Nigeria’s community midwifery programme is significantly improving maternal and newborn health in conflict-affected rural communities of Yobe, according to new research by the EQUAL Research Consortium released in Abuja on Monday.

Emilia Iwu, senior technical adviser at the Institute of Human Virology Nigeria, disclosed the findings during the close-out and dissemination meeting of the multi-country EQUAL project implemented across Nigeria.

The five-year study, conducted from July 2021 to April 2026, examined how community-trained midwives improve staffing and service delivery in rural primary healthcare centres.

Researchers found that community-trained midwives were nearly twice as likely as basic programme graduates to originate from rural areas and to remain working in primary health centres serving their own communities.

Sixty-seven per cent of community midwifery graduates secured employment within six months of completing training, while 64 per cent were deployed directly to underserved rural health facilities across Yobe.

Nearly all community midwives reported conducting deliveries, 90 per cent provided antenatal care services, and 70 per cent offered family planning, expanding access to essential maternal and reproductive healthcare interventions.

Ms Iwu said the programme was delivering results, with midwives serving vulnerable communities, but warned that unresolved systemic challenges could undermine its long-term impact and sustainability across conflict-affected settings.

She identified irregular salaries, political interference in postings, poor working conditions, and limited career advancement opportunities as persistent threats to retaining skilled midwives in rural communities.

Attrition is highest within the first five years of practice, Ms Iwu said, as many midwives migrated to better-paid urban or non-governmental organisation positions offering improved security and conditions.

In spite of progress, the study identified service gaps in newborn care, patient communication, and emotional support, with women citing financial hardship, family influence, and cultural barriers for delayed care-seeking.

Researchers urged harmonised salaries, improved facility security, mental health support, protected funding, and formal recognition of midwife roles within the civil service to safeguard programme gains.

The study estimated that modest increases in midwife-delivered interventions could prevent 22 per cent of maternal deaths and 23 per cent of neonatal deaths statewide.

Ebere Anyachukwu, health adviser at the Foreign, Commonwealth and Development Office, reaffirmed the United Kingdom’s commitment to improving maternal and newborn health outcomes in fragile communities.

He stressed that women and newborns in insecure and conflict-affected environments faced the greatest survival risks, requiring sustained investment, evidence-based strategies, and coordinated action among partners.

Mr Anyachukwu commended IHVN, the EQUAL Consortium, and Nigerian research partners for generating rigorous, context-driven evidence to strengthen maternal and newborn healthcare delivery systems.

Emmanuel Udontre, representing the registrar of the Nursing and Midwifery Council of Nigeria, lauded the research team for delivering solution-focused findings to reduce maternal and newborn mortality.

The research examined three themes: the political economy and financing of maternal health, workforce development for midwives, and quality-of-care assessments in conflict-affected health facilities.

Hadiza Sabo, provost of Shehu Sule College of Nursing Sciences, said the findings exposed hidden workforce pressures, including excessive workloads, low pay, and limited structured career progression pathways.

Ms Sabo called for a state-level service scheme to formalise career progression and strengthen retention of trained midwives within Yobe’s rural healthcare system.

In collaboration with traditional birth attendants, she clarified that council-regulated midwives held certified qualifications, while traditional attendants remained unregulated, limiting formal integration within Nigeria’s healthcare framework.

She described the research as an eye-opener for policymakers, urging evidence-based reforms to improve student welfare, reduce burnout, and enhance maternal and newborn healthcare delivery across the state.

(NAN)