Nigeria—Women for Health (W4H)

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 Foreign, Commonwealth & Development Office (FCDO) trained women to be service providers in six states in northern Nigeria through its Women for Health (W4H) programme.

Since November 2012, W4H increased the number and capacity of female health workers in Borno, Jigawa, Kano, Katsina, Yobe, and Zamfara, while at the same time supported women’s empowerment, promoted gender equality, and tackled trauma. It improved women’s access to and use of health services in northern Nigeria and advanced Nigeria’s journey toward universal health coverage. W4H worked closely with other health and education programs in the states, and took a “building back better” approach in conflict and humanitarian emergency-affected areas of Borno and Yobe states and ensured the sustainability of progress in Jigawa, Kano, Katsina, and Zamfara.

A national team, led by Dr. Fatima Adamu, provided technical support to state-level teams, backed by a senior technical advisory group. The programme was led by DAI’s Global Health team in partnership with Save the Children. W4H worked 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. Click here to visit the project’s Facebook page.

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 25 training institutions.
• Helped 14 schools receive full accreditation and 11 to achieve provisional accreditation.
• Constructed 35 houses to accommodate midwives to support retention in rural areas.
• Enabled 8,792 female students to enroll in midwifery, nursing, and community health extension worker training, with 38 percent of the 1,551 graduates to date employed and working in rural facilities, a 134 percent increase compared to the start of the program in 2012.
• Enabled 2,818 rural female students to enroll in an access course and sponsorship initiative to achieve the qualifications needed to enter professional health training.
• Increased by more than 6,000 the number of students in training.

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 70 tutors on a humanitarian curriculum and 350 students using that curriculum.
• Established a Foundation Year Programme in Borno to build the academic, personal, and social capital of young rural women so they can access professional education.
• 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.

Find open and free access to the W4H materials on Human Resources for Health, hosted by the Center for Gender Studies of Bayero University in Kano.