Gov. Umo Eno: Midwifing A New Phase of Community Health System in Akwa Ibom State

Ekomobong Peter

Before sunset, there were messages informing those concerned of the Governor’s appointment the next day. Characteristic of the usually terse protocol messaging, it read:
Governor’s Appt for Monday 17-2-2025
Invitation to the 2025 State Convention of Traditional Birth Attendants
Time:4pm
Venue: Ibom Hall, IBB Avenue, Uyo

Convention is a relatable phrase to many in this part of the world with strong ties to culture, politics and religion. A gathering has to be massive to be a convention.
Slated for 4pm, the venue, a timeless architectural masterpiece, sitting within a circumference of a manicured lawn, capable of containing the exodus of men and women across the length and breadth of the State flung the venue as early as 9am for accreditation of over four thousand members clad in blue uniforms with flashes of white on the neck and sleeves.

This group of life savers are seen in every community. Some are trained as auxiliary nurses by doctors. Others inherited the craft from their forebears through observation and involvement over the years. Called “Abia Uman” , that is midwives used loosely within the larger Ibibio linguistic groupings, of the State. They are a mirror of Africa’s traditional civilization before modernization came to fore..

Despite breathtaking successes in modern medical practices, Traditional Birth Attendants are influential in most communities. Their large presence at that convention attest to this, no thanks to either of these factors: dearth of Primary Health facilities; shortage of medical professionals or deviant cultural beliefs that binds women to this bunch of mystique caregivers.

Solomon Eshiet, a Media Aide to Gov Umo Eno amazed by the formidability of the group whom he never knew had attained such prominence until their first public political statement on November 29 2022, when they thrilled Pastor Umo Eno then candidate of the Peoples Democratic Party and the political nucleus in the State with his endorsement as their candidate as the March 2023 guber election closed in wrote, “my mother told me, I and my siblings were delivered by our grandmother, Mma Maggie, a popular birth attendant. Many in our community trusted Mma and were often referred by hospitals”.

The testimony of Chief Assam Assam, a Senior Advocate of Nigeria, former Ambassador to Russia and Director of Campaigns to Governor Umo Eno that he is a product of TBAs validates the cultural and social relevance TBAs wield in communities.
Otobong George, leader of TBAs in the state, sounded kinky, ” If there was a head count , you will be shocked by the proteges of TBAs you will find”. The people trust we care. Our members do not harass pregnant women. They do this job not for money, afterall, how much can families in villages afford? Our services are signs of our allegiance to our communities as first members of that community.”

Despite their contributions to addressing maternal and infant mortality, they have not been spared some knocks. Chiefly are concerns around ethical and clinical competence, hence the tag quacks by some medical professionals.
There is no mincing words they have to continue training to optimize much expected gains in community health, and reduce indices of infant mortality rate. This much Comrade Otobong George requested when he formally welcomed the Chief Midwife of the State, Pastor Umo Eno to the ceremony. The midwifery profile of the Governor is evident in his mediation charter to professionals to train, orthodox and alternative health practitioners. While the later should innovate by accepting modern reality. The common ground is that the governor is incentivising both ends without compromising standard.

Heading into midterm, Pastor Umo Eno, has reversed the dearth fortune of primary healthcare in Akwa Ibom with aggressive building and commissioning of the Model Primary Health facilities across local communities to make healthcare accessible, available and affordable. Pregnant Mothers and the elderly have no worries about medical bills; the launch of ARISE healthcare Insurance Scheme has widened the dragnet of beneficiaries to include low income earners from formal and informal sectors where over Ten Thousand have been captured.

To contain this renewed faith in community health made possible by Umo Eno, 15 Model Primary Health Care Centers were commissioned as of May 2024. Personal Physician to the Governor (PPG) and Commissioner designate, Dr Ekem John stated in a chat that the Governor targets 100 of such facilities in the first phase as work intensifies at different sites across the state.

Further search reveals the Model PHC in the state exceed the minimum 13 rooms requirement by Nigeria’s National Primary Healthcare Development Authority (NPHCDA). Dr Ekem when contacted on this, proudly confirmed and listed features in all of the State owned model PHC as : laboratory, Pharmacy/Pharmacy Stores; Theatres; Consulting rooms; Records; Male and Female Wards; Call rooms; well- furnished Doctors and Medical Officers quarters;ICT rooms; Observation rooms; Adolescent Service and Minor Procedure rooms; Delivery Suites; Maternity; Injection rooms;Emergency room; Immunization Office, Immunization waiting area; Solar Control rooms; Food and Nutrition Space; Laundry and Linen rooms; Administration/Officer in charge office; Security house; Generator House; 2 motorbikes to aid logistics and delivery.

There is a complimentary mobile health scheme with ambulances to carter for health emergency across the ten(10) Federal Constituencies.

A soon-to-be constructed Mother and Child hospital; first- of-its-kind in the state will change the game in healthcare delivery in line with Sustainable Development Goals

Confident in the foundation his administration has laid to turn around healthcare provision in the State, specifically meeting the health needs of rural folks through infrastructures, training and recruitment, Pastor Umo Eno announced a ray of hope to the admiration of attendees and TBAs, “As society evolves and old approaches get subjected to modern and advanced methods to ensure wholesome and holistic outcomes, I wish to implore and advice that you also reinvent your methods of carrying out your duties.”..
Pastor Umo Eno never ends his speech without his trademark call for partnership and further offer for advancement as he directed the Ministry of Health to train and certify TBAs as community healthcare workers,
“We are willing to partner with you to train, supervise and certify your members so that the service you provide are aligned with contemporary methods thus making it more acceptable to the larger society.” He assured them on completion of their training and certification, they will be made to assist at various PHCs across the state.

The Governor’s call to reinvent methods and his approach at modernizing traditional practices to bridge the gap in health needs finds precedence in India’s health and medical revolution.

India has successfully modernized Traditional Birth Attendants by providing training and education. Equipping them with modern medical knowledge and practices to ensure safer deliveries while still respecting their cultural norms within communities, by integrating them with formal healthcare system and encouraging timely referrals to skilled medical professionals when necessary.
This forward integration strategy which improves infant and maternal health is anchored on key aspects as: Formal training programs; Emphasis on hygiene and sanitation; Early warning sign and recognition; Community Engagement and Cultural Sensitivity.

It is to the advantage of developing countries like Nigeria to adopt this model by Pastor Umo Eno of not banishing earliest civilizations, but evolved through campaigns, recognition, funding of research institutes, education and literacy, certify by training and integration; set measures to regulate practice against abuse of rules. This will reverse considerably the japa syndrome that has depleted the medical workforce with its attendant effect.