GH Pro conducted an endline evaluation of USAID’s Maternal Child Survival Program (MCSP-MNCH) to assess if it had achieved its objectives and planned outputs, as stated in its program description, in Nigeria’s Ebonyi and Kogi states. Five questions evaluated increases in access and utilization of reproductive, maternal, newborn, and child health interventions; gender-transformative strategies; sustainability; the program’s learning agenda vis-à-vis the Nigerian government’s learning needs; and use of program data.
The evaluation team used a retrospective analytic and a cross-sectional design to address the five questions, and mixed methods were used for data collection, including reviews of the national District Health Information System (DHIS) 2, MCSP-MNCH datasets, and 51 program documents.
Apparent improvements were noted in the utilization of six interventions: oxytocin, partograph, Chlorhexidine 4% gel, newborn resuscitation, essential newborn care, and integrated Community Case Management, particularly with referral of danger signs. MCSP-MNCH baseline data was not available nor calculable for magnesium sulphate or Kangaroo Mother Care. Data was also not available for postpartum family planning for first-time parents and Bubble Continuous Positive Airway Pressure for newborn resuscitation, as a study was undergoing analysis and data was not ready. Furthermore, the dataset MCSP-MNCH provided to the evaluation team was incomplete, imprecise, and contained errors, raising concerns about noted improvements.
The program’s work in male engagement and Mothers Savings and Loans Clubs hold promise for transforming gender norms but reached too few people. Most of the program’s reproductive health and MNCH interventions are likely to be included in budgets in Ebonyi and Kogi through the World Bank’s Saving One Million Lives project, but without specific commitment from the states’ governors, funding release may be jeopardized. The learning agenda helped inform implementation, but the government did not help shape the research. Last, MCSP-MNCH project created a new DHIS database instance for its project data only, including new indicators that it introduced (like application of Chlorhexidine 4% gel for newborn cord care), as well as indicators that were already available in the national DHIS 2 database; it is housed within the same server as the national DHIS 2.
 USAID’s Maternal Child Survival Program (MCSP) comprises projects focused on different areas of health care, one of which is material, newborn, and child health (MNCH). As this evaluation addressed only MNCH activities, we refer to the program as “MCSP-MNCH.”