Operations Research:

Women Investing Savings for Health

(WISH) Groups, N. Nigeria

REENA V. GADHIA, RN

AND

RACHEL S. KAGEL

Presentation to Practicum Seminar 9/28/2010

 Life in Nahuche
Population
Education
MMR
Health and Demographic
Surveillance Site under
Partnership to Revive
Routine Immunization in
Northern Nigeria-
Maternal Child and
Newborn Health
(PRRINN-MNCH)
 PRRINN-MNCH

Partnership to Revive Routine Immunization

in Northern Nigeria –
Maternal Newborn and Child Health
 Our Work

Operations research (OR) is:

 Analytical research designed to determine the most efficient
way to do something
Women Investing Savings for Health (WISH)
Groups
 Objective: to build a fund of savings women can use to pay for
emergency health services, especially in cases of complication
during pregnancy or delivery.
 WISH Group background

 Groups engage in savings and health education

 20-60 women, with elected leaders
 Support of husbands and family
 Some groups meet on monthly basis; some meet as needed
 Contributions range from 40 N-60 N per month
 Investment of savings
 WISH Group Background

WISH Principals:
 OR: WISH Groups

Research Question:
‘What are the opinions, perceptions, and experiences
of the WISH groups in the Nahuche community?’
 Research Design

Qualitative Research:
 Definition: Inductive research process and involves the
collection and analysis of textual data to search for patterns,
themes, and holistic features

Mixed methods: Focus Group Discussions and Key

Informant Interviews
 Saturation
 Triangulation
 Research Activities: Focus Groups

10 Focus Group Discussions

3 segments
 Current WISH members: 4 groups of Women
 Husbands and Men: 2 groups of Husbands; 1 group of Nahuche
Village Development Committee members
 PHC Staff: 2 groups of CHEWs; 1 group of Midwives
Focus Group Discussion Guides
Gender and language appropriate moderators
 Half-day moderator training
 Research Activities: Key Informant Interviews

7 Key Informant Interviews

 Leaders of 3 existing WISH Groups
 Nahuche I District Head
 Nahuche II District Head
 Chairman, Nahuche Village Development Committee
 the Officer-in-Charge at the Bungudu LGA Women’s
Development Center
 PRRINN-MNCH Community Engagement Team
 Hududullah Finance and Investment Company Limited Gusau
Branch Manager
 Research Activities: Data Analysis

Grounded theory

2 researchers coding independently

Constant comparative method

 Findings: Focus Group Discussions

Initiation and Governance

Community Perceptions

Challenges

Effects
 In Their Own Words: Initiation & Governance

“We want to expand out of Nahuche even out of

Zamfara state to extend to other women there and
assist them”
–WISH Group Member

Goals
Recruitment and Membership
Leadership
Financial Structure and Management
Activities Undertaken
 In Their Own Words: Community Perceptions

“It is a very good idea and there is benefit; for

women, children and their family, because our
wives are taking themselves for ANC and
Immunization in our Health Centre, because of this
women group”
-WISH Group Member’s Husband
 In Their Own Words: Challenges

“Some people are ignorant of the aims and objectives

of this association. Because they think health
functions are restricted to hospitals only.”
–WISH Group member

Internal
 Trust issues concerning finances
 Loss of membership
External
 Misunderstanding of group and false information spreading
 In Their Own Words: Effects

“We have recorded considerable progress in areas of

child care and immunization and encouraging
women for antenatal, and take care of women in
time of delivery, we have recorded serious
progress.”
-WISH Group Member
 Findings: Key Informant Interviews

Impressions of WISH Groups

 Group Expansion

Challenges
 Perceptions of facility-based delivery
 Limitation of savings model

Ideas to support & publicize groups and activities

 Member ID cards
 Community dramas and radio broadcast
 Other Relevant Findings

PHC
 Community Integration
 Staff Teambuilding

Building group autonomy & sustainability

 Own unique goals and guidelines
 WISH group primary objective
 Needs specific to this group in this community
 Recommendations:
for Government

Publicize! Raise
Awareness! Encourage
members!
Support savings and
health education
activities:
 Finance and Business
trainings
 Meeting space
 Micro-loans
 Speaking opportunities
 Other communities
 Health education trainings
 Recommendations:
for the Community

WISH Member
Identification Cards

Intergroup Experience
Sharing

Educate and Involve

Husbands and Families

Support and encourage

women participating
 Recommendations:
for PRRINN-MNCH and External Stakeholders

Replication of WISH
Groups

WISH Group Manual

WISH Group
Coordination for
Awareness Raising
 Overall Thoughts
STRENGTHS WEAKNESSES
 Great colleagues, overall  Isolated site and little
 Gap in OR and research recreation
resources  Communication barrier
 Community cooperation  Limited access to women
and acceptance (professionally and
socially)
 Challenges along the way

One extremely difficult colleague -research logistics

Transcription delays
Gaps between national and state level within PRRINN-MNCH
Poor food access
Silly security guards!
Recreation!
Bed Allergies!
Thank you!