"Women must take part in creating policies and legislation that reflect the society they want to live in"
A brief introduction
As Founder-President of The Wellbeing Foundation Africa (WBFA), Mrs Toyin Ojora Saraki is a global advocate for women’s and children’s health and empowerment, with two decades of advocacy covering reproductive, maternal, newborn, child and adolescent health; ending gender-based discrimination and violence; and improving education, socio-economic empowerment, and community livelihoods in sub-Saharan Africa.
Mrs Saraki is the Emeritus Global Goodwill Ambassador for the International Confederation of Midwives (ICM); special adviser to the Independent Advisory Group (IAG) of the World Health Organization’s (WHO) Regional Office for Africa (AFRO), was named by Devex as UHC Global Champion, is the Save the Children Newborn Health Champion for Nigeria; and is a Global Champion for the White Ribbon Alliance for Safe Motherhood
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SPEECH FROM September 24th, 2019
Good morning. I am delighted to extend a very warm welcome to all of you to this International Day of the Midwife event, hosted jointly by the Wellbeing Foundation Africa and ACT Foundation.
SPEECH FROM July 11th, 2019
Thank you to the Dutch Government, Bernard van Leer Foundation, the International Confederation of Midwives, and the Dutch Taskforce for Healthcare for hosting us and facilitating this 23rd Board Meeting.
I know that as we sit here in the Hague, all of our discussions are focused upon our shared value and commitment to ensuring that women’s, children’s and adolescents’ health (WCAH) is at the top of national, regional and global agendas. I think it is right, therefore, that the Board Meeting seeks to evaluate and enhance its political engagement at all levels.
At the World Health Assembly this year, alongside Helga Fogstad, PMNCH Executive Director, Dr Tedros Adanhom Ghebreyesus, WHO Director General, and Her Excellency Mrs Emine Erdogan, First Lady of The Republic of Turkey. I commended PMNCH’s Call to Action on Aligning Women’s, Children’s and Adolescents’ Health and Wellbeing in Humanitarian and Fragile Settings.
Given that more than two billion people live under the threat of conflict and emergencies of diverse and complex natures, and that 69 million people have been displaced by humanitarian crises, we need bold steps to enhance coordination and bring together synchronized knowledge, policies and actions for a whole-system approach to achieving health for all, routinely across nations, in order to build the resilience for effective responses in protracted emergencies and in the humanitarian-development nexus. That is why I so strongly support PMNCH’s initiative and call to action, which is best placed to bring us all together – from every sector, region, country and background – to remove the inefficiencies, identify and address gaps of capacity and delivery in every sense.
PMNCH is uniquely positioned to mobilise broader political strategies, and partnerships of all kinds, as it can act as the standard-bearer and interlocutor between the WHO, global institutions, CSOs, governments, the private sector and frontline healthcare workers. This support is invaluable to Governments and healthcare providers, who we can consider to be the duty-bearers.
At the Wellbeing Foundation Africa, of which I am the Founder-President, we have learned the value which emanates from engagement with PMNCH in Nigeria, as members who supported the ‘Saving One Million Lives’ campaign, the promotion of routine administration of the reinforced ORS-Zinc formula for management of diarrhoea, and the Midwives Service Scheme, a public sector collaborative initiative, designed to mobilize midwives, including newly qualified, unemployed and retired midwives, for deployment to selected primary health care facilities in rural communities.
I must report from Nigeria that whilst there has been an improved focus on surveillance – and a growing acceptance of the fact that suitable civil registration and vital statistics systems will be essential if we are to achieve universal health coverage – I hope that these milestones in accountability also able to catalyse improved services at the frontline. That can only be achieved with expanded investment in primary health.
I strongly support the PMNCH position that we must put women, children and adolescents at the heart of universal health coverage. The relationship between achieving health for all and WCAH must be at the core of our advocacy as the former is simply unachievable without significant improvements to the latter.
It is of course no coincidence that women, children and adolescents – despite accounting for 60% of the global population – tend to constitute the groups with the least political influence and power, which is why United Nations, WHO and national policies must explicitly highlight and focus on WCAH as part of their UHC strategies.
Only then can we claim to be truly working towards the principle of “leaving no one behind,” which is central to the Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030).
On a final note, as the Global Goodwill Ambassador for the International Confederation of Midwives, one of our co-hosts this week, I must highlight the launch at the World Health Assembly this year, of the report ‘Strengthening quality midwifery education for Universal Health Coverage 2030: A transformative approach to improving quality of care’ produced by ICM, alongside WHO, UNFPA and UNICEF. Women and newborns are the most vulnerable in humanitarian and fragile settings where quality midwifery education saves lives by preparing all midwives to legislate for and respond to emergency health situations. As a critical element in achieving UHC and WCAH, I am sure that we all know that midwives can and do lead the way.
As Nigeria’s first and oldest country member of this esteemed and dedicated alliance, I am honoured by the Wellbeing Foundation Africa’s PMNCH Board Observer Privileges, and delighted to extend a warm welcome to Helen Clark, former Prime Minister of New Zealand, as Chair of PMNCH – who I know will ensure that women’s, children’s and adolescents’ health and wellbeing are reinforced as a global priority. Thank you.
SPEECH FROM June 23rd, 2019
Good morning. It is a pleasure to join you to present the Goodwill Message of Mrs Toyin Ojora Saraki, Founder-President of the Wellbeing Foundation Africa (WBFA), Global Goodwill Ambassador for the International Confederation of Midwives (ICM) and Special Adviser to the Independent Advisory Group to the World Health Organization Regional Office for Africa.
Thank you to Dr Tunde Segun, Country Director for MamaYe! Evidence for Action, for the kind invitation to join you today on this 7th MamaYe Day, to discuss such an elemental and yet crucial aspect of health care service deliver: accountability.
According to the Global Strategy For Women and Children’s Health, the tracked indicators in Nigeria are some of the worst in Africa, with one of the fastest growing populations globally: our population is likely to reach 440 million people by 2050. We know the key issues Nigeria faces: from having the second largest number of people living with HIV, the highest burden of malaria globally – which remains the top cause of child illness and death – to having the second highest burden of stunted and malnourished children in the world.
To achieve accountability in health service delivery, we must be able to accurately assess the demographic need for health: which necessitates a well-designed civil registration and vital statistics (CRVS) system. Only with the collection and dissemination of accurate data can we hope to ensure effective delivery, evaluation and monitoring of sustainable, effective public health strategies.
In the late 1950s, Professor David Morley developed the ‘Road to Health’ chart in Nigeria for monitoring the growth of infants and young children. This home-based chart was originally designed to monitor growth in resource-poor countries, but developed into a record of a child’s growth and development, kept by parents – it was revolutionary in its time. At the Wellbeing Foundation Africa, we took that concept and designed the Personal Health Record (PHR), a book in which the medical records of each mother and child are recorded and stored for future reference and analysis. The PHR evolved from a child immunisation and growth record to a comprehensive CRVS tool.
This forms part of what I call the value of a statistical life. Without a centralised health database for many families to rely upon and keep them informed of the necessary health processes in a child’s first thousand days of life, the PHR came as an innovation that placed this knowledge directly into the mothers’ hands, and empowered her to provide, analyse and follow-up on her own data – to be in control of her own situational analysis. Home-based records have since been successfully deployed in countries like the UK and Japan.
Registering births and linking birth registration to vaccinations is an important part of CRVS and social accountability. Nigeria is currently battling with a situation where only 1 in 4 children, of our population of 198 million citizens, is immunised against preventable diseases. The Global Alliance for Vaccine and Immunisation
(GAVI) has revealed that despite considerable investment – of about $700 million – we only have total immunization coverage of around 30%. CRVS would allow us to hold Governments accountable for their policy, spending and distribution decisions – including in cases such as this.
At the United Nations General Assembly in New York last September I attended the launch of the IAP report ‘Private Sector: Who is Accountable.’ That report rightly called on governments, parliaments, private sector partners and multilateral agencies to establish effective accountability systems. As I noted at the time, only two countries in Africa have met the Abuja declaration to pledge 15% of their government budgets to health. Meanwhile, tuberculosis kills more than 4,000 people every single day. This can be avoided – and there are five key interventions which would take us far closer to delivering the 2030 Agenda and achieving universal health coverage:
We know that the road to universal health coverage does not rest upon singular interventions, but rather on a plethora of interconnected interventions and initiatives; from water, sanitation and hygiene standards in healthcare facilities to breastfeeding education and training for healthcare workers. In a country as large as Nigeria, resilience throughout the whole nation’s system is necessary if we are going to be able to tackle critical health emergencies in fragile settings, for example in the north-east. That is why a strengthened primary health care system is imperative as the foundation and bedrock of achieving health for all and should be a focal point for investment.
Thank you once again for the kind invitation to join you today, and I look forward to working with all of you for stronger, more accountable, and safer health systems.