White Ribbon Alliance



December 7, 2015
Neglect and abuse in health facilities is not only a violation of women’s rights, it also discourages women from seeking care – and this puts lives at risk. Tonte Ibraye explains how White Ribbon Alliance Nigeria is changing birth in his country through a campaign for Respectful Maternity Care:

“Disrespect and abuse in Nigeria’s health facilities had been a serious problem for many years, but until the White Ribbon Alliance Nigeria campaign, most State Ministries of Health had done nothing about it. We set out to ensure that Respectful Maternity Care (RMC) is embedded in every level of the health system, and that women know their rights and entitlements to it.

We pushed for the opportunity to present Respectful Maternity Care to Nigeria’s National Council of Health, and our members and partners across the country wrote letters to their State Commissioners, putting the case and demanding action. As a result, when the meeting took place, the Commissioners were already persuaded and they agreed to adopt Respectful Maternity Care as a national standard.

Nigeria Web

The letter writing initiative gave WRAN members a high level of engagement and ownership, while policy makers were made to feel that this was a national issue and not one that they could afford to reject. Our members in Kwara State also appealed for support to their own State leaders, drawing on their shared identity – with the message ‘please act, because we are all Kwarans!’

But as we have seen in New York at the UN General Assembly, leaders may make promises but it doesn’t mean that anything will happen. Policy does not equal implementation; we had to make sure that this new policy became practice. And so WRA Nigeria focussed on one state, Kwara, to make sure that all health workers adopted and practised RMC.

Trainings in RMC were provided for health workers, and while these were going on health workers were encouraged to hold ‘Maternity Open Days’ in Kwara so that women had the opportunity to interact with and question them, holding them to account for the quality of their services and making complaints if that service was poor. At the same time women received information on family planning and information on safe pregnancy and birth. In addition we set up a State level Task Force (Working Group) on RMC to report back to the government.

These activities helped us to engage with citizens, while media reporting has also increased and RMC is now being talked about everywhere. The then Commissioner of Health for Kwara State has said that without WRA Nigeria there would have been no policy on RMC. Health workers now ensure that they explain treatment options to women, and that they have permission from women before they perform procedures. Health workers in Kwara have also reported that our campaign has helped them to push for improvements such as screens in the maternity wards to protect women’s privacy. And even in crowded health facilities women are now allowed to bring in a birth companion to support them.

All this contributes to dignified and respectful care. In turn this means that women will have confidence that they will receive good quality services – which will encourage them to attend health facilities, so reducing the risks during birth.”