RPLD Program

About Professor Ransome-Kuti

Professor Olikoye Ransome-Kuti was a Minister of Health in Nigeria from 1985 to 1993. As a Minister, he provided a foothold for the institutionalization of primary health care. After his tenure in the ministry, he went to Washington DC to work for the World Bank, where he chaired the Better Health for Africa Panel, a position where he was able to expand the concept of primary health care to other parts of Africa. Indeed, he produced a blueprint for adopting primary health care for Africa, and for sustaining health care in Africa for years to come. The scope of Professor Ransome-Kuti’s actions signifies his deep commitment to primary care in areas of health most critical to sub-Saharan Africa: He ensured exclusive breast feeding practice in Nigerian hospitals, made compulsory the recording of maternal deaths, fought for the interests of pregnant women, and pioneered effective HIV and AIDS campaign in the early years of the disease.

Establishment of the RPLD Program

After the demise of Professor Ransome-Kuti in 2003, the Women’s Health and Action Research Center (WHARC) established the Ransome-Kuti Policy and Leadership Development (RPLD) Program in 2006. The goal of the program is to stimulate the development of effective policies and the right kind of leadership for the implementation of reproductive health and primary health care in sub-Saharan Africa. The Ford Foundation provided initial funding in 2006 which was used in providing postgraduate fellowships, and several research grants in the area of reproductive health and primary health care. The funding also facilitated the establishment of structures for the launch of a Trust Fund to sustain the program beyond the initial funding by the Ford Foundation.

The RPLD Program was established to sustain in perpetuity, the legacies of Professor Olikoye Ransome-Kuti in primary health care and reproductive health. Specifically, the RPLD program’s interest lies in facilitating progress in areas of primary health care, safe motherhood, child survival and HIV and AIDS. While it is true that no one will fill Professor Ransome-Kuti’s shoes, the program hopes to continue along the path he pioneered by promoting responsible policy and encouraging passionate leadership in primary health care and reproductive health.

Subprograms : The RPLD Program is made up of three subprograms: The Ransome-Kuti graduate fellowship program, the Ransome-Kuti research competition and the annual Professor Olikoye Ransome-Kuti memorial lecture

• The annual memorial lecture was initiated as an international policy dialogue, in which policy makers and stake holders in the core areas of the program are invited to deliver lectures on contemporary issues. The 1^st annual international policy dialogue was delivered by Professor Adetokunbo Lucas. The topic of the lecture was ‘Primary Care versus Primary Health Care: Clarifying the confusion and resolving the conflict’. The event held on June 1, 2006 at Abuja. The 2^nd lecture which held on May 3, 2007 was delivered by Professor Fredrick Torgbor Sai, Advisor to the President of Ghana on Reproductive health, population and HIV/AIDS. The topic of the lecture was ‘Why should Africa’s women continue crying out for life?’ The 3^rd lecture was delivered by Professor Babatunde Osotimehin on June 2, 2008. The topic of the lecture was ‘the control of HIV/AIDS in Nigeria: The journey so far’. The 4^th memorial lecture which held on June 2, 2009 was delivered by Professor Wole Soyinka. He spoke on the topic ‘Ethics, Bioethics and Environment in healing designs’. Copies of the lectures are available at the Center: contact us to book a copy.

• The Graduate fellowship is awarded annually to support promising students as they work towards earning a degree in Public Health. The sum of 20,000 USD each is awarded for this purpose. In 2006, the award recipients were; Dr. (Mrs.) Titilayo Abiona and Dr. Muhammad Saddiq. 2007 recipients were; Mrs. Nnenna Anikpe-Okorie, Miss Ndidiamaka Umeuzuegbu, and Dr. Regina Dim.

• The Professor Olikoye Ransome-Kuti Research Competition: The objective of this subprogram is to promote research in the core areas for which Professor Ransome-Kuti made a mark during his lifetime. These include child survival, primary health care, sexual and reproductive health, especially HIV/AIDS and safe motherhood. The sum of 5,000USD is awarded for this purpose. 2006 recipients are Dr. (Mrs.) Asia Kassim Hussein (Tanzania) and Prof (Mrs.) Abigail Imogie (Nigeria). In 2007, Dr. (Mrs.) Rosemary Ogu, Dr. (Mrs.) Zainab Bello, and Dr. Michael Okobia won the grant award.

Achievements : The RPLD Program has received concentrated mention and accolades in the Nigerian media. One immediate benefit of the program is the increased policy attention now being given to primary health care in Nigeria. The last administration of President Olusegun Obasanjo accorded increased pre-eminence to primary health care towards the end of his tenure. An evidence of this is the expansion of the mandate of the National Primary Health Care Development Agency (NPHCDA), to include childhood immunization and the merging of the National Program on Immunization to NPHCDA. The present administration of Alhaji Umaru Musa Yar’Adua has continued in this policy trust.

The Professor Ransome-Kuti Trust fund : This was established and registered with the Corporate Affairs Commission of Nigeria, in order to sustain the RPLD Program in perpetuity. The Ford Foundation provided initial funding for the program which ended in 2008; they also provided a support grant for the establishment of structures for the Trust Fund. The Fund was launched on March 17, 2009 and re-launched on the 2nd of June, 2009. The Fund is managed by a committee headed by Dr. Abel Guobadia, former INEC Chairman. Other members of the committee include Professor FE Okonofua (Secretary), Dr. Dotun Ransome-Kuti (Vice Chairman), Mr. Bright Ekweremadu (member), and Mrs. Beatrice Eluaka (Member).

WHARC acknowledges the donations of various individuals and corporate bodies to the Trust Fund

 

Reproductive Health Research Network

The research network was established to provide an opportunity for WHARC to mentor emerging leaders and researchers in sexual and reproductive health, across several states of Nigeria. Members of the network are obstetricians and gynecologists and researchers drawn from Rivers, Imo, Abia, Gombe and Edo States of Nigeria.

Recently, the network successfully implemented a study on ‘The perceptions of policymakers towards maternal mortality and unsafe abortion in Nigeria”. The study was funded by the Guttmacher Institute and Ipas, and has been accepted for publication in International Family Planning Perspectives.

HIV/AIDS Program

The goals of the program are : to increase access to quality, specialized and affordable Sexual and Reproductive Health (SRH) and HIV/AIDS care, support services and delivery systems; and to strengthen instituitional capacity to manage specialized SRH and HIV/AIDS programs and technical services.

Our strategic objectives include:

1. Conducting research on specific SRH and HIV/AIDS issues
2. To increase access to SRH and HIV/AIDS research findings and information
3. To develop and update a research agenda in SRH and HIV/AIDS
4. To provide a wide-range of accessible, affordable and quality SRH services
5. To promote the system for referral to and from WHARC and
6. To carryout evidence-informed advocacy and research on the social behaviours related to HIV transmission.

HIV/AIDS Projects Completed
With funding from the Macarthur, Rockefeller and Ford Foundations, WHARC has implemented successful STDs and HIV/AIDS prevention programs among youths in Edo state, Nigeria. One of these projects has focused exclusively on out-of-schol adolescents, using an integrated approach to provide continuing sexuality education and reproductive health services to out-of-school youths.

In 2002 WHARC obtained funding from the Global Health Council to increase the capacity of community nurses / midwives in Edo State to provide HIV/AIDS counseling and home-based care for PLWHAs. These  efforts have increased the effectiveness of the health community responses to HIV/AIDS prevention and care in Edo State. WHARC provides technical assistance to the Edo State Agency for the Control of AIDS and was involved in their launch of KEEP HOPE ALIVE ORGANIZATION - an umbrella organization for PLWHAs in Edo State. Indeed, the Secretary of this organization is an associate of WHARC. WHARC has previously coordinated the Edo State Chapter of the Civil Society for the HIV/AIDS (CiSHAN). Till date, WHARC continues to provide HIV/AIDS education to in-school adolescents through it's Peer Education program for adolescents.

Future Projects
In order to ensure continuity in our efforts to curb the spread of HIV/AIDS, and increase support for Persons living with HIV (PLWHA), plans have been set in place to establish the WHARC Youth Friendly Center and a support group for PLWHA in the local community. In the coming year, the Center will facilitate the assesment of the level of implementation of the adolescent sexuality education curriculum in secondary schools. This will guide us in advocating for proper implemetation of sexuality education curriculum in schools. The Center currently seeks funding for the HIV/AIDS unit, in order to implement the projects.

Safe Motherhood

WHARC embarks on series of programmatic efforts on safe motherhood which revolve round the reduction of maternal mortality in Nigeria. WHARC is implementing a project with funding support from the Venture Strategic for Health and Development (VHSD) California, USA in three LGS and four LGAs of Ondo state respectively to prevent and treat PPH in women in rural areas of Edo and Ondo state by building the capacity of local health care providers to properly dispense Misoprostol for the treatment and prevention of post-partum Hemorrhage and to ensure its availability in line with guidelines provided by the Federal Ministry of Health (FMOH) and World Health Organization (WHO).

The project is being implemented in Esan west, Esan central, and Igueben local government area of Edo State, and in Akure South, Owo, Ifedore and Akeoko North-West Local Government areas of Ondo state respectively.

Furthermore, the effectiveness of Traditional Birth Attendant was determined through their ability to provide quality maternal and health delivery in Edo State. WHARC in collaboration with the school of public Health at the University of California is working to determine and assess TBA’s effectiveness in administering Misoprostol for reducing the incidence of maternal mortality arising from post-partum Hemorrhage (PPH). This project is ongoing and consists of TBA’s from the Okokhuo intervention community. These TBA’s were taught to administer 1000 micrograms of misoprostol for prevention and treatment of PPH and to fill the study questionnaire. This intervention sites is in the same Local Government Areas as the control sites, (Igbogiobo community).

Moreover, WHARC is implementing a project titled policies and program in reducing maternal mortality in six states of Nigeria with funding support from the Macarthur foundation to strengthen advocacy activities aimed at promoting policies for maternal health and reducing maternal mortality in the six states (Kano, Enugu, Lagos, Cross River and Plateau), by indentifying the existing policies and programs relating to maternal health in the states, determining the impact of the policies on maternal health services delivery coverage and quality including cost, personnel, maternal health facilities and equipment in the states, determining the needs and perception of pregnant women and making necessary recommendations on the policies and programs aimed at reducing maternal mortality.

The project is designed to be implemented for a period of three years March 2009-Feb 2012 in three phases (research and data collection, report writing and advocacy visits) to improve the policies for maternal health with the general objective of reducing maternal morbidity and mortality.

WHARC indentifies strategies for implementing the project and it includes; formation of project teams in each of the states, held project debriefing workshop, conducted in-depth interviews with stakeholders in each of the states, conducted focus group discussions and the project is still on, and presently on the report writing stage.

Adolescent Sexual And Reproductive Health

WHARC has an active Adolescent Sexual and Reproductive Health (ASRH) Unit.  To date, some of the principal outputs of the Unit have included the following:

• Active advocacy for the abolishment of female genital mutilation, which resulted in the first bill for the prevention of female genital mutilation to the passed in Nigeria – the Edo State Prevention of Female Genital Mutilation Bill, 2000. Several other states have since followed this example shown by Edo State, and practice of female genital mutilation is now on the decline in Nigeria
• Research which documented the health seeking behavior of Nigerian adolescents towards sexually transmitted diseases.
• Intervention research, which demonstrate that capacity building of health providers identified by adolescents as their preferred choice of care, and information provided to adolescents to use such services, can increase adolescents´ use of evidence-based providers and methods for the prevention and treatment of sexually transmitted diseases.
• One of the first interventions to address the needs of out-of-school adolescents in Nigeria was implemented by WHARC. This consisted of scholarships and career counseling provided to poor adolescents to return to school, skills and entrepreneurial development for those that cannot return to school, and job opportunities provided to adolescents that have completed schooling.
• More than a dozen papers that describe adolescents´ experiences of unwanted pregnancies and their use of unsafe abortion as a preferred option for resolving such pregnancies, the pattern of morbidity and mortality associated with unsafe abortion, and the current lack of relevant policies to address the problem of unsafe abortion in Nigeria.
• Comprehensive formative research that describe the social, developmental and health needs of adolescents in Edo state of Nigeria.
• A comprehensive action plan for improving adolescent reproductive health in Edo State, and a Memorandum of Understanding (MOU), which was signed by the Governor of Edo State as evidence of the State´s commitment to implement the plan.
• The establishment of a youth friendly adolescent reproductive health clinic and library, that provides comprehensive information and clinical services to adolescents in a very congenial and friendly environment.

Current Focus - As a result of the experiences gained from the above initiatives, WHARC has re-strategized and is focusing on the following initiatives in its adolescent reproductive health programming :

1. Comprehensive Sexuality Education - To ensure that there is a buy-in by governments at all levels in adopting the Comprehensive Sexuality Education Curriculum that has been approved for use by the National Council on Education. Not only buy-in, but actual use of the curriculum will be pursued.
2. Ongoing Research - In particular, WHARC would focus on research that provides an understanding of the social and cultural determinants of adolescent reproductive health in both urban and rural settings. We will also focus on intervention and operations research that identify best practices and evidence-based approaches for addressing adolescent reproductive health in the region.
3. Providing livelihood skills for poor adolescents - WHARC is located in a region of Nigeria that has the highest rate of sex trafficking among adolescents, which in large part is driven by poverty. Thus, WHARC will continue to seek ways to improve livelihood skills for adolescents in order to break the cycle of intergenerational poverty, and reduce the associated health risks for adolescents.
4. Building capacity for adolescent-friendly services - WHARC will seek collaborative ways to ensure that public health institutions understand the concept of adolescent-friendly services and are able to integrate the related practices into their services.

For further information about WHARC´s Adolescent Sexual and Reproductive Health Unit, please contact Ms Helen Obi, the programme officer in charge of the Unit.

 

IPPF Project

The overall goal of this project is to increase access to safe abortion care and post-abortion family planning, and to contribute to the achievement of Millennium Development Goal five in four states of the Niger-Delta region of Nigeria.

WHARC obtained a grant from the International Planned Parenthood Federation (IPPF) to implement the project in Edo, Delta, Bayelsa and Rivers states of Nigeria.
The project, which was designed to be implemented in six phases is now in its second year of operation. During the first year, a needs assessment survey was carried out and completed. This resulted a paper titled “A survey of the attitudes and practices relating to reproductive health and family planning services among private medical practitioners in four states of Niger-Delta region of Nigeria”. The paper was presented at an International seminar on Interrelationship between Contraception, unintended pregnancy and induced abortion organized by the International Union for the Study of Populations (IUSSP) in Addis Ababa, Ethiopia, December 1-3, 2008.
The project has now entered the implementation phase. During the first half of this phase, training curricula, IEC materials and project monitoring materials (e.g. patient evaluation forms) were developed, pre-tested, printed and distributed to the project sites. Project materials including contraceptive commodities, Manual Vacuum Aspiration (MVA) kits, and misoprostol were procured and also distributed to the project sites.

The training of trainers and debriefing workshop for project coordinators was organized for the four project states at WHARC’s headquarters in Benin City. The training materials, procured contraceptive commodities, MVA kits and medication abortion drugs were then distributed to the project states in preparation for training workshop for private providers. Thereafter, capacity building workshop for private practitioners was organized in all the four states in May-June 2008 which involved key private providers. Sixty participants (15 participants from each state) attended the workshops.

The second year of the program operation began on July 1, 2008 and has witnessed the provision and monitoring of service delivery of post abortion care by private providers in the project states. These evaluation forms were bulk produced and forwarded to the project coordinators to gather information from patients seeking services on post-abortion care, family planning, and medication abortion. This was to ensure internal consistency in matching the project specific objectives with process and outcome indicators.

WHARC has recorded remarkable achievement in terms of building the capacity of substantial proportion of private practitioners in evidenced-based methods in the area of qualitative service delivery in the principles of post abortion care, medication abortion, family planning in the oil-rich Niger-Delta Region of Nigeria which has some of the highest rate of unsafe abortion in Nigeria, with associated high rates of maternal mortality.

Infertility and Fertility Regulation

The Centre is currently actively promoting the use of emergency contraceptives among young people in Nigeria. A research project to assess the knowledge and use of emergency contraceptives among rural communities in Edo State is currently in progress. We intend to complete the project during the year, write a report and use the results to design and test interventions for the promotion of the use of EC in selected rural communities in the State.