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.