Nigeria
We collaborate with the federal and state governments, local organizations, communities, and the private sector to improve health access and address challenges to the health of women, children, and families.
MOMENTUM is partnering with nearly 40 countries to accelerate progress and advance USAID’s work to save lives and improve health outcomes for women, children, families, and communities in all of their diversity. MOMENTUM brings together specialized technical and country expertise through six distinct yet integrated awards with the depth and breadth of experience to spur reductions in maternal, newborn, and child mortality and morbidity.
In Nigeria, we work with our partners to vaccinate children against preventable diseases; prevent gender-based violence, child marriage, and early pregnancy among women and girls; improve surgical obstetric care for women; and prevent and treat obstetric and iatrogenic fistula and female genital mutilation/cutting. We also conducted a study to compare the costs of delivering health services in the private and public sectors to better understand how private for-profit and nonprofit providers can better serve Nigerians.
Ending Obstetric and Iatrogenic Fistula
Obstetric fistula—a maternal injury that occurs when obstructed labor leaves a hole in the birth canal—is treatable and almost always preventable. About three out of every 1,000 women of reproductive age in Nigeria have had obstetric fistula.1 MOMENTUM Safe Surgery in Family Planning and Obstetrics collaborates with communities, health workers, and institutions in Bauchi, Ebonyi, Kebbi, and Sokoto states and the Federal Capital Territory to raise awareness of obstetric fistula prevention and treatment and provide holistic care for women with fistula.
On our blog, meet Dame Pauline Tallen, Nigeria’s Minister of Women Affairs and Social Development, who is fighting for the needs of Nigerian women experiencing obstetric fistula.
Improving Surgical Care for Women
MOMENTUM Safe Surgery in Family Planning and Obstetrics partners with state and local governments, organizations, and health workers in Bauchi, Ebonyi, Kebbi, and Sokoto states and the Federal Capital Territory to strengthen the public health sector’s ability to provide high-quality surgical services for pregnant women, such as cesarean sections. Our collaboration focuses on:
- Improving referral systems so that pregnant women can more readily access lifesaving care.
- Helping facilities share information about safe surgical care with each other.
- Collaborating with the Government of Nigeria at federal and state levels to update, adopt, disseminate, and encourage health facilities and providers to use evidence-based guidelines and checklists for cesarean deliveries, hysterectomies performed after childbirth, and fistula care and prevention.
- Training health workers to provide safe, high-quality surgical obstetric care.
- Working with the Federal and State Ministries of Health, non-governmental organizations, the private sector, and community stakeholders to create an enabling environment for safe surgery.
Learn more about how we prevent and treat obstetric fistula in Nigeria.
Eliminating Female Genital Mutilation/Cutting
In Nigeria, one in five women ages 15 to 49 has undergone female genital mutilation/cutting (FGM/C).2 MOMENTUM Safe Surgery in Family Planning and Obstetrics works with partners to prevent FGM/C in Bauchi, Ebonyi, Kebbi, and Sokoto states and the Federal Capital Territory and respond to adverse health impacts among women who have experienced it. We partner with the federal and state governments, the health sector, and communities so that health workers can provide appropriate medical care and counseling to women who have experienced FGM/C and effectively advocate against it. We also collaborate with local organizations and leaders to create strategies to eliminate female genital mutilation/cutting and help survivors.
Reaching Nigerian Children with Lifesaving Vaccines
In Nigeria, 2.4 million children have not received the first dose of the vaccine for diphtheria-tetanus-pertussis (DTP).3 MOMENTUM Routine Immunization Transformation and Equity works with the Government of Nigeria to help more children receive lifesaving, essential vaccines, partnering with the National Primary Health Care Development Agency (NPHCDA) to strengthen the coordination, management, and quality of routine immunization services throughout the country.
MOMENTUM Routine Immunization Transformation and Equity also supports the national and state primary health care development agencies to build their capacity and enhance health workers’ ability to deliver high-quality immunization services. We provide technical assistance to inform community engagement strategies to make them more gender-responsive and help strengthen the linkages between facilities and communities to drive demand for routine immunization. Finally, we work with national and state governments to strengthen health data governance and improve data quality for routine immunization and primary health care.
Vaccinating Nigerians Against COVID-19
MOMENTUM supports five states in Nigeria to coordinate COVID-19 vaccination. We engage implementing partners to discuss and explore solutions to persistent COVID-19 vaccination data issues, and we conducted data quality assessments for COVID-19 vaccinations. MOMENTUM is working with the NPHCDA to integrate COVID-19 vaccination services into the national primary health care system for co-delivery of COVID-19 vaccinations with routine immunization services.
Addressing Social Norms that Influence Gender-Based Violence, Child Marriage, and Early Pregnancy
In Nigeria, social norms that influence intimate partner violence (IPV), sexual violence, early adolescent pregnancy, and child marriage contribute to the suffering and death of many mothers. MOMENTUM Country and Global Leadership partners with indigenous organizations in Ebonyi and Sokoto states to:
- Prevent violence against women and girls and mitigate its consequences.
- Address the causes of child, early, and forced marriages.
- Help young women begin using voluntary contraception as early as possible to avoid adolescent pregnancy.
- Support facilities to identify, manage, and refer cases of violence against women and girls.
- Contribute to a strengthened referral network for survivors of gender-based violence (GBV).
- Galvanize local action through Multi-Sectoral Task Force groups to mitigate and respond to GBV.
MOMENTUM works with local partners to implement the adapted Choices, Voices and Promises interventions to explore social norms that promote gender equitable behaviors for girls and boys, prevent child, early and forced marriage, and also promote the early adoption of family planning for older adolescents. We also partner with the Federal and State Governments to strengthen the health system, and build the capacity of healthcare workers to provide responsive service to adolescents, especially family planning.
In addition, we use the Integrated Technical Organizational Capacity Assessment tool to help local partners address gender-based violence, early marriage, and adolescent pregnancy, and the Behaviorally-Focused Applied Political Economy Analysis to engage local leaders in changing harmful social norms.
Learn more about our program fighting gender-based violence in Nigeria.
Improving Quality of Care for Maternal, Newborn, and Child Health
High quality of care is essential for improving the health of women and children. MOMENTUM Country and Global Leadership is supporting and partnering with the government of Nigeria at national and state levels to support stronger policies and governance around quality of care for women and children. MOMENTUM also works closely with national technical working group members, partners, and stakeholders to build consensus on key program approaches for quality of care and align program approaches with the national plan.
We are also working with six academic institutions from North West, South East, South West, and South to lead research studies focused on quality of care. MOMENTUM has convened technical meetings to co-develop research protocols within the prioritized areas of research.
Understanding the Costs of Delivering Private and Public Health Care
Seventy-five percent of health spending in Nigeria is funded domestically by the private sector.4 However, little is known about the cost of private health care, making it difficult for government decision-makers to effectively allocate resources within the health system. In Ebonyi state, MOMENTUM Private Healthcare Delivery conducted a study comparing health costs—especially for maternal health services and family planning— in the private, nonprofit, and public sectors so that publicly funded health programs can decide whether and how to work with private providers.
Our Achievements in Nigeria
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308 community volunteers trained
From October 2021 to September 2022, MOMENTUM partners trained 308 community volunteers to provide messaging and information on fistula, female genital mutilation/cutting, danger signs in pregnancy, and where to seek care. These volunteers carried out 8,241 household visits, reaching 25,133 people.
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640 surgical fistula repairs
From October 2021 to September 2022, MOMENTUM-supported facilities in Nigeria provided more than 640 surgical fistula repairs.
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3.7 million COVID-19 vaccines administered
MOMENTUM has helped to administer 3.7 million doses of COVID-19 vaccines across five states.
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550 health workers trained to support GBV survivors
From October 2021 to August 2023, MOMENTUM built the capacity of more than 550 health workers to provide quality support to survivors of gender-based violence.
MOMENTUM Country and Global Leadership: Jhpiego, Save the Children, Pact, IHI, Excellence Community Education Welfare Scheme (ECEWS), Daughters of Virtue and Empowerment Initiative (DOVENET), Essential Health Network for Rural Dwellers, Helping Hands and Grass Root Support Foundation, NANA Girls and Women Empowerment Initiative, Rural Women and Youth Development, University of Ilorin, Bayero University, University of Calabar, Ondo State University, Alex Ekwueme University
MOMENTUM Private Healthcare Delivery: Avenir Health
MOMENTUM Safe Surgery in Family Planning and Obstetrics: EngenderHealth, Nigerian Federal Ministry of Health, Ebonyi State Ministry of Health, Bauchi State Ministry of Health, Kebbi State Ministry of Health, Sokoto State Ministry of Health, Nigerian Federal Ministry of Women Affairs and Social Development, Ebonyi State Ministry of Women Affairs and Social Development, Bauchi State Ministry of Women Affairs and Child Development, Kebbi State Ministry of Women Affairs and Social Development, Sokoto State Ministry of Women and Children Affairs, Centre for Population and Reproductive Health, DOVENET, Institute of Social Work of Nigeria (ISWON)
MOMENTUM Routine Immunization Transformation and Equity: JSI, Results for Development, CORE Group Partners Project (CGPP), National and State Primary Health Care Development Agencies
Interested in partnering with us or learning more about our work in Nigeria? Contact us here or check out our regional reference brief.
Learn more about USAID’s programs in Nigeria.
References
- Maheu-Giroux, Mathieu et al. 2015. “Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data.” The Lancet Global Health 3(5): e271-e278.
- National Population Commission (NPC) and ICF. Nigeria Demographic and Health Survey (DHS) 2018. Abuja, Nigeria and Rockville, MD: NPC and ICF, 2018.
- National Bureau of Statistics (NBS) and United Nations Children’s Fund (UNICEF). Multiple Indicator Cluster Survey 2021, Survey Findings Report. Abuja, Nigeria: National Bureau of Statistics and United Nations Children’s Fund, August 2022.
- World Health Organization (WHO). Domestic private health expenditure (PVT-D) as percentage of current health expenditure (CHE) (%). Global Health Observatory. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/domestic-private-health-expenditure-(pvt-d)-as-percentage-of-current-health-expenditure-(che)-(-)
Last updated February 2024.