Total Awarded: $2.2 million
Duration: 2013 - present
Total Grants: 7
Geographic Focus: Nigeria
In 2013, MacArthur began funding a portfolio of seven grantees working to increase government accountability for maternal health in Nigeria. Since then, grantees have been employing a combination of four accountability strategies—budget analysis, community mobilization, legal approaches, and maternal death audits—to address this issue at federal, state, and local levels in 12 Nigerian states and the Federal Capital Territory (FCT).
At the same time MacArthur hired EnCompass, LLC to assist the Foundation in refining the portfolio's theory of change and evaluate progress toward the portfolio's intended results. EnCompass also provided technical assistance to each portfolio grantee in order to build their individual and collective capacity for monitoring, evaluating, and learning from their work.
In 2014 EnCompass conducted a baseline evaluation that examined the maternal health landscape in Nigeria before grantees began implementing activities, as well as a midline evaluation in 2015 to assess the portfolio's progress and identify strategies for amplifying grantee-level and portfolio-level effectiveness. In 2017, MacArthur provided its final round of 3-year awards to each of the 7 grantees in order to consolidate gains that had been achieved over the course of the portfolio's implementation period.
In 2016, the Foundation commissioned EnCompass to conduct an endline evaluation of the portfolio with two purposes in mind: to provide evidence to share with the maternal health field on which accountability areas—and which interventions in each area—have shown to hold the most promise for building government accountability for maternal health in Nigeria; and to enhance the sustainability of the organizations by providing information that identifies areas in which grant activities should continue to focus.
The evaluation used a mixed-methods design, including individual and group interviews and focus group discussions with key stakeholders, analysis of grantee monitoring data, and a desk review of relevant documents, such as findings from the 2013 and 2015 evaluations.
The evaluation surfaced key findings related to the four accountability strategies employed by grantees:
Maternal death audits, which are in-depth systematic reviews of maternal deaths to determine the underlying factors that contributed and to prevent similar future deaths, have had the most concrete evidence of progress in holding government accountable for maternal health. This accountability strategy shows great promise for the future, as it has produced clear evidence on the quality of maternal health services in facilities and has led to improvements in health facility infrastructure and services. Maternal death review committees have been institutionalized in state-level government policies.
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