Nigeria—Women for Health (W4H)

Client: U.K. Department for International Development

Duration: 2012-2020

Region: Sub-Saharan Africa

Country: Nigeria

Solutions: Global Health

Nigeria has the highest number of maternal deaths in Sub-Saharan Africa and high rates of under-5 child mortality. These indicators are even more severe in northern Nigeria, where up to 90 percent of pregnant women deliver their babies without a skilled birth attendant. States such as Yobe and Borno are particularly fragile, suffering insurgency which has terrorised young women. Female health workers are particularly important in the north of the country because social norms in rural communities can prohibit women from receiving care from male health workers. The U.K. Department for International Development (DFID) is tackling this problem by training women to be service providers in six states in northern Nigeria through its Women for Health (W4H) programme.

Since November 2012, W4H has increased the number and capacity of female health workers in Borno, Jigawa, Kano, Katsina, Yobe, and Zamfara, while at the same time supporting women’s empowerment, promoting gender equality, and tackling trauma. It has improved women’s access to and use of health services in northern Nigeria while advancing Nigeria’s journey toward universal health coverage. W4H works closely with other health and education programs in the states, taking a “building back better” approach in conflict and humanitarian emergency-affected areas of Borno and Yobe states while ensuring the sustainability of progress in Jigawa, Kano, Katsina, and Zamfara. A national team, led by Dr. Fatima Adamu, provides technical support to state-level teams, backed by a senior technical advisory group. The programme is led by DAI Global Health in partnership with Save the Children. W4H works closely with 22 midwifery, nursing, and community health extension worker training institutions and state ministries of health to support the training of female health workers and their deployment to rural health facilities.


Sample Activities

  • Improving the capacity of colleges of nursing and midwifery and colleges of health technology to train female health workers, improving the accreditation status and training capacity of health training colleges, and increasing graduation rates.
  • Improving the recruitment, deployment, and retention of midwives in rural facilities while implementing a Foundation Year Training Programme, or access course, for rural women to improve their academic credentials, study skills, and confidence to enter health worker training.
  • Engaging with community, religious, and training institutions to create a gender-friendly environment for women to pursue health careers, and facilitating locally led scale-up.
  • Institutionalising short-term courses and modules in the curriculum to prepare health workers for deployment in conflict settings and humanitarian programming.

Select Results

Global Health:

  • Strengthened management systems and structures of 20 training institutions.
  • Helped 14 schools receive full accreditation and 11 to achieve provisional accreditation.
  • Constructed 35 houses to accommodate midwives.
  • Trained 1,074 midwives who are now working in rural areas, a 62 percent increase compared to the start of the program in 2012.
  • Increased by more than 6,000 the number of students in training by supporting health training institutions to gain, regain, maintain, and increase accreditation.
  • Increased female friendliness of health training institutions. Watch these videos to learn more.

Fragile States:

  • Strengthened the capacity of State Ministry of Health and Health Training Institutions in Borno and Yobe to respond and deliver in a humanitarian setting.
  • Trained 60 tutors on a humanitarian curriculum and 350 students using that curriculum.
  • Supported a memorandum of understanding for recruitment of graduates.
  • Supported trauma assessment for those affected by trauma to become midwives and nurses with the World Health Organisation.

Resources, Publications, and Toolkits

The W4H website and Facebook page offer stories of transformation, how-to guides, technical briefs, and a three-part film highlighting approaches and results.



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