In Northern Nigeria most rural women are not giving the opportunity to go to school or further their education, they are normally married up below the age of 20, because their parents considered girl-child education less important, so they are subjected to some of the medical problems, which results the increase of maternal mortality.
Studies has shown that North has the highest rate of maternal and child deaths in the country. Many of these deaths can be prevented if a skilled birth attendant attends to our pregnant women. Although 61% of childbirths in Nigeria occur without skilled health workers in attendance, the situation is worse in the Northern Nigeria where more women deliver without skilled health workers (84% in the North East and 90% in the North West).
However, shortages of skilled health worker in Northern Nigeria are caused by a number of factors including varying standards in pre-service education; poor absorption into workforce (e.g health worker recruitment embargo in some northern states); ineffective deployment; poor monitoring, supervision and regulation to mention just a few.
Since 2012, the UK aid funded Women for Health (W4H) Programme has been working in five Northern Nigeria State, namely Kano, Jigawa, Katsina, Zamfara and Yobe to increase the number and quality of front-line health workers and support their deployment to rural health facilities, where they can have the greatest impact on maternal, infant and child mortality.
Furthermore in order to achieve the objectives, W4H interventions has improved the standard, quality, governance and accessibility of Health Training Institutions across the 5 programme states.
On 24th of April 2017 Kano State Government in collaboration with Women for Health (W4H) Programme organizes an event to celebrate the students graduating in the year 2017 as Nurses, Midwives and Community Health Extension Workers from the programme states, at the Coronation Hall in the Kano State Government House. I was opportune to be invited to the programme. I interact with some of the graduating students from different states and wish to share the stories of two young ladies which I believe  would serve as a lesson and motivation to others.
The Story of Ummulkhairi
Ummulkhairi is a 22year old orphan, hails from Katsina State, she is single and came from a large extended family from Kusada Local Government Area of the State; she stays with her mother and relatives. Her father died before she graduated from secondary school; in her community girl-child education is however encouraged so far you have the requirements and strong parents to support you. Ummulkhairi while in secondary school has the ambition of becoming a health worker in her community, so she make sure she read and pass her exams, she got 5 credits.
When the Women for Health (W4H) programme introduced the Foundation year Programme to her community, it was warmly accepted because the community had a lot of challenges with regards to maternal health care and infant mortality. Ummulkhairi’s maternal uncle quickly collected her credentials as she was lucky she had 5 O-level credits and that of her sister Zainab and submitted them for screening.
After the exercise, Ummulkhairi was lucky to pass and was given admission in the preparatory level of the Women for Health Foundation year  programme, but  her sister will undergo foundation year programme to be able to write WAEC and NECO. After 6 months studies in the preparatory class she passed the examination and was given admission to study “Nursing”
One of the greatest challenge she had which almost shattered her dream before she started the programme is when her paternal uncle came to her mother and warn her that he heard everything about Ummulkhairi’s going to School of Nursing, Katsina for 3-years just to study, he said “This is unacceptable and will not happen”. She overheard their conversion and suddenly burst into tears because she knew him as very strict person and also has the backing of everybody in his family.
Ummulkhairi’s mother was left with the only option of going to the District Head house seeking his intervention to the matter. The District Head summoned the entire family, after they all gathered, he explain the programme in detail to my uncle and everybody present, he further request that they should please allow me to go to school. Finally they all accepted but on the condition that every weekend she must come back home and visit them, Ummulkhairi’s mother agreed their condition and proceeded with the preparations of Ummulkhairi’s study.
 “Today being our graduation celebrations day, I cannot explain how happy I was, especially when I remember what my lovely mother use to tell me Ummulkhairi I am proud of you, Allah will protect you always” says Ummulkhairi.
Ummulkhairi while in tears thanked the Women for Health (W4H) Programme “I don’t have words to use to thank you (W4H) for supporting an orphan like me and making my dream come true”.  She added that she learned so much about personal hygiene and also she confessed that living with other students has truly shaped my her life, now she can freely interact with people.
The Story of Adnanatu
Adnanatu is a 26 year old from Zamfara State; she is married with three kids. She hails from a community in Anka Local Government that does not support girl-child education beyond secondary school. They have only one Primary Health care outlet which is located very far from their community; bad road, poor staffing, insufficient facilities and drugs were some of the problems experienced by the community in terms of health care delivery.
The introduction of the Foundation Year Programme in 2013 to Adnanatu’s community by W4H suffers rejection by members of the community for their reasons best known to them, though the community leader made it clear that it is by choice and interest; there is no compulsion at all.  Adnanatu narrates her story as such, on a fateful day my husband came in and ask for my SSCE result which I had only one credit; I gave it to him without hesitation of what he going to do with it. After some weeks he came in and told me that I should prepare myself for and an interview, I asked him which interview? That was when he told me about the programme, he encourage me to try my uttermost best to make it so that I can become a health personnel in our community.
“The interview went on smoothly though I was nervous at the beginning couldn’t speak very well but I was ok late , at the end it was announced that I was through along with two other ladies, one of them is also married” says Adnanatu.
She mentioned that, her husband and her parents were overwhelmed with my success, and pledge there support to her. Adnanatu’s mother took over the care of her kids as she is leaving for Gusau for the first time to commence the Foundation year Programme.
Adnanatu added that, she experienced a huge challenge during Foundation Programme, she finds it very difficult cope with the new environment and on the other hand she misses her kids and her family. It was only love, care and encouraging words from my husband kept me moving, I always remember his words “Adnanatu I have faith in you, I know you can make it, please try make us proud in our community”. I took the challenge and God’s willing I passed my final exams and was admitted to study an 18 month  course ‘Community Midwifery’ to become Community Midwife.
She also narrates that; during her first year, she concluded to drop out of the programme, because the studies is becoming more and more difficult than the Foundation programme; on the other side she began to rethink about disappointing her husband, and loosing the prestige she started getting in the community as  a potential health worker; “these were the only reasons that change my mind and concentrated on my studies”; luckily the teachers also understands the situation a number of students are facing, they gave us special treatment and introduce addition hours to us after official closing hours to help us go over our lesson for the day.
As wise men say “Anything that has begging, surely has an end” Adnanatu said “I cannot believe I am about to graduate to become the one and only Community Midwife in my community” she thanked the overwhelming support of her husband as well as her parents. She extended her gratitude to Women for Health (W4H) for changing her life and that of her community. She urged parent and community leaders to embrace the programme with two hands because of its importance. She pleaded for Government’s support to health care in the rural communities.

By Nabila Abbani

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