Intergovernmental Relations and Policy Coordination in Maternal Health Programme Delivery in Gombe State, North East Nigeria

This study examines intergovernmental relations and policy coordination mechanisms in the delivery of maternal health programmes in Gombe State, North East Nigeria. Nigeria's persistently high maternal mortality ratio, particularly in Northern states, reflects systemic coordination failures across federal, state, and local government health governance layers. Drawing on intergovernmental relations theory and current maternal health governance literature from 2019 to 2024, the study employs a professional practitioner research design. Data are gathered from federal Ministry of Health programme officers, Gombe State Ministry of Health officials, local government primary healthcare coordinators, and maternal health implementing partners through structured professional interviews and policy document review. Content analysis and policy coherence assessment frameworks are applied. The study anticipates finding misalignment between federal maternal health policy targets and state budget commitments, inadequate vertical integration between state and local government health data systems, insufficient community midwife deployment to rural facilities, and coordination failures in emergency obstetric care referral networks in Gombe State. It also examines how the Basic Health Care Provision Fund is being utilised to address maternal health financing gaps. Recommendations address formalising state-local government joint planning committees for maternal health, standardising referral protocols, expanding community-based skilled birth attendance programmes, and improving maternal health data reporting through integrated health management information systems. Keywords: intergovernmental relations, maternal health, policy coordination, Gombe State, healthcare governance