WBFA/UNFPA Mamacare +N Project
A Nutrition International N-Lift Sub-Implementation Grant
The Wellbeing Foundation Africa (WBFA) and the United Nations Population Fund (UNFPA) in Nigeria collaborated to launch and execute the Reproductive, Newborn, Child and Adolescent Health – Nutrition Program, a Nutrition Leverage and Influence for Transformation (N-LIFT) initiative. N-LIFT a pioneering initiative that seeks to integrate nutrition interventions into existing development platforms that do not already focus on nutrition. Funded by the Government of Canada through Global Affairs Canada, Nutrition International invested up to $2 million (CAD) to incorporate nutrition components into existing UNFPA sexual and reproductive health services.
In Nigeria, the prevalence of anaemia is high among women, affecting 48.percent of non-pregnant women and 57.9 percent of pregnant women. Worldwide, women experience difficulties obtaining accurate nutrition information and accessing crucial iron-folic acid supplementation (IFAS) to prevent and control anaemia. To address this challenge, the United Nations Population Fund (UNFPA) provides sexual and reproductive health (SRH) services that reach adolescent girls and women in over 45 countries
In 2018, WBFA became an Implementing Partner (IP) with UNFPA to execute the MamaCare + Nutrition programme through its existing advocacy platform, MamaCare360. As an IP, the Foundation was responsible for the Provision of Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) services, especially maternal nutrition counselling in the Federal Capital Territory, Abuja. The foundation implemented the programme in 30 health facilities across all the 6 Area Councils of Abuja: Abaji, Abuja Municipal, Bwari, Gwagwalada, Kuje, and Kwali Area Councils.
WBFA conducted sensitization of Ward Development Committee (WDC) members in 30 wards, providing RMNCAH and nutrition counselling through trained nurse/midwives, and providing supportive supervision to the 30 health facilities providing maternal nutrition counselling at the antenatal clinic (ANC), postnatal clinic (PNC), and family planning (FP) service delivery points. WBFA’s actions contributed to UNFPA and Nutrition International goals by improving dietary diversity among programme participants, increasing demand for RMNCAH and nutrition services in target communities, improving health worker’s skills and capacity and creating demand which will translate into improvement in nutrition knowledge, attitude and practices of the community at large.
Nutrition International and UNFPA’s commitment to increasing the impact of nutrition and family planning interventions to reduce anaemia and related morbidity for women and adolescent girls through a joint pilot project with the Wellbeing Foundation Africa through its Mamacare360 programme in the Federal Capital Territory (FCT), enabled UNFPA to address the needs of pregnant women by integrating essential nutrition interventions into Mamacare360’s existing reproductive and maternal health outreach in various hospitals.
Mamacare + N was incorporated into the routine WBFA Mamacare classes in the ANC, PNC, and FP clinics in the Health facilities across the six (6) area councils of Abuja, Nigeria.
Wellbeing Foundation Africa was saddled with the responsibility of scaling up the provision of Reproductive, Maternal, Neonatal, Child and Health services including nutrition counselling to women in ANC, PNC, and FP service delivery points in 30 health facilities across the six Area Councils of Abuja, Nigeria. Through the effort of 94 trained Midwives/health workers from the selected facilities and 6 WBFA volunteer Midwives, WBFA contributed to the UNFPA’s 8th country programme goals of three zeroes (0 preventable maternal deaths, 0 unmet need for family planning, and 0 gender-based violence and harmful practices) by
- Providing support for RMNCAH service provision including maternal nutrition counselling at the 30 health facilities in the 6 area councils of Abuja
- Sensitization of 30 WDCs to create higher demand for RMNCAH services including maternal nutrition
- Conducting joint monitoring and supportive supervision to 30 health facilities providing RMNCAH including maternal nutrition counselling services.
Nutrition counselling and training services were provided within all the area councils in the Federal Capital Territory, Abuja. This Provision, including community-based services, was provided within the framework of WBFA’s existing Mamacare programme. With UNFPA’s technical assistance, WBFA ensured a robust, data-driven strategy that deployed and evaluated a midwife-led approach to improving maternal health and survival, through the provision of nutrition counselling to pregnant and postpartum women on anaemia-in-pregnancy, benefits of micro-supplementation and dietary diversity among other nutritional information.
WBFA implemented the Mamacare + N in seven quarters in the 30 selected facilities at the 6 area councils in FCT. There are 7 quarters between July 2019 and March 2021. July 2019 to December 2019 has two quarters, January 2020 to December 2020 has four quarters while January - March 2021 has one quarter.
- Health facilities reached on RMNCAH+N
The Wellbeing Foundation Africa was tasked with providing maternal nutrition counselling and supporting RMNCH service provision in thirty (30) health care facilities. This project was designed to be a pilot and plans were made by UNFPA, NI, and FCT Primary Health Care Board to scale up the programme to all public facilities within the capital city should this pilot phase be successful.
Despite the numerous security challenges in communities hosting some programme facilities, WBFA successfully provided maternal nutrition counselling and RMNCH services to all 30 facilities leading to a decline in the prevalence of iron deficiency anaemia and increasing the dietary diversity and micronutrient supplement intake of prenatal and postnatal women attending ANC, PNC, and FP service delivery points. The midwives adopted the use of anatomical models from Laerdal in teaching across all benefiting facilities to achieve set outcomes.
The first quarter operation spanned from July 2019 to September 2019 with a total number of 18,659 women receiving the Mamacare+N counselling at the ANC clinic, 6876 women at the PNC clinic and 8336 women at the family planning clinic.
The second quarter spanned from October 2019 to December 2019 with a total of 15,409 women participating in the intervention at the ANC clinic, 7471 women at the PNC clinic and 8504 women at the family planning clinic.
The first quarter in 2020 represents the third quarter of operation of the Mamacare+N project. In this quarter, the Ward Development Committee (WDC) were engaged in the need for women in their various communities to make use of available health services at the various primary health centers in their communities as this will give the women the opportunity to listen to WBFA volunteer midwives educate them on Mamacare+N messages. The major role of the WDC members was to create demand. Consequently, this led to an increase in attendance, especially at the postnatal clinic where the clinic attendance was relatively low.
A total of 17,208 women were reached in ANC clinic, 15,913 women at the PNC clinic and 7845 women at the family planning clinic.
- Sensitization of Ward Development Committees
WBFA was tasked with the responsibility of engaging the Ward Development Committee (WDCs) members (made up of the community, religious, and economic leaders in communities who are influencers and have a catalytic effect on achieving desired behavioural change in communities) in all programme communities to enlighten them about the importance of the programme as well as encourage them to disseminate our message to every household in order to create increased demand for RMNCAH and nutrition counselling in their respective communities. Five members per community were targeted for counselling and advocacy.
This sensitization was first conducted in the first operational quarter of 2019 with 165 WDCs members reached. Furthermore, WBFA was tasked with re-sensitizing these WDC members in the first and second quarter of 2020 to discourage patronage of traditional birth attendants by ensuring that all adolescent girls and women are allowed to assess lifesaving interventions in the health facilities located within their community. A total number of 255 WDC members comprising 237 males and 18 females were reached.
The 3rd quarter WDCs meeting was a follow-up to the previous meetings to ensure that the members are still on course with the mission of the program and to harvest possible challenges perceived by the communities. A total number of 195 comprising 186 males and 10 females were reached.
- Joint Monitoring Exercise
Throughout the life of the program, routine Joint Monitoring Exercise was carried out by representatives from Nutritional International Nigeria, UNFPA, WBFA, FCTPHCB and FCT Budget and Planning. Health care facilities were selected from different areas. The exercise was unanimously judged satisfactory as the majority of healthcare workers demonstrated good nutritional knowledge except for a few health workers at DutseMakarantha PHCs. It was concluded a retraining exercise should be conducted by WBFA and FCTPHCB at the facility. The retraining exercise was conducted by WBFA with support from the nutrition unit of FCTPHCB.
In the thick of the unprecedented challenges the pandemic presented, The Wellbeing Foundation Africa however, continued sustaining the program throughout all the 30 HCFs with all the volunteer midwives sustaining the nutritional counselling at the community and HCFs. A total number of 35,999, 55,248, and 17,180 were reached at the ANC, PNC and FP service points for the end of the second quarter of the year 2020.
At the end of the programme, an impact assessment was carried out by the WBFA Intervention Team on healthcare workers in the various PHCs to assess the programme’s engagement, watch here and here.
The Wellbeing Foundation Africa (WBFA) looks forward to the continued support and guidance of UNFPA, as we aim to reach women, girls and families across Nigeria, over the remaining years of the 8th Country Programme of UNFPA.