Currently, Nigeria’s maternal mortality rate – 545 deaths per 100,000 live births and the second highest worldwide – contributes about 10% to the global death indices of women in direct relation to their pregnancy or delivery.
Despite this significantly high rate, over 70% of pregnant women in Nigeria are more likely to have their pregnancy and labour supervised by traditional birth attendants (TBAs) – mostly unskilled – across various communities. The Agbowa Ikosi community of Ikorodu, Lagos Nigeria is not exempted from this situation.
Community entry; first engagement with the community head of the TBAs
However, following several needs assessment in this hard-to-reach riverine community, it was found that the pregnant women who fall into labour in the Agbowa Ikosi Beach Community must travel about 9km to get their labour supervised by a skilled health worker because their make-shift health post is not equipped to carry out these services. This then causes the women to remain in the community with trusted TBAs who monitor their labour supervised birthing process using leaves, tree barks, and the likes.
The Ikosi beach rural community health post
The result of this community needs assessment birthed the TIWANI HEALTH Project as an intervention towards improving maternal and infant health outcomes in their community. This intervention organised by young health advocates, was coordinated as a 3-pronged approach to educate their pregnant women and women of childbearing age; train the community Traditional Birth Attendants (TBAs); and foster collaboration between them and other public health institutions for sustainability.
TIWANI HEALTH is a project by the 2022/2023 class of the Carrington youth fellowship initiative (CYFI) aimed at instilling the spirit of ownership and responsibility among members of the community, by teaching them to take ownership of their own health.
The TIWANI HEALTH team
During the training session done of the 26th of April 2023, the TBAs were correctly re-educated on the importance of perinatal care and immunization, best practices for safe delivery, contraception, as well as how to make hygienic disinfectants for their workspace. They were also provided with basic items needed to ensure knowledge reinforcement, practice of newly acquired skills and lasting impact. These include birthing kits, contraceptives, hygiene products and IEC posters – written in their local dialect (Yoruba) – for their facilities.
Medical personnel and Apex nurse of the Agbowa community PHC during the TBA training session
Likewise, during the community awareness on maternal health carried out on the 29th of April 2023, women and men in attendance were taught about the importance of antenatal care, proper nutrition during pregnancy, personal hygiene, menstrual hygiene, family planning and essential tips a safe and healthy delivery. Additionally, they were taught how to make simple, hygienic cleaners for their home use, such as disinfectants and soaps.
Through this project, The Tiwani Health Team was able to sensitize over 70 members of the community, including traditional birth attendants, pregnant women, women of childbearing age, and men on best practices for maternal health towards improving maternal and infant health outcomes in their community.
The team and some participants at the maternal health community awareness
According to Itunu Ashade (trainer and medical personnel on the TIWANI HEALTH team), she believes that this project is an impactful way of raising awareness on maternal health in the community and making a difference in the lives of their women and children. She also stated that her experience on this project will remain vital to continuous engagement, partnerships and training for TBAs in the community and beyond.
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