Building Resilience Through Actionable Hope – To Recover from COVID-19, Rebuild Sustainable Systems, Respond to the Needs of the Planet, Respect the Rights of People, Replenish And Redeem The Promise Of Multilateralism At The Frontline, And At Scale
Download Her Excellency Toyin Saraki Global Office and Philanthropy and The Wellbeing Foundation UNGA76 Advocacy And Activity Statement here:
The COVID-19 pandemic has proved to be the most challenging period the world, and the global health and development community has seen since the Second World War. It’s given way to the new disturbing normal – deepening inequalities and vulnerabilities, decimating economies and plunging millions into extreme poverty. Yet we all agree that the world must prioritize a sustainable recovery, rooted in the 2030 Agenda, and supporting countries and communities as we work to rebuild systems shattered by the pandemic.
The backdrop to this year’s 76th UN General Assembly, UN Global Compact, and the important Concordia Leadership Council and Concordia Summit is a world that feels fractured — just when we need to come together against the continued ravages of COVID-19, the accelerating climate emergency, unfolding humanitarian disasters, rising inequality, and much more.
Fixing it will take bold leadership, brave choices, and sustained commitments. At UNGA, it means bringing together world leaders, civil society champions, young people, global businesses and many others to reinforce and reinvigorate our collective determination to solve our shared problems.
At the Wellbeing Foundation Africa, we have consistently honoured and expanded our central mission to make childbirth safer and reduce preventable deaths by deepening and knowledge-driven impact to community frontlines even as governments and multilateral agencies sought to strengthen health systems, deliver COVID-19 testing, treatment and equipment, and contribute to the most ambitious vaccination campaign in history.
Through the core platform at the heart of our frontline impact, the multi-faceted institutionally endowed Mamacare360 Community Midwifery powered Antenatal and Postnatal Social and Health Education and Nursing Care Program, and to guarantee the progression of a healthy future towards attaining our Women Girls and Gender Development Targets, the WBFA has continued to promote respectful and comprehensive maternal, newborn, child and adolescent health, care, and combat both non-communicable diseases and neglected tropical diseases through improvements in nutrition, water, sanitation and hygiene practices. From the research bench to the health facility, household and hut in over 670 communities, we are committed to improving competencies in clinical practice of health workers, creating an enabling environment for healthcare leaders and facility managers and enacting policy and programs that work for, and directly with, women, their newborns and their families.
The Wellbeing Foundation Africa (WBFA) programmatic initiatives are targeted at remediating the weaknesses of health systems challenged by a myriad of issues from demand creation for health seeking orientation for social behavioural change to better supply chain management, diagnostics and treatment, all with reaching people, from conception and birth, to advanced age, and building sustainable cities to enable better health and wellbeing at the core.
Of all our programming across Nigeria, the 2 programs that were most prophetic of the skills and capacities needed to combat COVID-19 during the restrictions of socially distanced physical lockdowns, were our organic introduction of Mamacare360 and MaternalMonday Whatsapp Groups to continue the conversations in our Mamacare360 classes, and our WASH For Wellbeing program, teaching clean hygiene to mothers and medical workers in HCF, and its counterpart Primary and Adolescent PSHE-WASH in Schools. We had initiated these focused platforms in April 2018, as our responsive commitments to both the UN Secretary General’s call for improved WASH, the WHO Resolution on Hygiene in Health Care Facilities, and, our stark finding that only 22% of Delivery Rooms in Nigeria had direct access to a basin, soap, and clean water. As Covid-19 appeared, we were positioned in 670 communities, to ramp up the key learnings for social behavioral change, right in the communities and households, schools and marketplaces where trusted learning needed to reach.
The WBFA continues in its quest to develop a concrete Nigeria-wide public health informed approach that looks at the contextual factors, and responds with key actions for individual women, children, their families and the schools and health facilities within their communities in which they live that make it more or less likely that vulnerability and adversity in childhood has a lasting impact on their lives. A holistic inclusive approach, that takes our community midwifery approach further into a school nurse-visitor information, education and learning approach, and a reporting index will address inequality and the broader causes of vulnerability which might otherwise be overlooked to support decision-making and prioritisation.
Our ongoing project with our global partner, Nutrition International has seen our program implementation model expand to Northern Nigeria where reported health indices represent the lowest and worst levels in the country.
The WBFA ‘Scaling up Zinc and LO-ORS to Improve Childhood Diarrhoea Treatment’ programme which commenced in July 2021 in the two highest-burden of diarrheal disease localities, Kano State (the second most populous state in Nigeria after the megacity, Lagos) and Sokoto State – aims to redefine the health system services to sick children via improved availability and uptake of Zinc and low-osmolarity oral rehydration solution (LO-ORS) which are critical in the treatment of childhood diarrhoea.
We advocate that Zinc reduces diarrhoea-specific mortality by 23% and LO-ORS decreases this mortality by an additional 84%3. For this reason, the World Health Organization recommends treatment with zinc and LO-ORS for the clinical management of acute diarrhea. Our objectives to improve the provision of appropriate information to caregivers and influencers, develop the capacity of and improve the supportive supervision for health workers, and the states to increase and sustain availability and access to zinc and LO- ORS commodities demonstrates our commitment to improving the survival rates and health outcomes of infants whose future should be protected.
The WBFA is proud to have successfully concluded our ambitious 5-year collaboration with Johnson & Johnson Global Health and the Liverpool School of Tropical Medicine’s Centre For Maternal and Newborn Health, to improve the quality and availability of maternity, newborn and obstetric care in Kwara State, North Central Nigeria, by delivering a comprehensive skills-based and certificated training package for 62,800 multitiered professional health workers in Emergency Obstetric & Newborn Care (EmONC). The project was centred on improving maternal and neonatal health by building capacities of in-facility health care workers in basic and comprehensive emergency obstetrics and newborn care (BEmONC and CEmONC) respectively.
The impact is clear, a 15% reduction in maternal mortality, and a 20% decrease in stillbirth rates by 20% – giving Kwara State the enviable ranking of the highest and best maternal, newborn and child survival rates in Nigeria, while partners await the initiation and implementation of the newly-introduced WHO guided perinatal birth and death audits.
Upon conclusion the programme saw the growth of invaluable support to health solutions and improved quality and availability of skilled birth attendants (SBA). Successes included the upgraded capacity in 27 healthcare facilities across 9 Local Government Areas (LGAs) to provide quality EmONC. A total of 290 healthcare providers were trained in EmONC, whilst the training in quality improvement of 88 healthcare providers were conducted across all LGAs in Kwara State. 50 master trainers and skills lab coordinators were also trained and positioned to facilitate training and anatomical skills laboratory sessions on a regular basis. 11 skills labs were established and are being used on a regular basis by healthcare providers in the 16 LGAs.
The upgrading 21 facilities (100%), alongside the certification of two cluster Centres of Excellence for ongoing impact, and their improved availability of Emergency Obstetric Care services to their patients will have a lasting effect in combating maternal mortality in Kwara State – which we hope will extend to influence pre and post service qualification and regulatory curriculae across Nigeria on the whole, while lighting a path of an effective community of clinical practice for other states to replicate.
Reflecting on the General Assembly’s vital work in the areas of peace and security, disarmament, human rights, gender equality and sustainable development while also overseeing the adoption of major resolutions on key issues – from peacebuilding to counterterrorism and preventing crimes against humanity – addressing climate change and ending human trafficking, the WBFA, which enjoys special consultative status to the Economic and Social Council ECOSOC of the United Nations, and through its leadership of advocating for Nigeria’s ICPD25 commitments, and participation in both the African Womens Leadership Network (AWLN) and the UK-France PSVI Consultations in support of United Nations Resolution 1325 on Women Peace and Security, can affirm that the General Assembly has proven, time and again, the value of multilateralism and a rules-based international system to drive community-level action, and impact thereof.
We live and work in unequal, challenging and ground-breaking times, and must seize strategic opportunities to transform the prevailing challenges to historic innovation – in order that progress will prevail productively for the last mile.
From the earliest moments of the last year of global, national and sub-national activity we knew that COVID-19 would dominate our agenda, yet we also braced ourselves to grapple with the challenge of significantly reduced global aid portfolios, by advocating strongly for increased domestic resource mobilisation as our long-standing collaborations and campaigns with multilateral agencies themselves seek greater investments to continue their essential work to ensure that unmet needs are met.
Yet, because we have observed health-focused private sector industries grow huge profits from the pandemic, largely in provision of testing and tracing, some of which are mandatorily inclusive of government levies, we must call for greater accountability, philanthropy and corporate social responsibility support towards civil society organisations, upon whom the task of frontline mitigation has often fallen.
As Covid-19 variants continue to drive surges of outbreaks, democratising access to open-source and universally accessible reliable genomic surveillance capacities will help accelerate timely analysis and inform response measures to keep countries one step ahead of the virus and counter emerging threats in the future, using data insights to help community health workers and health facilities around the world contain any potential pandemic threat within 100 days of an outbreak.
We can’t achieve our goals on our own. We work together with businesses, government, research institutions and nonprofits, and each partner plays a specific role in accelerating progress.
Covid-19 caught the world flat-footed. We must act now, before the next disease outbreak hits, to ensure that we have the data and information needed to respond quickly and prevent it from spreading. Inasmuch as we have reiterated our call that the world needs the WHO, this reinforces our belief that the world needs a more effective and more responsive UN, in a shift from focusing on procedures at the cost of substance to a more streamlined and inclusive priority driven agenda which prioritizes the perception of the UN family of agencies, of which the WBFA is honoured to enjoy close collaborations with the WHO, the PMNCH, the UNFPA, UNWomen and UNHCR, as an indivisibly integrated entity of respect, integrity and progress.
In the busy months ahead, we will have to factor in a mitigation and growth strategy to drive and bring national and regional resilience to bear upon the difficult circumstances and effect of conflict and climate change; deepening poverty, exclusion and inequality; and a pandemic that continues to threaten lives, livelihoods and futures, particularly close to our programmatic frontline home in the African Union and ECOWAS regions.
These challenges are worsened by the divisions scarring our world…between the rich and poor. between those nations who have the luxury of being able to take basic services for granted – and those of our nations for whom these essentials remain a distant dream.
Towards ensuring that the benefit of our programs impact and reach even the most fragile and vulnerable citizens of concern, the WBFA has commenced a compassionate new science driven partnership – The Medela Cares and Wellbeing Foundation Africa (WBFA) ‘Lactation and Human Milk Initiative’.
As an Every Woman Every Child commitment centred partnership, our collaboration is breaking new ground in influencing Neonatal And Intensive Care Unit Clinical and Healthcare policy in Nigeria on the importance of own mothers milk (OMM) to improve infant feeding and ultimately health outcomes. The initial 12 month quality improvement education program which commenced in January 2021 is specifically designed for mothers of, and the premature, fragile and sick infants in Neonatal Intensive Care Units (NICU), putting the latest in healthcare quality improvement technology into practice.
Nigeria consistently ranks as a high-burden country for neonatal mortality, with over 371,000 babies being born prematurely annually, and with complications due to prematurity being the leading cause of death in children under 5. These complications cause >30% of neonatal mortalities (WHO child mortality reports). Additionally, these infants experience more morbidities and long-term complications. All of these negative aspects are significantly reduced with increased dose and exposure to own mother’s milk (OMM).
The Medela and WBFA project is a thorough and wide reaching initiative currently running in four facilities in three states in Nigeria, Lagos, Abuja and Kwara. Through this NICU quality improvement intervention, Medela Cares and WBFA will upskill and enhance lactation and human milk knowledge, skills and expertise for NICU, maternity and affiliated health care professionals. The project will drive the much required change from a facility, policy and health systems management level on the importance of lactation and human milk to reduce the indices of neonatal mortality
It is no coincidence that the start of this year’s General Assembly was immediately preceded by World Equal Pay Day, as we focus on Building resilience: The Future of Protecting Global Health, and the role of health workers in responding to COVID-19 and delivering essential services, yet in so many countries, the female health workforce cannot celebrate equal pay for work of equal value or build upon the United Nations and ILO commitments to human rights and against all forms of discrimination, including discrimination against women and girls.
Globalization, digital innovation and climate change, among other factors, continue to change the world in which we work — posing both challenges as well as opportunities in realizing women’s economic potential for a better tomorrow. Across all regions, women are paid less than men, with the gender pay gap estimated at 23 per cent globally. Gender equality and the empowerment of women and girls continues to be held back owing to the persistence of historical and structural unequal power relations between women and men, poverty and inequalities and disadvantages in access to resources and opportunities that limit women’s and girls’ capabilities. Progress on narrowing that gap has been slow. While equal pay for men and women has been widely endorsed, applying it in practice has been difficult.
The Wellbeing Foundation Africa had made strategic early investments in a female centred frontline health workforce, with our midwives, nurses, doctors and coaches serving as dedicated community educators and interlocutors, proving time and time again, with unstinting dedication that an educated, empowered, equipped and equally remunerated female health professional can deliver a five-fold demographic dividend, for herself, her family, her patient, her health facility, and her community.
In order to ensure that no one is left behind, throughout UNGA76 and beyond, we must amplify the Sustainable Development Goals (SDGs) that address the need to achieve gender equality and the empowerment of all women and girls, promote decent work and economic growth by seeking full and productive education, employment and decent work for all women and men, including for young people and persons with disabilities, and equal pay for work of equal value, thus mainstreaming the gender perspective as being crucial in the implementation of the 2030 Agenda for Sustainable Development with specific focus on the labour force, unemployment, occupational segregation, the gender wage gap, unpaid work, parental leave, informal work, migrant workers, violence against women, legal barriers, social protections and the digital divide.
Achieving equal pay is an important milestone for human rights and gender equality. It will take the effort of the entire world community and more work remains to be done to promote equal pay for work of equal value and the economic empowerment of women and girls.The journey forward: Impatient Optimism towards sustainable cities and systems for safer births – a more equal and equitable multi-lateral paradigm towards a healthy future for all
The pandemic is upending health systems and health workforces around the world—and threatening to reverse decades of progress in global health. That’s why the Wellbeing Foundation Africa, a member of the UN Global Compact, is joining Reckitt, and many other private sector and socially responsible corporate allies and businesses to fight poverty, addressing social determinants towards a better future in actionable hope.
As supporters of WHO standards and targets, the WBFA is committed to the targets of the Frontline Health Workers Coalition in advocating for immediate investments and policy changes to support and protect the frontline health workforce, particularly in low- and middle-income countries.
We must underscore the need to speed-up our response to COVID-19, with vaccines, treatment and equipment for all; to invest in human development, health care, nutrition, water and education; and also commit, and look forward, to both the bold targets for displaced and refugee communities in October, and making progressive contributions to climate targets at the COP26 UN climate conference.
My leadership of the Wellbeing Foundation Africa’s mission is filled with impatient optimism that today’s actions will have an immediate impact. They will also shape our collective tomorrow. Half the world is under 30, another 10 billion will be born this century. They should benefit from the peace and prosperity, the global equity and sustainability that the Sustainable Development Goals could bring.
Throughout the UNGA76 sessions, I have continued to advocate for recognition and respect for local and frontline organisational capacities with regards to global partnerships, in order to ensure equitable funding practices and donor-grantee relationships.
In order to ensure true equity across the sector, donors and grantees need to unite in their shared values and ambitions, to combine the donor’s resources with the grantee’s on-the-ground knowledge of how these can be translated into tangible changes – to ultimately strive for equality, and true accountability as a united front.
Nowhere have inequities been thrown into higher relief as in the war to contain, control and combat the coronavirus pandemic; Safe and effective COVID-19 vaccines were developed in record time. But the virus is moving faster than the global distribution of vaccines. The vast majority have been administered in high- and upper-middle-income countries, mostly in 10 countries alone. If these doses had been distributed equitably, they would have been enough to cover all health workers and older people globally.
The global failure to share vaccines equitably is taking its toll on some of the world’s poorest and most vulnerable people. New variants of concern mean that the risks of infection have increased in all countries for people who are not yet protected by vaccination.
There are enough doses of vaccines globally to drive down transmission and save many lives, if they go to the people who need them most around the world. Worldwide access to COVID-19 vaccines offers the best hope for slowing the coronavirus pandemic, saving lives, and securing a global economic recovery.
To stop the pandemic, and to achieve vaccine equity, we need to vaccinate at least 70% of people in every country, and work towards integrating COVID vaccination campaigns within routine immunisation strategies.
Believing that it is only by constant replenishment and reinforcement that we can harness the crucial resilience to respond to critical points of crisis, the Wellbeing Foundation Africa’s mission to strengthen the primary health care tier with a visionary new paradigm of universally accessible and affordable comprehensive community care, will see our Wellbeing Apex partnership birth a network of quality universal health coverage targeted facilities, driven by prompt diagnostics and efficient supply chain management, at scale, deliver family health services across communities – powered by concrete investments in generating more professional health workers to address the health worker – patient ratio.
Our informed, intentional and deliberate optimism isn’t a belief that things will automatically get better; it’s a conviction that we can make things better. Creating that better future for all, by improving access and availability to health services, and empowering effective agency and autonomy from conception and birth, to advanced age, is in our hands.
The war against inequities, poverty and injustice on our planet must succeed – These challenges and divisions are not an invisible intangible force of nature. They are (hu)man-made and require human solutions of redemption.
In the midst of hunger and crisis, the 2021 United Nations Food System Summit has convened global constituencies, world leaders and heads of state to engage deeply in the process of developing an initial set of country and multi-stakeholder commitments to action. These commitments are emerging to take forward the agenda to accelerate action to transform food systems to achieve the 2030 Agenda for Sustainable Development. We are less than a decade away from our shared target to bring greater safety, equity, and sustainability to our food systems that affect every area of our communal lives – our culture, our economy, and our health. We have a map to a resilient and sustainable and a healthy future for all but it is by harvesting our ambition, growing our seeds of change, and transforming the fruits of our dedicated labor – as change-makers, policy-makers and decision-makers – that we can ensure the future that we want.
The same can be said for one of the darkest fights in the history of the human race: the war to eradicate racism and discrimination which continues to permeate institutions, social structures and everyday life in every society. 20th years after the Durban Declaration and Programme of Action (DDPA), Heads of States and Governments have gathered in the General Assembly hall as part of UNGA76, to discuss reparations, racial justice and equality for people of African descent. Structural racism and systematic injustice still deny people their fundamental human rights, and linkages between racism and gender inequality are unmistakable.
As we re-commit to redeeming and replenishing the promise of multilateralism, matching the UN values of human rights at our last-mile frontlines, supporting the most vulnerable, peace through dialogue, action and solidarity with shared values. Over the next year, every day, we will keep this better world in view, living, working and breathing our central values during UNGA76, and across our world.
Download Her Excellency Toyin Saraki Global Office and Philanthropy and The Wellbeing Foundation UNGA76 Advocacy And Activity Statement here: Keeping A Better World In View