In Nigeria, midwives come out of retirement to share life-saving skills

by Pact Nigeria

Rhoda Ceshan Ayuba, 59, and Aliya Ahmed Adamu, 61, are retired midwives – each of them having worked for 35 years in government-owned health facilities in Nigeria. They had started to enjoy the benefits of retirement, such as lots of free time to rest or do anything other than work. But here they are at Tudun Wada Primary Health Center in Gombe, teaching models in hand. They are showing about a dozen nurses and community health extension workers, or CHEWs, how to resuscitate a baby.

“I am happy to be here to help these young women learn and do the right thing,” says Ayuba, who left her home and immediate family in Abuja, Nigeria's capital, to return to the wards of a health center in her home state of Gombe after retiring over a year ago.

Adamu, too, left her home in nearby Bauchi after a year of retirement to help out at Tudun Wada's public primary healthcare center. Both women freely returned to work to be part of the Clinical Mentorship Scheme introduced by Pact as part of the State Accountability for Quality Improvement Project, or SAQIP.

SAQIP, which is funded by the Bill & Melinda Gates Foundation, is working to improve the capacity of the public health system in Gombe State. The mentorship scheme was created to address a shortage and skewed distribution of skilled health workers in Nigerian health facilities. In some cases, only CHEWs with limited skills are available to attend to pregnant women and their babies.

Ayuba and Adamu were deployed to the Tudun Wada health center to mentor 17 younger midwives, nurses and CHEWs. As mentors, they have been helping the young health workers with clinical knowledge and skills to achieve competence and confidence in providing quality care.

“When we got here, we noticed gaps in both the knowledge and practice of some of the nurses and CHEWs," explains Adamu, who is also originally from Gombe State. "But we also noticed they were eager to learn and do the right thing, and that was what we set out to do with them – learn and do the right things."

Says Ayuba: “I am happy to be part of the scheme. I did it because it was like coming back home to help my people."

Aisha Usman, the officer in charge at the Tudun Wada health center, is pleased with the development. “We have seen noticeable changes through the help of the mentors,” she says.

Assumpta Ibekwe, a 33-year old registered nurse and one of Ayuba’s and Adamu’s mentees, says she's learned a lot from her mentors. 

“Even if you ask them a question a hundred times, they are ready to explain,” she says. 

“I will always remember Madam Ayuba’s saying that the labor room is the powerhouse of the hospital,” says Yohanna Dogara, a 27-year-old CHEW at the health center.

Because of her strong performance during the mentorship, Dogara has graduated from a mentee to a mentor and will now train her peers in the health center as well as surrounding centers that have not yet had mentors – a strategy put in place to sustain the scheme.

Overall, SAQIP has deployed 73 mentors to 57 health facilities, benefiting more than 400 mentees. The scheme is a component of clinical training interventions through which both mentors and mentees benefit from the basic emergency obstetric and newborn care, or BEmONC, training. SAQIP paid the mentors monthly stipends while local Ward Development Committees, which oversee primary health centers, provided their accommodations. The committees are also responsible for the transportation of graduated mentees to neighboring health centers.

Because of the success of the mentorships, the Gombe State Primary Health Care Development Agency plans to sustain them as a strategy for bridging knowledge and skill gaps among healthcare workers in the state, and ultimately for reducing maternal, newborn and child mortality in Nigeria.

Lead photo: Aliya Ahmed Adamu, left, and Rhoda Ceshan Ayuba, right, with two of their mentees at Tudun Wada Primary Health Center. (Photo by Shawn Asala for Pact.)