir Health Sep 2021

Cost-Effectiveness Analysis Comparing Integrated And Malaria-Only Social And Behavior Change Programming In Nigeria: Initial Costing Data, Avenir Health

Sexual and Reproductive Health, Rights, and Choices

Breakthrough RESEARCH is conducting an effectiveness evaluation of social and behavior change (SBC) programming implemented by Breakthrough ACTION in Nigeria, comparing an integrated SBC program in Kebbi and Sokoto states with a malaria-only SBC program in Zamfara state. Using these results on impact, a cost-effectiveness analysis will determine which approach is more cost-effective in achieving improvements in health. This report presents estimated costs for the initial stage of the project, from April 2018 through December 2019, in the three northern states where the study is being conducted.


Breakthrough Research—Social And Behavior Change Costing Community Of Practice Series Brief #3: Capturing The Start-Up Costs Associated With Social And Behavior Change Interventions, Breakthrough Research Sep 2021

Breakthrough Research—Social And Behavior Change Costing Community Of Practice Series Brief #3: Capturing The Start-Up Costs Associated With Social And Behavior Change Interventions, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

A successful social and behavior change (SBC) intervention requires the investment of time and resources in the intervention’s start-up phase, which is defined as the time from the project initiation until the project begins broad implementation. When conducting a costing study of an SBC intervention, it is useful to capture these initial costs separately and allocate them appropriately over the life of the intervention. By examining start-up costs separately, the post-start-up implementation costs can be forecasted more accurately for future budgeting purposes and for determining the appropriate costs for scaling-up interventions. This is the third in a series of briefs …


Exploring Barriers And Enablers Of Service Provision For Survivors Of Human Trafficking In The Bay Area: An Action Research Study, Pooja Sripad Sep 2021

Exploring Barriers And Enablers Of Service Provision For Survivors Of Human Trafficking In The Bay Area: An Action Research Study, Pooja Sripad

Reproductive Health

Despite increasing recognition of public health and rights issues associated with human trafficking globally and in the United States following the Trafficking Victims Protection Act of 2000, there has been limited research on how to systematically strengthen service access for survivors of sex and labor trafficking. The experience of service providers may provide insight into how trafficking survivor responses and service networks function in California’s Bay Area. This study explores provider perspectives on existing service networks and collaboration dynamics, including the barriers to and enablers of long-term service provision and survivor follow-up. A participatory research design included qualitative interviews with …


Women's Perceptions On The Effects Of Covid-19 On Access And Use Of Private Sector Family Planning Services In Nigeria: The Integrate Project, The Integrate Project Aug 2021

Women's Perceptions On The Effects Of Covid-19 On Access And Use Of Private Sector Family Planning Services In Nigeria: The Integrate Project, The Integrate Project

Reproductive Health

In Nigeria, Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of care for many common illnesses. Although CPs and PPMVs are not formally recognized as family planning (FP) service providers, 22% of modern contraceptive users report receiving their last method from a PPMV and 12% from a private pharmacy. PPMVs are popular for FP because of their widespread availability, consistent drug stocks, extended hours, personable interactions, and lack of separate fees for consultations. As in many places, the COVID-19 pandemic poses unprecedented challenges to health services in Nigeria. By limiting person-to-person contact, especially during …


Integrate Project Results: Family Planning Knowledge And Quality Of Care Received From Community Pharmacists And Patent And Proprietary Medicine Vendors, The Integrate Project Aug 2021

Integrate Project Results: Family Planning Knowledge And Quality Of Care Received From Community Pharmacists And Patent And Proprietary Medicine Vendors, The Integrate Project

Reproductive Health

In Nigeria, Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of care for many common illnesses. Although CPs and PPMVs are not formally recognized as family planning (FP) service providers, 22% of modern contraceptive users report receiving their last method from a PPMV and 12% from a private pharmacy. PPMVs are popular for FP because of their widespread availability, consistent drug stocks, extended hours, personable interactions, and lack of separate fees for consultations. As the Federal Ministry of Health explores expanding its task sharing policy to include CPs and PPMVs, evidence is needed on …


Investing In Social And Behavior Change Is Cost-Effective For Improving Malaria Behaviors In Côte D’Ivoire, Breakthrough Research Aug 2021

Investing In Social And Behavior Change Is Cost-Effective For Improving Malaria Behaviors In Côte D’Ivoire, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

Social and behavior change (SBC) interventions are considered an essential part of malaria prevention and treatment interventions, yet gaps in information on the cost and impact of SBC mean decisionmakers have underappreciated the value of SBC for contributing to improved health outcomes. To address this issue, Breakthrough RESEARCH has leveraged evidence from 112 studies on the impact of SBC interventions on malaria health behaviors and 70 studies on general SBC intervention costs to model the cost-effectiveness of SBC programming for malaria in the Business Case for Investing in Social and Behavior Change for Malaria.


More Than Brides Alliance—Marriage: No Child’S Play, Endline Evaluation Brief, Population Council Jul 2021

More Than Brides Alliance—Marriage: No Child’S Play, Endline Evaluation Brief, Population Council

Poverty, Gender, and Youth

This brief summarizes key results from the endline evaluation of the More than Brides Alliance (MTBA) project “Marriage: No Child’s Play” (MNCP) in India, Malawi, Mali, and Niger. The MTBA consists of partners Save the Children Netherlands, Simavi, Oxfam Novib, and the Population Council, along with 25 local implementing partners. The MNCP project—which took place from 2016 to 2020—aimed at being holistic and targeting pathways to child marriage on multiple levels simultaneously, treating communities as either having the full MNCP package or no intervention. The Population Council’s MNCP evaluation was designed to estimate program impact and trends among girls at …


Using Social Listening To Inform Integrated Social And Behavior Change Programs In Burkina Faso, Nrupa Jani, Leanne Dougherty, Martha Silva Jul 2021

Using Social Listening To Inform Integrated Social And Behavior Change Programs In Burkina Faso, Nrupa Jani, Leanne Dougherty, Martha Silva

Reproductive Health

No abstract provided.


Health And Ideations Of Married Female Adolescents, Breakthrough Research Jul 2021

Health And Ideations Of Married Female Adolescents, Breakthrough Research

Reproductive Health

This brief provides rigorous evidence-based insights to implementers and researchers of social and behavior change (SBC) programs that seek to improve knowledge, attitudes, norms, and behaviors of married female adolescents. The brief focuses on married adolescents’ uptake of services and health knowledge in Kebbi, Sokoto, and Zamfara states in northwestern Nigeria using a subset of data from a household survey of married women ages 15–49 years. It is one of a series of briefs that present findings from a Breakthrough RESEARCH study that uniquely captures data on a wide range of psychosocial drivers of behavioral outcomes in the areas of …


Preferred Incentives For Improving Community Health Worker Satisfaction And Retention In Bangladesh, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health Jul 2021

Preferred Incentives For Improving Community Health Worker Satisfaction And Retention In Bangladesh, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) are critical actors within community health systems, providing a range of reproductive, maternal, child, and primary health information, counseling, and services. To better understand factors that influence CHWs’ work motivation and satisfaction in Bangladesh, the Frontline Health project, implemented with collaborators from Johns Hopkins Bloomberg School of Public Health, and supported by the government of Bangladesh’s Directorate General of Health Services and the Directorate General of Family Planning, conducted a discrete choice experiment (DCE) study. This brief presents key qualitative findings from the DCE study in Bangladesh and implications for program and policy stakeholders.


Effectiveness Of Interventions Designed To Prevent Or Respond To Female Genital Mutilation: Evidence Brief, Dennis Matanda, Melanie Croce-Galis, Jill Gay, Karen Hardee Jun 2021

Effectiveness Of Interventions Designed To Prevent Or Respond To Female Genital Mutilation: Evidence Brief, Dennis Matanda, Melanie Croce-Galis, Jill Gay, Karen Hardee

Reproductive Health

Despite intensified efforts to conduct research globally that informs strategies to address female genital mutilation (FGM), there has been limited rigorous high-quality evidence on interventions that are effective in ending the practice. As we begin the final decade of acceleration toward zero new cases of FGM by 2030, increasing the rigor, relevance, and utility of research for programming, policy development, and resource allocation is critical. This brief highlights key findings from an evidence review that synthesized and assessed the quality and strength of existing evidence on FGM interventions from 2008 to 2020. A number of studies have collated evidence on …


Effectiveness Of Interventions Designed To Prevent Or Respond To Female Genital Mutilation: A Review Of Evidence, Dennis Matanda, Melanie Croce-Galis, Jill Gay, Karen Hardee Jun 2021

Effectiveness Of Interventions Designed To Prevent Or Respond To Female Genital Mutilation: A Review Of Evidence, Dennis Matanda, Melanie Croce-Galis, Jill Gay, Karen Hardee

Reproductive Health

Girls are one-third less likely to be subjected to female genital mutilation (FGM) today than 30 years ago. However, rapid population growth in some of the world’s poorest countries, where FGM persists, threatens to roll back progress. In 2020 alone, an estimated 4.1 million girls were at risk of being subjected to FGM. Without concerted and accelerated actions to end the practice, an estimated 68 million additional girls will have been subjected to FGM by 2030. Despite intensified global research efforts to inform strategies to address FGM, there has been little synergy between evidence generation and the implementation of programs …


Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah Jun 2021

Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Ghana is working toward achieving universal health coverage (UHC). This is driven, in part, by the Sustainable Development Goals (SDGs), specifically SDG 3—Good Health and Well-Being, which seeks to ensure healthy lives and promote well-being for all at all ages. Achieving this feat will improve equity of access as people, especially the poor can access quality health services without financial hardships. Ensuring equitable access to family planning (FP) is essential to securing the well-being of women and supporting the health and development of communities. One pathway to ensuring equity is the inclusion of FP in affordable insurance. While the inclusion …


Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana: A Health Facility Assessment, Population Council, Ministry Of Health, Ghana Health Service, National Health Insurance Authority, Marie Stopes International Ghana Jun 2021

Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana: A Health Facility Assessment, Population Council, Ministry Of Health, Ghana Health Service, National Health Insurance Authority, Marie Stopes International Ghana

Reproductive Health

In Ghana, National Health Insurance Act 852 of 2012 ensures that health-care benefits include family planning (FP) services, however people continue to pay for FP services because the policy is yet to be implemented in practice. Under the leadership of the Ministry of Health, the National Health Insurance Authority in collaboration with the Ghana Health Service, Marie Stopes International-Ghana and the Population Council implemented a pilot project to remove FP service out-of-pocket costs. All modern clinical FP methods were added to national health insurance and expensed by health facilities through the national health insurance claims process. The intervention significantly increased …


Management Of Intimate Partner Violence In Health Care Settings: A Training Manual For Health Care Providers, Division Of Reproductive And Maternal Health Jun 2021

Management Of Intimate Partner Violence In Health Care Settings: A Training Manual For Health Care Providers, Division Of Reproductive And Maternal Health

Reproductive Health

Intimate partner violence (IPV) is any behavior by an intimate partner that causes physical, sexual, or psychological harm. In healthcare settings where providers are well trained, caring, and sensitive, most survivors respond positively to being asked about their exposure to violence. Healthcare providers are in a unique position to identify survivors and offer appropriate management and referrals. The World Health organization developed clinical guidelines to provide evidence-based guidance to healthcare providers on the identification and appropriate response to IPV and sexual violence. Based on this guidance, the Ministry of Health developed a comprehensive training manual to empower healthcare providers with …


Diet Diversity Among Pregnant Women And Young Children—Insights For Improving Malaria, Family Planning, And Maternal And Child Health Outcomes In Northwestern Nigeria Through Social And Behavior Change Programming, Breakthrough Research May 2021

Diet Diversity Among Pregnant Women And Young Children—Insights For Improving Malaria, Family Planning, And Maternal And Child Health Outcomes In Northwestern Nigeria Through Social And Behavior Change Programming, Breakthrough Research

Reproductive Health

This research brief provides rigorous, evidence-based insights to policy-makers, implementers, and researchers of social and behavior change (SBC) programs on maternal and child nutrition during the 1,000-day period between a woman’s pregnancy and her child’s second birthday. It is one of a series of briefs presenting findings from a Breakthrough RESEARCH study that uniquely captures data on a wide range of psychosocial drivers of behavioral outcomes in family planning, malaria, and maternal, newborn and child health and nutrition (MNCH+N) in the three northwestern states of Nigeria.