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.
