Today on this 31st day of May 2021, Her Excellency Toyin Ojora Saraki's Wellbeing Foundation Africa (WBFA) officially closes out on a first of its kind six year state-wide training program, propelling Nigeria into a solid trajectory of improving the availability and quality Of Maternal And Newborn Care through Emergency Obstetric Newborn Care (EmONC) health care worker training.
The Program inaugurally implemented by the WBFA in partnership with the Liverpool School of Tropical Medicine and Johnson and Johnson Nigeria, kicked off in 2015 in partnership with the Kwara State Ministry of health, with the aim of improving the access to and delivery of maternal and neonatal health care, while building capacities of health care workers in basic and comprehensive emergency obstetrics and newborn care (BEmONC and CEmONC) respectively.
To date, the EmONC program has successfully trained a plausible 570+ midwives in the Western Nigerian state of Kwara.
Nigeria's Maternal Mortality ratio between the years of 1990 and 2015 - the year of the EmONC program's inception - was an estimated 814 deaths per 100,000 live births, with the neonatal mortality ratio standing at 37 deaths per 1000 live births.
These data conclusions coupled with the readiness of a robust frontline saw the journey of contributing to the global actualisation of the ICPD's 'zero maternal deaths' goal becoming a steady and closer reality.
Consisting of both live anatomical and simulation model demonstrations, the program boasted of a rapid rate of uptake and has continued to emphasise, cater to and numerically reiterate the impact and importance of targeted and essential health-related training on women, children, families and frontline staff, nationwide.
"When I was in the school of Midwifery we only received essentially theoretical training with little or no hands-on training. There is no way I would have been able to carry out an MVA without this EmONC hands on training. You can see that I would not have been able to save the life of that patient," tells Mrs Ayuba Ette, a Nurse-Midwife at Share General Hospital, Kwara State.
Ette, a beneficiary of the LSTM training on Manual Vacuum Aspiration, whose only other formal training on MVA Procedure was essentially theoretical successfully diagnosed a patient experiencing an incomplete miscarriage, and went on to carry out the MVA procedure and saving the patients life.
The EmONC program which sought to empower, reinvigorate frontline staff and contribute to the minimisation of national mortality and morbidity statistics successfully launched in 21 facilities across 7 local government areas (LGAs) in Kwara, before later scaling-up to 27 additional facilities in the remaining 9 LGAs state-wide.
Following the conclusion of the third and final phase of the WBFA x LSTM and JnJ Nigeria Program dissemination, Midwives in all 48 public health care facilities were empowered to deliver on a holistic continuum of care more autonomously, and equipped to provide life-saving skills training - EmONC- to a plethora of women - including those in some of the state's most remote areas.
In closing, WBFA Founder-President Her Excellency Toyin Ojora Saraki shares,
"In order to improve maternal health significantly, we have long identified the barriers that limit access, availability and quality of maternal and newborn health services. From the first moment I witnessed the impact of hands-on anatomically delivered simulation model training globally, I knew that building a community of well-practiced multi-disciplinary delivery teams could address the local frontline barriers to improving care services rapidly and whole-heartedly, at both the health system and societal level.
In 2015, my WBFA leapt at the golden opportunity to partner together with the Liverpool School of Tropical Medicine, CMNH-LSTM Nigeria and Johnson and Johnson to up-skill health care practitioners in the area of certificated Emergency Obstetric Care Skills and Drills. Having seen early and encouraging impact, by 2018, we were paying joint advocacy visits to the Kwara State House of Assembly to advocate, sub-nationally, for the training espoused by our EmONC program which was pioneering sustainable change across 21 public HCFs in the state - to be made a professional education curriculum requirement.
As we conclude the 5th year of this pioneering introduction in Kwara State, we now have convincing proof of a concept beyond suitable for whole nation deployment. The results are clear, we've recorded a 38% reduction in facility stillbirth rate since 2015, and we know that the improvements and upskilling in Kwara can, must and will inspire change across the country.
We must continue on the quest to lift and leap over barriers, to deliver new life safely, and ultimately save millions more lives."
Looking to the future
With an estimated 7 million births occurring in Nigeria every year, the need to scale up interventions to improve the availability and quality of Maternal and Newborn care can make the difference when a pregnant woman goes into a healthcare facility to deliver her baby.
As the implementing partners commence new grant activities to establish a national centre of Emonc excellence in collaboration with Nigeria Nursing and Midwifery Council, the findings from the implementation of Wellbeing Foundation Africa's EmONC project in Kwara state concludes that in effectively and successfully reducing maternal and perinatal death, HCPs must be equipped with adequate maternal and child care simulation skills training and the required equipment necessary to ensure a quality and optimal delivery of care in all HCFs.
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WBFA x LSTM and JnJ EmONC fast facts:
Key impact recorded to date following the programs inception are:
Building the capacity of healthcare workers in the University of Ilorin Teaching Hospital (UITH) to support EmOC&NC interventions in Kwara State
Establishment of EmONC Centre of Excellence at University of Ilorin Teaching Hospital
Maintaining activities in the 21 facilities across 7 LGAs where we have previously worked
Upgrading of capacity in another 27 healthcare facilities across 9 additional LGAs to provide quality emergency obstetric and early newborn care
51 public facilities in Kwara State were reached with the programme
16 local Government areas in Kwara State were supported and equipped to improve the availability of Emergency Obstetric Care services to their patients
723 Healthcare workers across all cadres have been trained in the EmONC-LSS training
The number includes 364 Midwives, 220 Doctors, 98 CHEWs, 12 CHOs, 25 Registered Nurses and 4 Pharmacists
Donation of 11 Skills Laboratories at EmONC cluster training facilities
Donation of 10 Skills Corners at Emonc training participant facilities