Initiatives Aim for Improved Maternal Outcomes

Pregnant women, newborns and new mothers face life-threatening chal­lenges in some parts of the world, in large part because of a lack of adequately trained health professionals to look after them. The World Health Organization esti­mates a shortage of almost 7.2 million physi­cians, nurses, midwives, and health support workers worldwide. Sudan and Nigeria are affected in different ways, but The Carter Center is helping both address the shortfall.

Sudan recognized a decade ago that it not only lacks frontline health workers, it also lacks up-to-date training for them. In partnership with the Qatar Fund for Development and the LUI Che Woo Prize, the Center’s Sudan Public Health Training Initiative works with the Sudan Federal Ministry of Health to strengthen its health workforce from within.

State-run health science training institutions, nursing schools, midwifery schools, and health extension programs have received new laboratory equipment, textbooks, computers, classroom materials such as anatomical models, and curricula in an effort to enhance the learning and teach­ing environment of professionals who will work directly with women and children and the faculty who train them. Depending on the academic program, training can take 15 months to three years.

The initiative in Sudan is expanding to cover almost half of the country.

“Sudan is a big, wide country; 70 percent of the population is rural,” said Dr. Amani Mustafa, the initiative’s coordina­tor in Sudan. “In many places, there simply are no doctors. Eighty percent of babies are delivered at home, so community midwives are a very important part of the system.”

The problem looks somewhat differ­ent in Nigeria. On a per capita basis there are plenty of frontline health workers, but they are concentrated in urban areas, leaving women and children in rural areas underserved.

In response, the Federal Ministry of Health and the health ministries of six states have partnered with The Carter Center to launch the Nigeria Public Health Training Initiative at four schools of nursing and midwifery and two colleges of health technology. As in Sudan, the goal is to opti­mize the training of frontline health workers who treat mothers and children, with a clear focus on rural areas.

To date, 1,010 pieces of furniture, 290 classroom accessories, 607 teaching and learning aids, 445 pieces of laboratory equipment, 750 laboratory consumables, and 138 pieces of information technology and communication equipment have been distributed to the six institutions in Nigeria.

The Nigeria initiative’s priorities include the development of courses to provide in-service training to more than 2,000 health professionals working in more than 950 health facilities in Plateau state alone over the next five years.

The Center has partnered with Georgia State University Georgia Health Policy Center, Emory University’s Nell Hodgson Woodruff School of Nursing, and consult­ing firm ICF to provide technical training in both countries. The initiatives intend to make themselves obsolete as Sudan and Nigeria develop well-supported, self-sustain­ing public health training systems staffed by professionals who are skilled at passing on their expertise to others. The ultimate goal is improved maternal and child survival rates and better health overall.

“In the beginning we learned what the needs were and where the gaps were, and we have been addressing those through procurement of equipment and training,” Mustafa said. “So far, so good. But now we must expand our reach to more areas. There is much more to do.”