Kwara Improving The Availability And Quality Of Maternal And Newborn Care In Kwara State, Nigeria The Emergency Obstetrics & Newborn Care (Emonc)


Nigeria still accounts for close to 20% of all global maternal deaths with over 800 deaths per 100,000 live births and about 37 newborn deaths per 1000 live births. Common causes of maternal death are pre-eclampsia, haemorrhage, sepsis, complications from abortion and obstructed labour, and 80% of these causes are preventable. Kwara has a population of 2.8 million inhabitants and an estimated 120,000 births per year, and it is composed of 16 Local Government Areas (LGAs).
WBFA’s Emergency Obstetric and Neonatal Care (EmONC) programme, Nigeria’s first and only whole-state grant-funded program to improve the availability and quality of maternal and newborn care, implemented throughout Kwara State in North-Central Nigeria, with the support of Johnson & Johnson (J&J) and Liverpool School of Tropical Medicine (LSTM), deployed Laerdal Global Health tools within its designed to provide comprehensive interventions encompassing community mobilization to establish and sustain mechanisms around client-oriented emergency obstetrical and neonatal care. The programme includes teaching the recognition of prolonged labour, infection, preeclampsia and haemorrhage, and neonatal resuscitation alongside the use of appropriate stabilization methods by all midwives, doctors and medical providers, and professionally qualified community birth attendants.

Programme Objectives

The programme was designed to achieve the following objectives:

Project Impact

Following the resounding success of the comprehensive project’s first and second phase (EmONC) competency-based training, Quality Improvement (Q.I.), and Data management, which ran from 2015 to 2018, WBFA’s partnership with the Liverpool School of Tropical Medicine (LSTM) and Johnson and Johnson, incited the third phase of the “Improving the Availability and Quality of Maternal and Newborn Care” project in Kwara State Nigeria.
The statewide project has supported capacity strengthening in Emergency Obstetric and newborn care (EmONC) and quality improvement in tertiary, secondary, and primary health care facilities, across the 16 local government areas (LGAs) of Kwara State, including leadership training for Kwara State Primary Health Care Development Agency (KSPHCDA), with the overall, objectives to reduce maternal/infant mortality. The first phase was in 3LGAS ( Ilorin East, Ilorin South, Ilorin West), and the second Phase in 4 LGAs ( Offa, Edu, Kaiama, Ireopodun) respectively making it a total of 7LGAs. During this period, there have been capacity strengthening in Emergency Obstetric and Newborn Care (EmONC) and quality improvement in 21 Health care facilities across the 7LGAs. Trainees from 10 hospitals and 11 primary health care centres, from the Kwara State Primary Health Care Development Agency (KSPHCDA), the University of Ilorin Teaching Hospital (UITH) and the School of Midwifery Ilorin all participated in the training and development sessions within the time period.
Across the facilities, a total of 290 health care providers were trained in EmONC and using their newly acquired skills on a regular basis. 88 health care providers were trained in quality improvement, and a total of 8 skills labs were set up and used on a regular basis by health care providers. This ensures the sustainability of the project for continuous hands-on experience for the trained staff and to support newly deployed staff. Peculiar about the program also is that it is facility-based training and health workers are trained in their respective facilities. The ongoing 3rd phase of the project consolidated on the achievements and gains made in the initial 21 health care facilities (HCFs). The third phase was to scale up interventions by strengthening Emergency Obstetric and Newborn Care (EmONC) and the quality of maternal and newborn care services in additional 27 healthcare facilities across 9LGAs (Asa, Ifelodun, Ekiti, Isin, Oke-oro, Moro, Oyun, Baruten, and Pategi ) making it a statewide program.
Since 2018 for this ongoing phase till the first quarters of 2019, additional 452 Health Care workers have been trained. At the same training, 35 master trainers for EmONC were also trained. Refresher training for master trainers and skills room/fire drills coordinators was carried for 50 health workers from 21 health facilities covered in the previous phase of the program. Emergency obstetric and newborn care skills rooms were set in the Comprehensive health centres in 5 LGA (Ifelodun, Patigi. Ekiti, Oke-Oro and Oyun), mannequins, and training materials were donated to the HCFs to help them organize and run training for their staff and other health facilities within the LGAs. Other facilities are also free to use collect and use the mannequins for their own staff training.

EmONC Full Report