FROM July 20th, 2018
Your Excellencies; Distinguished Guests; esteemed organisers of the African Women in Leadership Organisation; Ladies and Gentlemen; thank you for the kind invitation and gracious bestowment of an award today. I am delighted to address this Goodwill Message to the premier organisation for female leaders of African descent and I salute your goal of changing the narrative and unlocking the potential for women to achieve the best for them and our sisters.
It is my very great pleasure to accept the AWLO 2018 Phenomenal Woman of the Year Award. I do so not for myself, but for my sisters – the Wellbeing Foundation’s midwives, women in Government positions, those in global roles – who inspire me every day to lead for better outcomes for women and for all of society.
I would also like to take this opportunity to commend AWLO for its 1Mother1Child initiative, which recognises the role of motherhood as key to the nurture and future success of our children. You are right to support those crucial stages of development – which is exactly what the Wellbeing Foundation Africa, of which I am the Founder-President – achieves through its pioneering ‘MamaCare Classes’ led by our qualified midwives. Some of those classes, like 1Mother1Child, also take place in IDP camps, a frontline for women and their infants. Despite dire mortality rates here in Nigeria – where women face around a one in thirteen risk of maternal mortality in their lifetime – we have not lost even one of our over 200,000 MamaCare mothers during childbirth. Our MamaCare midwives have achieved this not only by providing classes to a global standard – and achieving the new WHO benchmark recommendation of at least 8 antenatal visits – but also because they act as even more than lifesavers. They provide safe spaces and safe conversations: no subject is taboo or off-limits. To unlock the potential for women and girls, our first obligation is to ensure that they are safe and healthy.
The Wellbeing Foundation Africa was founded with health for mothers and infants as its key objective. Its scope has expanded however, as I soon realised that we cannot confine our actions to our supposed speciality; legislative change, gender equality, maternal health, education and health security are so closely interconnected. To make a sustainable impact and truly open up opportunities for women in Africa, we must reach across borders, knowledge-bases and cultures.
Given that the challenges for women cut across every aspect of their life, our solutions must be universal. As a global advocate for Universal Health Coverage, in Nigeria and across Africa, I know that it not only improves health, but also reduces poverty, creates jobs, drives economic growth, promotes gender equality and protects populations against epidemics. Africa faces the burden of weak health systems and both communicable and non-communicable diseases in a population estimated to reach 2.5 billion by 2050. If we want to transform opportunities for women, we must treat their health and wellbeing as a security threat. That must translate into appropriate levels of funding. The WHO estimates that 85% of the costs of meeting the SDG health targets – including UHC – can be met through domestic resources. But resources must be maximised and utilised effectively. In Nigeria, for every 1 Naira spent on health, 2.5 Naira is spent on defence. It is time that Governments across Africa responded to healthcare deficits as swiftly and aggressively as they respond to military threats.
Indeed, whilst investment in releasing the potential of women is a moral obligation, we must not shy away from making the hard-headed business case for it. Women are key to achieving the demographic dividend that comes with an interplay of reduced total fertility rate, an expanded base of working-age population, and improved educational, infrastructural and healthcare investments. Success for women, both professionally and personally, is success for the whole of society. The UN estimates that gender inequality costs sub-Saharan Africa on average $US95 billion a year. Our countries have both a moral and economic imperative to transform the equality agenda.
The fight for gender equality must also be reflected in the institutions which seek to work in Africa to expand opportunities for women. The release earlier this year of the Global Health 50/50 report demonstrated that organizations from the United Nations system; bilateral and multilateral development institutions; philanthropic organizations and funders; civil society and nongovernmental organizations; public-private partnerships; and the private sector still have a long way to go to reflect the values they are trying to themselves instill. Of course I salute our male allies – when the Director-General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, became the first African to succeed to that role, he established a senior leadership team which consists of more than 60% women, declaring that “We need top talent, gender equity and a geographically diverse set of perspectives to fulfil our mission to keep the world safe.” António Guterres, Secretary-General of the United Nations, recently tweeted that he had kept his personal commitment to women’s empowerment and gender parity at the UN by creating a “50-50 Senior Management Group.” We must however use our influence to empower African women to take on leadership roles and ensure that global institutions practice what they preach.
Thank you once more for the kind invitation to join you today and to receive an award. I will follow your conversations during this conference closely and vow to work closely with all partners to help African women achieve their potential. Thank you and God Bless.
FROM May 15th, 2018
Good morning and thank you for inviting me to speak today about ‘the Role of Technology in Improving Mother and Child Healthcare in Nigeria’.
My name is Toyin Saraki and I am the Founder-President of the Wellbeing Foundation Africa and Global Goodwill Ambassador for the International Confederation of Midwives, and a special adviser to the Africa Regional Office of the WHO, with a committed purpose to transforming health in Africa towards realising universal health coverage for all.
Within all my roles and from years of frontline engagement with the challenges faced across Nigeria, and some successes, I have seen how digital technology can, at its best, ensure that quality and standards of care are improved and maintained – the ability to track, trigger actions and provide accountability empowers midwives and other health workers to lead the way with quality care, adapting to their own situational awareness.
I am also particularly delighted to join you today because I see this event as an opportunity. Of course, I am eager to share with you how technology facilitates the work of midwives and the Foundation, but the condition of mother and child healthcare in Nigeria means that I must consider this as an opportunity. In this room are technological experts, leaders in the corporate field and young entrepreneurs. So, I hope that today you will tell me what you can do, and what we can do, together, to improve mother and child healthcare. Let’s talk, let’s partner, let’s save and change lives.
Before we do so, however, I would like for us to take stock of mother and child healthcare in Nigeria and sub-Saharan Africa. For us to be able to apply technological solutions we must first understand the challenges currently faced and the impending factors which will further exacerbate the dangers for women and infants.
Around 20,000 babies will be born in Nigeria today – each one of them a blessing. Today, however, we will also lose about 2,300 under-five year olds and 145 women of child-bearing age. UNICEF rightly points out that although the rate of newborn deaths has improved, to 37 per 1000 births, this national average hides the differences between our 36 states and the slow progress in some of them. Whilst these figures are already startling and should constitute a national emergency, Nigeria’s growth rate of 3.2 percent annually means that our nation will, according to USAID, reach a population of 440 million people by 2040. As a nation which is currently unable to keep its mothers and children safe and healthy, we must urgently seek solutions to the scale of the challenge we are about to face.
It is these very statistics, and the absence of crucial detail within the raw statistics, that led me to establish the Wellbeing Foundation Africa in 2004, pioneering two key copyrighted and trademarked tools at its core: the patient custody IMNCH and now RMNCAH Personal Health Records, and the Mamakit Clean Delivery Solution.
A well-designed civil registration and vital statistics (CRVS) system is an essential component of a successful health system which delivers for mothers and children, and to inform Government policy on where projects must be implemented. 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.
My approach in 2004 was not revolutionary or entirely new, as in the late 1950s, Professor David Morley had developed the ‘Road to Health’ chart here 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 WBFA 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. So, what is 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. The digitisation of the PHR to inform similar nationwide efforts by qualified midwives would place Nigeria at the forefront of improving maternal and infant health outcomes. It would be fitting to imagine the impact of scaling and achieving comprehensive coverage of data for health here in Nigeria, where the idea for a home-based record was developed and has since been successfully deployed in countries like the UK and Japan.
The importance of registering births and linking birth registration to vaccinations cannot be overemphasised, as Nigeria is currently battling with a situation where only 1 in 4 children, of our population of 198 million citizens, is immunised against preventable disease, a crisis in the making, and right at the primary health frontline, where the battle to save lives, and deliver demographic dividend will be won, or won.
The second component I mentioned alongside the PHR – our Mamakits – provide the essential tools to take a safe delivery, and indeed ensure clean births and healthy infants. The impact on clean births without Sepsis was immediate and huge, leading, through its deployment by the NPHCDA’s Midwives Service Scheme, to a sharp drop of mortality rates by 40% between its adoption in 2010, and 2015.
However, we found that the instant popularity of these kits, designed to equip public health medical teams, which were adopted into government policy and replicated across the nation, had an unexpected responsibility shift, as when health agencies chose to distribute directly to mothers, these resulted in medical facilities growing irresponsibility in shirking the provision and budgetary Appropriations of the most basic of essential medical supplies in reliance of a mother to bring her own kit, without the healthcare facility providing their own materials on-site. We have therefore now restricted our distributions to licensed birth attendants, hospitals, IDP camps and humanitarian dignity situations.
Technology should be present at every stage of the life cycle of every child – which begins of course with pregnancy. From pregnancy to partograph and beyond, technology such as Philips’ Mobile Obstetrics Monitoring service – or ‘Mom’ for short’ – transforms health outcomes, allows for real-time situational awareness and provides accountability within the health sector. MOM, which features two mobile phone apps, in addition to training and education applications, allows midwives to collect vital measurement data such as weight, blood pressure and temperature, and sync it to the MOM web portal. This data is tracked and the condition of a woman’s pregnancy is reviewed – while specialists at regional primary care centres can also monitor and assess high-risk pregnancies via a dashboard interface. At the Wellbeing Foundation our midwives also have experience of InStrat Global Health’s CliniPAK Mobile Electronic Health Records, a tablet computer-based data capture and decision support tool which allows health workers to capture patient health information and share the data to remote servers via mobile networks. That system also allows for an immediate alert for at-risk patients and swift onward referrals, as well as up-to-date and accurate health data
We must however also get the basics right. More than 80 per cent of new-born deaths are due to prematurity, asphyxia, complications during birth or infections such as pneumonia and sepsis. These deaths can be prevented with access to well-trained midwives during antenatal and postnatal visits as well as delivery at a health facility, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact, proper cord care, and good nutrition. A shortage of well-trained health workers and midwives means that many Nigerians do not receive the life-saving support they need to survive. Whenever I talk about our MamaCare midwives and the work they do, I always consider how difficult it is to properly convey the level of their care and their innovative use of technology. The results are clear to see – over 200,000 women have taken part in our MamaCare classes, achieving the now standard number of eight visits recommended by the WHO, and we are yet to lose a single one to death in childbirth. Long may that continue. Furthermore, our midwives prove that even relatively simple technology can transform maternal and child health outcomes over a huge area. The Wellbeing Foundation WhatsApp groups have, for example, proven to be hugely popular with expectant and new mothers. Questions and worries are aired within that community 24 hours a day – and handled expertly by our qualified midwives. Of course, whilst our MamaCare classes do not yet operate throughout Nigeria, friends and family of those already in the group from all over the country are added, giving a huge scope to the community – which is constantly changing, as mothers leave to make space for newly expectant mothers. It also allows MamaCare midwives to attend to emergencies swiftly and discreetly.
The potential of using mobile phones to reach mothers with key information has of course been recognised for some time. The WBFA was a proud partner and supporter of the Mobile Alliance for Maternal Action – or MAMA – which remains an excellent example of a successful public-private partnership between USAID, Johnson & Johnson, the UN Foundation and BabyCenter. With a core set of messages timed and targeted to pregnant women and mothers, MAMA shared vital information exactly when it is most needed and successfully reached millions of women and families with free and modifiable messages. They were also able to demonstrate the knock-on effect of the scheme, with improved health behaviours from MAMA country program subscribers, including higher rates of exclusive breastfeeding, delivery in clinics or with skilled birth attendants, adherence to recommended pre- and post-natal care visits, and recommended vaccinations for mother and child. Importantly – and I believe we will hear from Nigeria’s Honourable Minister of State for Health, Dr Osagie Ehanire, later today – these technological innovations can be adopted and implemented nationwide by Government.
Whilst we are here to discuss the role of technology in the future of health, we cannot ignore the role of Government – not only in creating the right environment to encourage and adopt successful technology, but in ensuring that Nigerians can access it. Whilst internet access has increased, again the statistics are skewed by certain regions, whilst others lag behind in infrastructure. According to Nigeria’s Communications Commission, over 200 communities which are home to about 40 million people lack access to basic telephones and internet access. Our challenge is not therefore solely in producing technology to save lives but in ensuring that it can be used where it is most needed.
Technology informs the care of a mother and her infant and can benefit the training of health workers themselves. Last week I visited Gwagalada School of Nursing and Midwifery in Abuja to assess the use of another InStrat Global Health initiative deployed by the WBFA – video training, or VTR. VTR is available both as a mobile app and on the web. Whilst our focus is on midwifery and nursing students, its application also extends to teachers. The cost of upskilling teachers by sending them to a training centre is prohibitive or impossible for many institutions, an issue significantly reduced by VTR. As you can see from the slide, the students at Gwagalada very much enjoy the multi-media training content, which includes text, audio and video – with quizzes and tests, of course. Two students were unable to show me the programme from the beginning, because they had already progressed so far. The goal is not of course simply convenience or to operate within economic constraints, but to produce excellence – training health workers to a global standard so that they can save lives and empower powers and infants. A 2015 Human Resources for Health study of the use of an mHealth tutorial application to improve the knowledge and attitude of frontline health workers to the Ebola virus found an 11% improvement in average knowledge levels, and significantly improved knowledge retention. The connection between data, training and health policy is an exciting one – and one we must make the most of to improve maternal and child health.
As we examine the broad applications of technology to transforming health outcomes, I still believe that there is no substitute for hands-on experience. I would therefore like to briefly mention the Foundation’s hugely impactful experience of technology and training -driven public-private partnerships.
Since 2014, the WBFA has joined forces with the Liverpool School of Tropical Medicine, the oldest and most established school of tropical medicine in the world, and Johnson & Johnson, one of the largest global health companies. Together we implemented the Emergency Obstetrics and Newborn Care (EmONC) training programme in Kwara State. This is a unique partnership model, bringing together an esteemed higher-education institution, the private sector and a civil society organisation. I mentioned earlier that the majority of infant deaths are preventable; so too are maternal deaths. 80% of all maternal deaths result from five complications which can be readily treated by qualified and trained health professionals: haemorrhage, sepsis, eclampsia, complications of abortion and obstructed labour. Our EmONC training takes place in-house and equips doctors, nurses and midwives, as a collective team, with the skills needed to overcome these obstetric emergencies. At a recent impact assessment visit to Kwara, I asked a Doctor how the use of models and the training had affected his outcomes. His reply was both instructive and chilling. Before the use of this technology, live births had been the training ground for nurses, midwives and doctors. The demonstrations I witnessed in Kwara were wide-ranging and innovative – I was particularly impressed with the simple inexpensive and innovative use of a condom catheter balloon filled with saline to control postpartum haemorrhage, the excessive bleeding after birth which is the leading cause of maternal mortality and affects up to 5% of women. Together with Liverpool School of Tropical Medicine and Johnson & Johnson has trained 600 ‘master trainers’ in nine local Government Areas in Kwara State, establishing ten EmONC Skill Laboratories in ten selected Core-Training Medical Facilities. These 600 master trainers have gone on to train a further 62,800 health workers. The number of up-skilled frontline health workers continues to percolate, as the impact in lives-saved grows. Imagine a Nigeria where this technology and training was available across the nation.
“My vision is to combine the strengths of each virtual and physical technology experience and create a fully inter-connected PHC chain. The WBFA has produced a business plan to achieve exactly that – to bring global standards of training, referral, care and accountability to communities across Nigeria.”
I would like to finish today by addressing one of the most serious challenges to maternal and child health outcomes in Nigeria – water, sanitation and health, or ‘WASH,’ in healthcare centres. Here in Nigeria, the WHO found that 29% of healthcare facilities do not have access to safe water and toilets, whilst a WaterAid survey revealed that half of primary health facilities do not have handwashing facilities in delivery rooms. Pregnant women and new-borns are thereby placed in huge danger and at risk of sepsis, which is a leading cause of death in hospitals. Rita’s quote on the slide here is quite right: midwives cannot save lives if the conditions they work in are not sanitary. When it comes to patients, among the most vulnerable are pregnant women and newborns, both at great risk of sepsis — a leading cause of death in hospitals. I have launched a new, global WASH campaign, initiated by the Wellbeing Foundation Africa in partnership with the World Health Organization, Global Water 2020 and others, which aims to transform water, sanitation and hygiene in healthcare centres and schools around the world. I call on all of you here today to work on making existing technologies available to Nigerian healthcare centres and developing new ways of making giving birth safe. Thank you once again for inviting me to address you here today. The scale of our challenge is significant but not insurmountable, and technology will play a key role in Nigeria’s future success story. I look forward to your questions, your ideas and your innovations, as I imagine the impact in Nigeria, and imagine the impact of innovation, at scale.
Thank you.
FROM May 8th, 2018
Thank you to the National Association of Nigerian Nurses and Midwives for inviting me to address you today. It is an honour to be here following International Day of the Midwife, as we celebrate the work of frontline health workers in Nigeria and around the world. Thank you to all those of you here today whose life work it is to save lives and enable our fellow citizens to thrive.
As the Global Goodwill Ambassador for the International Confederation of Midwives, I consider my role to be twofold. Firstly, I advocate for health workers in every setting – from calling for more investment and support for nurses and midwives from the Federal Government, to championing the Midwifery Services Framework as the core of a successful Universal Health Coverage system. Secondly, I believe that it is my responsibility to provide a platform for health workers to share their own experiences and to use their knowledge to impact policy and global health debates.
Those two roles are inextricably interlinked – and mutually dependent. For example, last Friday, along with the World Health Organization, Global Water 2020 and other partners, I launched a new, global WASH campaign. Our goal is to transform water, sanitation and hygiene in healthcare centres and schools around the world. Everyone here today will understand the challenging WASH conditions which put lives at risk every day in Nigeria, with infants and mothers most at risk. That campaign was informed by the experiences of WBFA midwives, who identified WASH as a key priority – and it will be led by them and other health workers. I hope that you will join our campaign and add your voices to those calling for change.
I believe that the same is true of all health policy – it is not sufficient to simply celebrate health workers, although that recognition is of course important. We must empower those who have frontline knowledge to shape policy and debate. In doing so, we can also share best practices to raise standards everywhere. I know that our Wellbeing Foundation Africa MamaCare midwives go above and beyond the call of duty; and manage to use developments in technology and inter-connectedness to do so. The WBFA WhatsApp group, for example, gives WBFA midwives the platform to answer questions from concerned mothers 24 hours a day, dispelling fears and reacting to emergencies. They have become counsellors and friends, advising on topics from FGM to gender-based violence. I also know that on more than one occasion they have sternly informed a husband of the importance of an expectant mother of attending an antenatal class. Every nurse and midwife will have similar examples of innovation and extraordinary care – but it is crucial that they are shared by those in decision-making positions.
The holistic role of midwives and nurses makes their experiences uniquely important, but must be part of wider investment in healthcare standards and infrastructure. The publication of the UNICEF report “Every Child Alive” earlier this year provided a stark reminder of the progress that must be made. It found that five newborn babies die every minute across the world – meaning 2.6 million tragedies every year. A shocking 80% of these deaths can be prevented by access to skilled midwives, clean water, breastfeeding within the first hour and good nutrition. In Nigeria, the WHO found that 29% of healthcare facilities do not have access to safe water and toilets, whilst a WaterAid survey revealed that half of primary health facilities do not have handwashing facilities in delivery rooms. Pregnant women and newborns are thereby placed in huge danger and at risk of sepsis, which is a leading cause of death in hospitals. Without adequate WASH facilities, health workers all over the world are unable to safely carry out their crucial work.
Only with Universal Health Coverage can a nation make the most of its health workers and enable them to fulfil their potential to save lives. As a global UHC advocate, I believe that investment in high-quality and accessible healthcare will transform nations. The benefits go far beyond health – it allows young people to reach their potential, protects against epidemics, reduces inequality and stimulates the economy. The announcement last week from my husband the Senate President of Nigeria that one per cent of the Consolidated Revenue Fund (CRF) is set aside in the 2018 budget to boost the provision of basic primary healthcare services across the country is a welcome step in the right direction. We must build on that progress and ensure that health workers are able to provide their input into the future of health in Nigeria. Only then will it prove to be a success.
Thank you again for the invitation to address you today, and thank you most of all for your life-saving work. I commit myself to always championing your voices and your priorities – and making sure that your experiences and knowledge are at the forefront as we create a better and safer health care system.
FROM February 12th, 2018
Her Excellency Mrs Toyin Ojora Saraki
Wife of the Senate President of the Federal Republic of Nigeria
Founder-President, Wellbeing Foundation Africa (WBFA)
Inaugural Global Goodwill Ambassador, International Confederation of Midwives (ICM)
Sensitization Conference for Medical Directors: Orientation of Private Health Facilities in Lagos State on Infant and Young Child Feeding (IYCF) Practices
Venue: Sheraton Hotel, Ikeja Lagos, Nigeria
12th February 2018
Time: 9.30am
Good morning to all of you gathered here today and a particularly warm welcome to the Medical Directors who have joined us for this sensitization workshop. I know that your schedules are packed, but we sincerely appreciate your engagement as we work together to improve Infant and Young Child Feeding Practices here in Lagos. You are most welcome.
I am delighted by the nucleus of critical host community support from the Lagos State Government and thank our Alive & Thrive programme partners, FHI360 for their technical support and oversight, the Association of General and Private Medical Practitioners of Nigeria, the Wellbeing Foundation Africa Team and all those involved in the organization of this conference. Thank you for your efforts as Nigeria unites to ‘Start Strong!’ for infant and child nutrition as part of a global movement.
Alive & Thrive is an initiative to save lives, prevent illness, and ensure healthy growth and development through the promotion and support of optimal maternal nutrition, breastfeeding and complementary feeding practices in rural and urban Lagos as well as Kaduna. Good nutrition in the first 1,000 days from conception to two years of age is critical to enable all children to lead healthier and more productive lives.
All of us in this room are driven by the passion to save lives and empower women, infants and our communities to thrive. As Medical Directors, you do and will play a key role in the success of the Alive & Thrive programme in Lagos. With your leadership, our ‘coaches’ will have the access to your health workers that they need to ensure the programme is delivered successfully, and to gather the data needed to properly monitor and evaluate our impact. Only then can we secure the sustainability and long-term success of this project. I applaud your engagement and thank you for your passion for our collaboration.
Here in Lagos, there is much for us to accomplish. Malnutrition accounts for more than 50% of under-five mortality with a rate of timely breastfeeding initiation at only 28.9%. A mere 19.7% of children 6 months and under in the state are exclusively breastfed and only 10% of children aged 6 – 23 months are fed appropriately. The reality of those statistics is distressing: 47% of children in Lagos under-5 years are stunted, while 34% are under-weight.
The World Health Organization recommends the commencement of exclusive breastfeeding within one hour after birth, and until a baby is 6 months old. Nutritious complementary foods should then be added while continuing to breastfeed for up to 2 years or beyond. If 90 percent of mothers exclusively breastfed their infants for the first six months of life an estimated 13 percent of child deaths could be averted. If the same proportion of mothers provided adequate and timely complementary feeding for their infants from six to 24 months, a further 6 percent of child deaths could be avoided. That is the impact that, in partnership, we can have for the women, babies and infants of Lagos, and a goal which I know will motivate us all.
The crucial first hour is one which all mothers and healthcare professionals must hold to be of the utmost importance. The so-called ‘first vaccine’ of a baby is the goal: the first skin-to-skin contact along with suckling at the breast stimulates the production of breastmilk, including colostrum, which provides a rich dose of nutrients and antibodies.
Alive & Thrive works through a four-pronged approach: policy and advocacy; interpersonal communication and community mobilization; mass communication; and the strategic use of data. The Wellbeing Foundation Africa is the key implementing partner currently working with 500 private health facilities across 10 local government areas (LGAs) in Lagos by providing advocacy, capacity building and health promotion in the area of Infant and Young Child Feeding (IYCF) practices, whilst our partners at Save the Children engage with a number of public health facilities. For each part of the programme to be successful and achieve maximum impact, we rely on co-operation between all partners and stakeholders, and a significant amount of goodwill. You have demonstrated that goodwill by attending today, and I thank you.
I will conclude this welcome address by pointing out that this is a true partnership and collaboration; and our work together must therefore a two-way process. We have a wealth of experience and knowledge in this room: as medical directors, you have seen it all and truly understand your communities, patients and health workers. I call on you to engage with this process and feed back into our work and I look forward to our shared learning and growth as part of a global movement. Together we can make the most of this opportunity to save lives and help our fellow citizens to thrive. Let’s start strong together.
Thank you.
FROM December 21st, 2017
Your Excellency, the First Lady of Nigeria, Mrs Aisha Buhari; Chairman, Mrs. Selina Akunna Enyioha; Secretary Mrs Mary Ebedi; Mr Samuel Leda Madaki; Alhaji Jalal A. Arabi; Aishatu Gambo Jakada; Executive Members of the State House Nurse Cooperative Housing Estate Society Ltd, Ladies and Gentlemen. I would like to express my sincere thanks for the gracious invitation to join you today as Her Excellency, the First Lady of Nigeria, Mrs Aisha Buhari, performs the foundation laying ceremony. It is with deep regret that I am unable to attend and must instead send my apologies and this goodwill message.
All our good wishes and thanks must go to the nurses from the State House Medical Centre, the National Hospital Abuja and professional colleagues practicing in Britain and the USA, as well as members of Staff of the State House, whose contributions went towards the purchase of this land.
The Federal Government is also to be highly commended for the provision of housing for nurses and medical workers, and I hope that this laudable step will be replicated by State Governments across the nation. There can be no doubting the great and urgent need for housing, as our housing deficit lies at 17 million.
I have advocated for midwives and frontline health workers as the key to improved health outcomes for decades and continue to do so in my role as the Global Goodwill Ambassador for the International Confederation of Midwives. The supply of good quality and affordable housing for health workers is fundamental to solving the issue of the density of nurses, midwives and doctors in Nigeria, which according to the World Health Organization is still too low for essential health services to be effectively delivered.
The motto of the State House Nurse Cooperative Housing Estate Society Ltd – Good Housing, Good Health! – is most appropriate, and as I commend this initiative I must also pay tribute to all those here today who keep Nigerians safe and in good health. Please accept my blessings on this momentous day and all good wishes for the future of this housing estate.
FROM October 30th, 2017
Participants:
Format:
Supplied Moderator Questions and notes for answers:
Africa, with some of the fastest-growing economies in the world and yet facing huge challenges, presents a massive opportunity for those wishing to invest. It also represents a risk for philanthropists, both home-grown and from abroad, due to key issues that Governments all over the continent must deal with in order to facilitate effective philanthropy and foster investments.
There are three crucial areas to be addressed: the infrastructure gap, confidence of investors in transparent, long-term projects, and the unreleased potential of girls and women.
The lack of infrastructure has a significant impact on economies across Africa, as potential investors from abroad are often deterred and home-grown investors face a struggle to realise and scale their projects.
The effect of the infrastructure gap is of course most keenly felt in people’s day to day lives. This gap, specifically in the primary healthcare system and the corresponding infrastructure, is the reason that I founded the Wellbeing Foundation Africa: so that all women and children can access the healthcare they need. I established Mamacare classes, where women can receive ante-natal education on a weekly basis, delivered by a qualified midwife. I am also a keen advocate of strengthening primary healthcare infrastructure, establishing community clinics so those in remote areas are able to access services in a timely manner.
Without access to effective healthcare and other essential infrastructure, enterprises struggle to operate. A lack of quality roads and transport means that people – and by definition, potential employees – are unable to access education and workplaces. The results of this are dramatic. According to research from The World Bank Group (WBG), the 48 countries of sub-Saharan Africa, with a combined population of 800 million, generate roughly the same amount of power as Spain, with a population of only 45 million.
The lack of investment in infrastructure in Africa has reduced our ability to trade with the rest of the world and has had an impact on the buoyancies of economies across Africa, as large multinational businesses look to engage with countries with more advanced infrastructure.
Addressing this infrastructure gap is a key step to creating an environment in which philanthropy and investment can flourish.
Governments also need to explore avenues which address corruption and a lack of transparency. An openness to public-private partnerships will help those home-grown philanthropists who have the financial resources and innovative visions of the private sector with the scale and support of the public sector. Governments in developing countries are becoming more aware of the need to protect rights and contracts of foreign investors to prove they are sound places to invest going forward.
These partnerships feed back into addressing the infrastructure networks whilst providing stability and security for donors and investors. I know how they can work from first-hand experience. At the Wellbeing Foundation Africa, our initiatives such as the Personal Health Record (PHR) and the Safe Delivery Kit – otherwise known as the ‘Mama Kit’ – have been adopted into the very frontline of the Nigerian health system. The Personal Health Record is a very simple idea with a significant impact. We took a system that has been in use in the UK for many years and adapted it to suit the Nigerian health system. The PHR enables expectant mothers and midwives to track pregnancy progress and highlights the importance of immunisation and birth registration. The little green book puts real time patient data in the hands of expectant mothers, giving them the agency to take control of their health records and care. This addressed a very real need in Nigeria’s approach to maternal health. The Mama Kits share this principle of giving mothers access to the simple tools that can save their lives. These clean birthing kits include all necessary materials and consumables to achieve a safe childbirth, transforming any incidental delivery location to the likeness of an equipped health facility.
That brings me to the urgent need for Governments all over Africa to unleash the potential of our women and girls. The unmet need for contraception, the massive gender inequality, the lack to essential healthcare – these challenges are holding back philanthropy and our economies. The Copenhagen Consensus Centre reports that for every $1 spent on family planning, benefits worth $120 are reaped. Women are key to achieving the demographic dividend that comes with an interplay of reduced total fertility rate, an expanded base of working-age population, and improved educational, infrastructural and healthcare investments, and because, according to the World Health Organization, an estimated 225 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception, while we are also aware that the benefits of family planning go beyond women and mothers. Governments can help philanthropists and investors access a better-educated, safer and healthier workforce by providing basic healthcare to its population.
In doing so, we will certainly find that we have a growing number of women who are able to reinvest in their country as businesswomen and philanthropists.
The enormous benefit of governments partnering with philanthropists is avoiding the “one size fits all” approach. At the WBFA, we never sought to work against the local context or alienate existing organisations. Instead we collaborate with stakeholders and existing structures to create innovative but pragmatic measures which have an enormous impact on health outcomes.
We have partnered with regional and national administrations with the result that our initiatives such as the Personal Health Record (PHR) and the Safe Delivery Kit – otherwise known as the ‘Mama Kit’ – have been adopted into the very frontline of the Nigerian health system. The Personal Health Record is a very simple idea with a significant impact. We took a system that has been in use in the UK for many years and adapted it to suit the Nigerian health system. The PHR enables expectant mothers and midwives to track pregnancy progress and highlights the importance of immunisation and birth registration. The little green book puts real time patient data in the hands of expectant mothers, giving them the agency to take control of their health records and care. This addressed a very real need in Nigeria’s approach to maternal health. The Mama Kits share this principle of giving mothers access to the simple tools that can save their lives. These clean birthing kits include all necessary materials and consumables to achieve a safe childbirth, transforming any incidental delivery location to the likeness of an equipped health facility.
The effect of our partnerships is transformative. I can report that despite dire national mortality indices, we have not lost even one of our over 200,000 Mamacare mothers to death. Each mother has, moreover, achieved the new WHO benchmark recommendation of at least 8 antenatal visits, which is perhaps the secret of our 100% survival rate. However, our midwives cannot operate effectively in isolation. They need the support of a functioning health system with equipment, medicines and appropriate training and appreciate the importance of both utilising and optimising global partnerships.
There is a willingness of Governments to engage with philanthropists, charities and organisations with a track-record of success and transparency.
The colossal impact of the Gates Foundation can be used as a model for the best strategies to pursue. That model is not a one-size fits all approach but one that works closely with Governments, NGOs, the private sector and, crucially, communities, to find the most effective ways to engage.
Governments need to be encouraged to have ongoing regular dialogue with philanthropists who, in turn, need to respect provide attainable suggestions to policy makers and other charities to be most effective.
The strategies that are most likely to fail are ones that seek to work against local contexts and existing structures. At the WBFA we collaborate with stakeholders and communities to create innovative but pragmatic measures which have an enormous impact on health outcomes.
The benefit of engaging with local communities and fostering relationships with regional governments is that it allows philanthropists and social investors to be effective. Regional governments in turn should help partners to identify what is most pressing and what the public sector can do to facilitate investment and social action.
Philanthropists can however force the issue – with tact, of course. 14 years ago I began counting the deaths of mothers and their children. I then took it upon myself to meet the health minister and so began the Wellbeing Foundation Africa.
We have partnered with regional and national administrations with the result that our initiatives such as the Personal Health Record (PHR) and the Safe Delivery Kit – otherwise known as the ‘Mama Kit’ – have been adopted into the very frontline of the Nigerian health system. The Personal Health Record is a very simple idea with a significant impact. We took a system that has been in use in the UK for many years and adapted it to suit the Nigerian health system. The PHR enables expectant mothers and midwives to track pregnancy progress and highlights the importance of immunisation and birth registration. The little green book puts real time patient data in the hands of expectant mothers, giving them the agency to take control of their health records and care. This addressed a very real need in Nigeria’s approach to maternal health. The Mama Kits share this principle of giving mothers access to the simple tools that can save their lives. These clean birthing kits include all necessary materials and consumables to achieve a safe childbirth, transforming any incidental delivery location to the likeness of an equipped health facility.
The effect of our partnerships is transformative. I can report that despite dire national mortality indices, we have not lost even one of our over 200,000 Mamacare mothers to death. Each mother has, moreover, achieved the new WHO benchmark recommendation of at least 8 antenatal visits, which is perhaps the secret of our 100% survival rate. However, our midwives cannot operate effectively in isolation. They need the support of a functioning health system with equipment, medicines and appropriate training and appreciate the importance of both utilising and optimising global partnerships.
Across Africa corruption and a lack of transparency negatively impact the potential for effective philanthropy and investment. Tackling corruption and enhancing transparency on the continent will not happen overnight – we will need the support and backing of multinationals who choose to do business on the continent and both the public and private sector to ensure there is transparency at every step.
Governments need to explore avenues which address corruption and a lack of transparency. An openness to public-private partnerships will help those home-grown philanthropists who have the financial resources and innovative visions of the private sector with the scale and support of the public sector. Governments in developing countries are becoming more aware of the need to protect rights and contracts of foreign investors to prove they are sound places to invest going forward.
The e-health check tool is available for free at https://covid19.wbfafrica.org/ and users can access real-time updates on how to stay connected, safe, and healthy during the pandemic on Instagram and Twitter @Wellbeing_PPMD, and @WellbeingPPMD on Facebook.
