CIRCLE 2019 Nigeria VASA Final Project Management Report

The study aimed to provide direct, nationally representative estimates on the causes and social factors contributing to child deaths in Nigeria. The objectives of the study were to provide national and zonal estimates of the major causes of under-five mortality, data on care-seeking patterns and social factors related to deaths in children under-five, and qualitative narratives of factors associated with these patterns. The study was formally launched in July 2019, and quantitative and qualitative data were collected from October to December 2019 in all 36 states and the Federal Capital Territory (FCT). The study concluded with national and zonal dissemination events in November 2020, where the findings and study deliverables were formally accepted by the Minister of Health. CIRCLE played an instrumental role in the implementation of the 2019 VASA study, including general coordination, stakeholder engagement, leadership of the qualitative study component, financial management, and technical assistance for study design, data collection, and analysis. The CIRCLE project contributed to several key achievements, including the successful implementation of the 2019 VASA study, strong government ownership and buy-in for the study, creation of a technical sub-committee to guide and oversee study implementation, and development and dissemination of 16 VASA products that provide information on the causes of child deaths. The project also increased capacity within government to implement VASA studies and use the findings to inform strategies to reduce under-five mortality in Nigeria. The study found that Nigeria has one of the highest rates of under-five mortality, with over 117.2 deaths per 1,000 live births. The study also found that the major causes of under-five mortality in Nigeria include pneumonia, diarrhea, malaria, and birth asphyxia. The study's findings were intended to provide critical data and information needed by policymakers and program implementers to reduce child mortality and achieve the Sustainable Development Goal 3 (SDG) target of reducing child mortality to 25 deaths per 1,000 live births by 2030. The CIRCLE project suggests that USAID/Nigeria consider several lessons when planning for future VASAs and similar studies, including the importance of a comprehensive strategy that emphasizes collaboration and strong stakeholder engagement from the beginning, the need for flexibility and responsiveness in providing coordination and technical support for an activity intended to be owned by local government, and the importance of local leadership in engaging stakeholders and managing partner relationships. The study's findings have implications for policymakers and program implementers in Nigeria, highlighting the need for targeted interventions to reduce under-five mortality, including improving access to healthcare services, increasing awareness of the causes of child deaths, and promoting community-based initiatives to reduce child mortality. The study's findings also have implications for global efforts to reduce child mortality, highlighting the need for continued support for VASA studies and other research initiatives to provide critical data and information needed to inform strategies to reduce child mortality.