Frontline Health Workers Training: Key To Improving Maternal Health

Isaac Ejakhebe FASLN

Maternal mortality includes deaths during pregnancy, childbirth, or within 42 days of pregnancy termination, irrespective of the duration and site of the pregnancy. Common causes of maternal deaths include bleeding, hypertensive diseases in pregnancy, obstructed labour, eclampsia, maternal infections and unsafe abortions.


In Nigeria, maternal and child mortality rates are especially high:  According to the WHO the country contributes nearly 20 percent of global maternal deaths with 800 deaths per 10000 live births.  Approximately 262,000 babies die at birth annually, the world’s second highest national total. Infant and child mortality is only one adverse outcome associated with maternal death.  In 2015 an estimated 58 000 maternal deaths occurred. By comparison, the total number of maternal deaths the same year in the 46 most developed countries was 1700, resulting in a maternal mortality ratio of 12 maternal deaths per 100 000 live births. While there is a clear understanding of the interventions needed in the country, there is a gap especially in the facilities in the skillset of basic and comprehensive emergency and newborn care (BEmONC & CEmONC).


To contribute and improve the maternal health outcomes in Nigeria and particularly in Kwara State, the Wellbeing Foundation Africa (WBFA), Liverpool School of Tropical Medicine (LSTM) and Johnson and Johnson, incited the third phase of the “Improving the Availability and Quality of Maternal and Newborn Care” project in Kwara State Nigeria.


Having to date trained over 460 healthcare providers in 48 health care facilities, and selectively equipped the facilities with skills laboratories for continuous training, the first and second phase (EmONC) competency-based training, Quality Improvement (Q.I.), and Data management ran from 2015 to 2018.


  • Three LGAs were covered in the first phase (Ilorin South, Ilorin East, and Ilorin west).

  • Phase two: four different LGAs were covered (Offa, Edu, Kaiama, and Ireopodun LGAs).

  • The ongoing  third phase : target nine LGAs (Asa, Moro, Ifelodun, Patigin, Oyun, Ekiti, Isin, Oke – Ero, Baruten) making it a statewide programme.

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Isaac Ejakhebe, a Fellow of the Africa Science Literacy Network (ASLN) who is also the WBFA program manager in Kwara State said the project is a facility-based training in which health workers are trained in their respective facilities where the trainees would have the opportunity to learn and immediately put into practice what they have learned.


The WBFA Founder, H.E. Toyin Ojora Saraki Special Advisor to the WHO Africa Regional Office, stated that the project aims to improve the skills and quality of healthcare services knowledge and delivery, throughout Kwara State.


‘‘This kind of training is critical to building the skills and capacity of frontline health workers as the key players for skill birth delivery’’


Also speaking on the occasion, Dr Mohammed Hauwa, Senior Technical Programme Officer of the Liverpool School of Tropical Medicine stated that the training was centered around causes of maternal death in society.


According to her, “the training is very relevant in the sense that Nigeria is among the leading country in term of the number of maternal death rate. We need to look at the causes of maternal death and treat them early and appropriately”


Mannequins and training materials were donated to the HCFs to help them organize and run training for their staff and other health facilities within the LGAs. Other facilities are also free to collect and use the mannequins for their own staff training.


All of these efforts aim to affect significant improvements in pregnancy outcomes and save the lives of women and children.

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