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FROM March 8th, 2024

Today, on International Women’s Day, I was honoured to virtually provide the goodwill speech at the 2024 National Institute for Legislative and Democratic Studies International Women’s Day Celebration!

Under the exemplary leadership of the Director-General, Professor Abubakar Suleiman, a veritable ‘He4She’ who has significantly contributed to uplifting Nigeria – NILDS has been a steadfast champion for gender equality and inclusion, providing essential support and resources to engender women in overcoming obstacles and achieving their full potential. From advocating for women’s rights to promoting women’s representation in governance, NILDS has been at the forefront of driving meaningful change and creating opportunities for women to excel.

As a Member of the UN Women African Women’s Leadership Network and serving on the Steering Council of the African Women Leadership Network Nigeria, I stand witness to the spirit of African and Nigerian women and their integral role in shaping our nation’s democratic evolution. By channelling the principles of aspirational agendas such as the African Union Agenda 2063 and the United Nations 2030 Sustainable Development Goals, the Wellbeing Foundation Africa Women, Girls & Gender Development Target actions encapsulate a vision which recognises and empowers the birth-to-age rights of women and girls.

With Senior Leadership from the Wellbeing Foundation Africa in attendance, we gathered under the theme “Inspire Inclusion,” and were reminded of the importance of recognising and celebrating the contributions of both men and women towards the empowerment of Nigerian women and their increased participation in governance.

This #IWD2024 celebration led by NILDS highlighted the progress we have made while acknowledging the work that still lies ahead. When we inspire others to understand and value women’s inclusion, we forge a better world, and when women themselves are inspired to be included, there’s a sense of belonging and empowerment. Collectively, let’s forge a more inclusive world for women.

Happy #InternationalWomensDay!

FROM February 16th, 2024

Goodwill Speech:

Good Morning Honourable Ministers; Esteemed dignitaries; Distinguished Guests; Thank you to the Federal Ministry of Health and Social Welfare, Tropical Health & Education Trust and Ducit Blue Solutions for hosting the Global Health Workforce Programme Nigeria Launch Event today.

I am Toyin Saraki, the Founder and President of The Wellbeing Foundation Africa, an NGO which works to improve health and wellbeing outcomes for women, infants and children across Nigeria, prioritising frontline impact with global advocacy, in alignment with the United Nations Sustainable Development Goals and UNFPA ICPD Programme of Action and Three Zeros, in particular zero maternal deaths by 2030.

I am honoured to address you today as we launch pivotal partnerships to enhance and advance healthcare across the nation, including the the Wellbeing Foundation Africa partnership with the Liverpool School of Tropical Medicine in advancing Emergency Obstetric and Newborn Care competency-based curriculum for resident doctors in Obstetrics and Gynaecology at the National Postgraduate Medical College of Nigeria.

This partnership, supported by the Global Health Workforce Programme funded by the UK Department of Health and Social Care and managed by the Tropical Health and Education Trust and Ducit Blue, underscores our commitment to strengthening the healthcare workforce in Nigeria. Leveraging our previous partnership with the Liverpool School of Tropical Medicine, leaders in implementing and evaluating interventions and combining research with capacity strengthening in EmONC, we covered 51 HCFs in 16 LGAs in Kwara State between 2015-2020, establishing thirteen emergency obstetric and newborn care skill rooms comprising of ten main skill labs and three mini labs, benefiting over 700 healthcare providers directly, and reaching an estimated 62,900 women and their newborns, recording a 38% reduction in facility stillbirth rate, leading to the development of the Centre of Excellence. WBFA and LSTM aim to continue to collaboratively elevate healthcare delivery standards while advancing towards Universal Health Coverage for all, as fostering a more robust and sustainable healthcare workforce is paramount to ensuring the delivery of high-quality healthcare services and achieving UHC.

A well-trained and adequately supported healthcare workforce forms the backbone of all healthcare systems, serving as the frontline in addressing the diverse healthcare needs of populations. By investing in continuous professional development and training programmes, particularly in critical areas such as Emergency Obstetric and Newborn Care, we not only equip healthcare professionals with the necessary skills and competencies to provide timely and effective care but also contribute to reducing maternal and neonatal mortality rates, as according to the World Health Organization, the lifetime risk of a Nigerian woman dying during pregnancy, childbirth, postpartum or post-abortion is 1 in 22, in contrast to the lifetime risk in developed countries estimated at 1 in 4900.

Our objectives are clear and resolute. We aim to engage OBGYN students in post-graduate medical education, adapt training packages for revision courses and examination OSCE, establish advanced EmONC Centers of Excellence in Abuja and Lagos, and ensure the sustainability of these centres for postgraduate OBGYN revision courses. Furthermore, we are committed to supporting the NPMCN in providing training to residents, ensuring quality assurance, and rigorously evaluating the programme for maximum impact and effectiveness.

Central to the success of this programme are the esteemed experts from the Royal College of Obstetricians and Gynaecologists (Nigeria Liaison Group) and the experienced master trainers in advanced EmONC provided by LSTM. Their invaluable insights and guidance will undoubtedly contribute to the robustness and efficacy of our initiative, ultimately benefiting the healthcare landscape of our nation.

I extend my heartfelt gratitude to all our partners, stakeholders, government officials, dignitaries, and supporters who have joined us today. Your unwavering commitment and steadfast support will ensure we reach our mission of providing quality health and wellbeing for mothers and newborns across Nigeria.

FROM April 8th, 2022

Good morning, my name is Toyin Saraki and I am the Founder, President, of the Wellbeing Foundation Africa and Inaugural Global Health Ambassador for the WHO Foundation. My Foundation works across Africa to improve health and social outcomes for women and their children, a cause I have dedicated much of my life to.

I am delighted to join you all here today, to celebrate the launch and mark of the Smiles for Mothers Program First Use of Heat-Stable Carbetocin in Nigeria and Sub-Saharan Africa. Today is a life changing moment for women around the world, and the global health community as we will actively witness in real-time the vital impact of heat-stable carbetocin, a new formula which does not need refrigeration or cold-chain transportation, challenges we have faced time and time again in Nigeria.

I personally have been awaiting this major maternal health milestone since the publication of the CHAMPION (Carbetocin hemorrhage PreventION) trial results in 2018 – a study led by the World Health Organization (WHO) as part of a collaboration with MSD for Mothers and Ferring Pharmaceuticals. That data then contributed to heat-stable carbetocin being added to the WHO Model List of Essential Medicines (EML), as well as an update in the WHO’s recommendations on uterotonics for the prevention of excessive bleeding after birth.

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality, morbidity and long term disability related to pregnancy and childbirth in not just low-resource countries, but globally, accounting for nearly one quarter of maternal deaths worldwide. In Nigeria, low use of antenatal care (ANC) and delivery services contribute to PPH, with PPH observed to be the most frequently diagnosed obstetric hemorrhage complication, and majority of women who experience PPH complications have no identifiable clinical or historical risk factors prior to.

While improving overall quality of healthcare is crucial to addressing the high maternal deaths, the use of Heat-Stable Carbetocin will be revolutionary. Maternal health, with thriving mothers and children, is the first and most vital component of healthy societies, economies and nations. Healthy mothers lead to healthy families and strong health systems. It has a direct impact on the welfare of society especially in many developing countries, as a mother’s death is much more than an emotional crisis, it often leads to long-term social and economic breakdown, both for her immediate family and the wider community.

Throughout my years advocating for improved maternal health in Nigeria, one thing has always been clear – effective interventions to prevent and treat PPH do exist and can largely reduce the burden of this life-threatening condition.

I personally have addressed the challenges associated with a lack of access to PPH medication and training, and adequate timely maternal health care ,by developing and then implementing programming through my Wellbeing Foundation Africa to improve access to skilled birth attendance, particularly better quality primary health care at a grassroot community level.

The WBFA, in partnership with the Liverpool School of Tropical Medicine and Johnson and Johnson has successfully introduced, implemented and championed Emergency Obstetric and Newborn Care (EmONC) Skills and Drills training in Nigeria which takes place in-house and equips doctors, nurses and midwives, as a collective team, with the skills needed to overcome obstetric emergencies. The training uses lifelike anatomical models and simulation case scenarios to enable health workers to develop expert first-hand experience – which is often not common in the developing world. At implementing facilities, there’s been a 15% reduction in maternal fatality & 38% reduction in the stillbirth rates – validating our push to scale these lifesaving innovative capacitation to the pre-service curriculum with the denomination of the Kwara State School of Nursing and Midwifery as Nigeria’s First National Centre of Excellence.

As the Inaugural and Emeritus Global Goodwill Ambassador to the International Confederation of Midwives, since 2014, the WBFA has recognised the role of midwives as primary educators and health carers for chilbearing women in our frontline programmes towards safer births and healthy futures through our flagship Mamacare360 Antenatal and Postnatal programme, which covers the mother’s nutritional status, mental wellbeing, and lifestyle choices, before, during and after pregnancy; profoundly affecting the future health and wellbeing of the mother and child. Antenatal education forms part of the early intervention and promotes positive perinatal outcomes and should be viewed as part of a life-long journey. My Foundation promotes respectful care and the involvement of pregnant women and their families by making the mother a premium partner in her own outcome, through education and awareness in birth preparedness.

The quest for real and practical solutions to improve PPH outcomes in Nigeria has seen us walk the daily path from research bench to hospital bedsides and birthing stools in huts over decades, from a simple mat placed under the mother to measure the flow of blood as a practical signal in 2008, and the oxytocin shot for life, to misoprostol with DFID PATHS2 in 2010, to fighting alongside with Flight For Every Mother for hands-on training across Africa in 2013, to our 6-Year WBFA-LSTM-JNJ Program To Improve The Availability and Quality Of Maternal And Neonatal Health Care In Nigeria through the EmONC Skills and Drills Program pioneered from 2015 to 2021 throughout Kwara State, to the London School of Tropical Medicine’s WOMAN Trial of tranexamic acid in 2018, to advocating to the Global Board of Ferrings in January of 2020, and an ongoing working partnership with Laerdal Global Health to improve community midwives access to modern tools and training in the 670 community HCF we have engaged with across Lagos, Kwara, Osun, Cross River, Kaduna, Kano, Sokoto and the FCT Abuja.

Now, with accessible treatment of PPH through heat-stable carbetocin, we will be much closer to reaching the Sustainable Development Goal 3, with our healthcare workers given timely access to appropriate medications and support in procedures relevant to the management of PPH, and our mothers being aware and knowledgeable on advocating for heat-stable carbetocin.

The fact remains that despite significant statistical improvements, becoming pregnant is still one of the most dangerous things a woman can do in her lifetime in Nigeria where there is a 20-fold higher risk of death than in better resourced regions of the world – but today, with the entry of heat-stable carbetocin into the arsenal, we are a quantum leap closer to tackling and ending PPH, demonstrating first-hand how work across both the public and private sectors can help achieve development goals in global health.

It is my hope that the ground-breaking progress we have made today will also mark a new era in strengthening the Essential Medicines Supply Chain and Drug Revolving Fund Management at the Primary Health Care frontline where this matters most, and to transforming maternal care around the globe with positive impact that will be implemented and accessible everywhere through heightened investment and commitment to the cause. When we save the lives of mothers, we are also saving families and communities from tragic emotional, mental and socio-economic costs of irreplaceable losses, but also realizing and potentiating an enormous opportunity for human development and a healthy future for all.

Thank you.

FROM February 27th, 2020

Thank you to the Independent Midwives Association of Namibia and the ICM Board Members for the Africa region, who as our hosts have accorded us the warmest welcome here in Namibia.

I am delighted to offer my own welcome to you all, as ICM’s inaugural Global Goodwill Ambassador, to the Africa Regional Conference of the International Confederation of Midwives (ICM).

I would like to pay tribute to the work done by my dear friends Sally and Franka, at the leadership of level of ICM, who along with their team, work tirelessly with and for midwives all around the world.

In fact, the numbers increase every time I give a speech for ICM. I believe that ICM now supports and represents an incredible 140 Members Associations, representing 121 countries. Thank you for all that you do, and for bringing us here together, with the support of generous partners and sponsors.

Most of all, of course, welcome and thank you to our midwives. It is a real pleasure to see many familiar faces here today, and I look forward to meeting more of you over the duration of this conference.

The theme here today, ‘midwives leading the way for quality and equity in Africa,’ is striking in its simplicity and accuracy. As we share our experiences and knowledge here in Namibia,
I know that we will focus on how midwives already lead the way across Africa in so many different respects. I look forward to strategizing how we overcome barriers that prevent midwives from providing the very best of care to women, newborns, families and communities wherever they may be – from a small village in Namibia to the bustling streets of Lagos.

I have always operated according to the central belief that a women-centred, midwife-led model of care – one that follows normal physiologic labour and childbirth with no unnecessary or excessive interventions – saves lives and allows women and their infants to stay alive and thrive. That is, of course, essential. But midwife-led care is also transformative beyond the labour room.

At the World Health Assembly in Geneva earlier this year, I welcomed the launch 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.

Wherever they work, midwives are the community leaders and interlocutors who are best placed to advocate for and ensure safe environments including, but also beyond, pregnancy, birth and breastfeeding. In many instances rural midwives represent the sole point of access to health care in remote and under-served areas. When midwives are safe and able to carry out their full range of services, we will have a real opportunity to drive forward Universal Health Coverage.

That means providing whole-system support for midwives, including the adequate tools, equipment, and medicine to provide the full scope of timely, high-quality care; and the capacity to carry out the WHO-recommended 8 antenatal visits.

That can only be achieved through effective supply chain management and procurement. By that I mean we must overcome challenges related to drug selection, registration, quantification, procurement, storage and distribution, quality assurance, and information systems.

Where midwives’ human resources metrics are not tracked, they cannot be managed. Thus, more data on midwives is needed: from midwifery schools on graduate profiles; to professional associations on licensure, registration, and continuing professional development. We need routine, robust, and up-to-date human resource information systems.

Midwife-generated data streams can provide valuable feedback on how services are delivered. With accurate information we can advocate for service improvements. A comprehensive civil registration and vital statistics system must form the foundation of health services and personnel decision making. Metrics provide the evidence needed to understand and advocate for how midwives’ enhanced leadership roles can optimize health systems.

We also know, and demand that a midwife’s workplace must be free from sexual harassment and gender discrimination. This as an absolute essential element of a functioning, decent and dignified health system. According to a global survey conducted by the ICM and the WHO, 37% of midwives reported that they have experienced harassment at work, whether from colleagues or patients. Effective interprofessional collaboration is important to keeping midwives’ workplaces safe. Midwifery must have its own ‘MeToo’ moment – and the harassment must end. Respect for both Midwives and their work in maternity care is a non-negotiable necessity.

At the Wellbeing Foundation Africa, of which I am the Founder-President, I have seen the remarkable effect that midwifery-led care has on equity in relationships and communities. Our ‘MamaCare’ midwives deliver their antenatal classes to women, but are also counsellors on issues as diverse as domestic violence and financial access. Men may attend some classes, and I have seen them sit quietly at the back of the room taking notes. Quite right too. I know that this is an experience mirrored by midwives across Africa, who act as strong role models and champions for women.

I am delighted to be here with you all in Namibia and I look forward to our shared learning and growth. Next year the Year of the Nurse and Midwife will be upon us. The Africa Regional Conference is going to be an important event for midwifery, it is an opportunity for us to lay the groundwork to drive progress forward. It is a space that allows us not only to share the latest developments in midwifery knowledge but also to build new partnerships that strengthen our networks within the region. A space we can exchange learning experiences and professional realities, and work together on solutions to the challenges we must overcome.
Thank you.

FROM September 25th, 2019

The Honourable Minister of Health, Prof. Isaac Adewole;

The Executive Director of the UNFPA, Dr Natalia Kanem;

The Executive Director, FP2020, Beth Schlachter;

President of Global Development at The Bill & Melinda Gates Foundation, Dr Chris Elias;

Distinguished Colleagues and Partners;

Ladies and Gentlemen.

 

It is an honour and a privilege to welcome you all, especially our visitors, to Nigeria, on this occasion of the Family Planning 2020 Reference Group (FP2020 RG) meeting sessions in Nigeria. The FP2020 is a global movement that we all are very proud of – a catalyst of contributions, innovations, advocacy, policy action, equity, and wellbeing. We salute your individual and collective participation, for the ideals of improved human welfare and economic empowerment, through greater access to the high-quality contraceptive choices for the women and families who desire such, and in line with the Sustainable Development Goals (SDGs).

 

This year, the global health community lost my dear brother, Babatunde Osotimehin. Professor Osotimehin was an indefatigable ally in his role as Executive Director of UNFPA, especially in our shared goal of improving the conditions and outcomes of pregnant mothers, newborns, children, adolescents, and their communities. He also served tirelessly, of course, as a co-chair of the FP2020 Reference Group. Our thoughts and prayers have been with his family, friends and colleagues since we heard the terrible news in June. The new Executive Director of UNFPA and FP2020 Reference Group Co-Chair Dr. Natalia Kanem, is the right person to carry on the legacy of Professor Osotimehin and, alongside Dr. Chris Elias of The Bill & Melinda Gates Foundation, she is superbly placed to help realise our vision for a world where every pregnancy is wanted, every childbirth is safe, and every young person’s potential is fulfilled.

 

We are all united by the principle on which FP2020 was created in London, back in 2012 – that all women, no matter where they live, should have access to life-saving contraceptives. I founded the Wellbeing Foundation Africa (WBFA) in 2004 to improve the reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH+N) indices of Nigeria, as well as much of sub-Saharan Africa; and to eliminate all forms of gender-based discrimination, neglect, abuse and violence. Despite being rich in human and natural resources, estimates from 2013 stated that Nigeria accounted for almost 13% of global maternal deaths, with close to 40,000 women dying due to pregnancy- and birth-related complications, every year. The evidence of the life-saving effects of family planning for mothers and children is irrefutable, including potentially averting 32% of all maternal deaths and nearly 10% of childhood deaths, if it were available to all those who wanted it.

If we are to achieve the FP2020 goal, and ensure universal access to sexual and reproductive health services and rights by 2030, as laid out in Sustainable Development Goals 3 and 5, the work of the Performance Monitoring & Evidence Working Group will be absolutely crucial. I am a strong believer in promoting the use of data and investments in proven tools such as the WBFA client-held Personal Health Records (PHRs), a family planning health information delivery platform for women, as well as an accountability tool that can identify gaps in their reproductive care. The move towards the Expert Advisory Community expanding its role to become a two-way channel between the Secretariat and the family planning community of experts is welcome for the same reason – not only to better share information but also to hear back from those who have the evidence from the frontline. The emphasis on supporting and reinforcing country-level activities is one that the WBFA is fully in support of, so that we can play our part in increasing access to information, services and family planning supplies. 

At the Family Planning Summit in London this July, the WBFA team and I were encouraged to learn the results of the scaled deployment and accessibility of the innovative Sayana Press Uniject injectable contraceptive device, for which I led the advocacy for, from its acceptance into Nigeria’s National Council on Health’s approval for the Task-Shifting and Task-Sharing Policy in 2012, to its scaled implementation as an affordable solution in diverse humanitarian settings from crisis, to development in the Ouagadogou Partnership, the Sahel Women’s Empowerment and Demographic Dividend Project, and within the developing strategy for Nigeria’s Lake Chad Basin.  

I call on all global and national leaders to honor their FP2020 commitments to improve family planning funding and services; partner with donors and other NGOs to increase financial backing for family planning at all levels; and join with the relevant agencies to build the capacities of healthcare providers. Such leaders and other stakeholders (as in the private sector) must also strengthen primary health care facilities to provide family planning counselling and services for increased access and better coverage, while improving their forecasting capacities.

 

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:

  1. Civil registration and vital statistics systems must be implemented and strengthened to allow Governments to prepare for epidemics and allocate investment where it is needed the most. CRVS is the only way to ensure that we leave no-one behind. 

 

  1. Investment in family, community and primary healthcare – along with hospitals where needed – to bolster healthcare wherever people need it; in rural areas and urban, cities and villages.
  2. Government investment in strengthening health insurance systems is also paramount to achieving Universal Health Coverage – in Nigeria and around the world, too many people are plunged into poverty by health emergencies that they or their families experience.

 

  1. Non-communicable diseases kill over 41 million people every year. The Director-General of the WHO, Dr. Tedros, has rightly highlighted the NCD crisis and it must be a core focus of all Government programmes. Strengthening the primary health tier is key to prevention, detection and treatment of NCDs.

 

  1. Finally, and most importantly, the murder of young midwife and mother Saifura Hussaini Ahmed Khorsa in Nigeria last year must spur Governments and global institutions on to strengthen security provisions for frontline health workers, in particular those who work in fragile humanitarian settings. Women and newborns are the most vulnerable in humanitarian and fragile settings where quality midwifery education saves lives by preparing all midwives to prepare for and respond to emergency health situations. 

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.