White Ribbon Alliance for Safe Motherhood, Nigeria
The Wellbeing Foundation
#143 Ademola Adetokunbo Crescent,
Opposite Oti Carpets,
- Capital City
- Lifetime risk of maternal death
- 1 in 29
- Maternal Mortality Ratio
- Births attended by skilled personnel
CAMPAIGNING FOR RESPECTFUL CAREIn Nigeria, a woman's risk of dying from pregnancy and childbirth is one in 13, and 62% of births take place at home, where women's lives are at a greater risk. Fear of disrespect and abuse plays a significant role in a woman's decision to give birth at home.
EVIDENCEIn 2013, White Ribbon Alliance Nigeria (WRA Nigeria) learned that while there were many cases of disrespect and abuse in health centers across the country, the government was not tracking and addressing the problem. WRA members agreed that immediate action was needed, and organized town hall meetings to gather testimonies from health workers, citizens and policymakers. In this process, four major barriers emerged: community members and health workers did not have an understanding of respectful care; there was little recorded evidence of disrespect and abuse in healthcare; there was no policy supporting respectful maternity care (RMC); and many health centers lacked the basic amenities to support RMC.
CAMPAIGNUntil 2014, there was no explicit policy protecting the rights of childbearing women in Nigeria. Therefore, WRA worked to establish a clear national standard of practice for RMC and to embed it into all levels of the health system.
WRA Nigeria’s initial focus was on building support for RMC, so that the National Council on Health would establish RMC as a standard of medical practice. WRA Nigeria convened RMC meetings with policymakers, professional associations, regulatory bodies and civil society organizations. Everyone ultimately agreed to call on the Federal Ministry of Health to officially establish RMC as a standard of practice in Nigeria.
Throughout the campaign, WRA Nigeria worked with the media and key champions to build political pressure for RMC so that the policy would be passed and promoted.
To date, RMC has been incorporated in the revised Lifesaving Skills Manual for health workers. WRA Nigeria has worked with the Federal Ministry of Health and professional organizations to develop national RMC promotional materials, and led efforts to monitor progress on the government’s commitment to embed RMC at all levels of the health system.
IMPACTIn response to WRA’s campaign, Nigeria became the first country to officially establish RMC as a standard of practice. The Government of Kwara State developed a plan to include RMC at every level of the state’s health system and has already established a working group that is actively monitoring improvements at six health facilities. These health facilities have implemented RMC, by rearranging delivery beds, adding separation curtains, and securing personal medical files to provide patients with privacy. Health workers are actively educating community members about RMC and ensuring that expectant women understand the level of care and respect they should receive in the delivery room. Although these changes were primarily directed at improving the experience of expectant mothers, everyone using the health centers has benefited from the improved respect to patients.
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