NANA HRH APPROACH
NANA HRH IMPLEMENTATION
Nigeria with an estimated population of 162,265,000 (2012), is the most populated country in sub-Saharan Africa, and is among the 57 countries identified by the WHO as having a human resources for health (HRH) crisis due to insufficient numbers of health providers . Several efforts are been made to improve the HRH stock in the nation through several national policies, training and retraining. A key strategic approach to addressing the severe shortage of health care workers in many countries is in-service trainings. In Nigeria several in-service trainings have been is being conducted with support from both government and international According to a report, wielding the largest health workforce in Africa, Nigeria still ranks 7th among 49 countries classified as facing a critical shortage of health workers by WHO. The distribution of health workforce in Nigeria is skewed towards urban areas, southern parts, in tertiary health care services; and in delivery and curative care. The maternal and child mortality rates in both North East and West Nigeria are above the national average, with North East experiencing 155 maternal deaths per 1000 live births- ten times higher than the South West, which has 17 maternal deaths per 1000 live births. The contraceptive use statistics also show a similar asymmetry in the regions. The Contraceptive Prevalence Rate in the North West is 3.6% and 2.7% in the North East, compared to 0.5% in the W4H implementing states of Kano and Yobe. The efforts of the government to address the issue of unequal distribution of health workers between South and North, urban and rural regions through different schemes like the Midwifery Compulsory Service Scheme, which involves rural posting allowances, and - the community midwifery schemes and task shifting have recorded limited success. Most of the female health workers deny postings outside the state capital, citing marital and family reasons. A snap study of 24 nurses, midwives, and their spouses in W4H states, shows 75% of partners did not permit their wives to take a rural posting. Considering the importance of HRH and the need to increase the number of female health workers in Nigeria especially in the northern part of the country where there are shortage of Health workers especially the female health workers and to reduce addresses some socio-cultural factors which also prevent women from taking the postings in the far off areas. Nana took it as a task which is of utmost important to the organization. Nana is contributing its quota in ensuring that the shortage of female health workers in sokoto and kebbi state is addressed, so that there will be an improvement in the number of female health workers in this two regions of the country where the situation is alarming, especially in the rural areas, especially the remote areas through two different approaches. The first approach was through the recruitment of girls from secondary schools in the two states (Sokoto and Kebbi). These girls who are selected based on standard criteria are supported through an extensive extra coaching classes, called the bridging classes for maximum period of two years. This is done to equip them to pass the senior secondary school certificate examination (WASSCE and NECO), and the Jamb in case of universities. Admission is been obtained for the successful ones after their secondary school into the selected Health institutions in the states to study different aspect health related courses, but majorly, Nana preferred enrolling them into School of Nursing and Midwife Science to become Nurses and Midwives. Others are enrolled into School of heath technologies to study other related health courses such as CHEW, Pharmacy technician, X-Ray technician and other related health professional courses. The second approach is by selecting these girls/women from their communities (community base). This approach involves scouting the girls/ women from their immediate community, giving more attention to the hard to reach areas with no female health personal or areas with no single female personal using the data of available female health workers in the states obtained from the ministry of health as per requested. The criteria for the selection is that the girls/ women must be a science student and have completed secondary school with a minimum of a credit in all the five science subjects (Mathematics, English, Chemistry, Physics, and Biology). After meeting the first criteria, the successful ones emerged from the performance in a written exam conducted based on their score. At least three to four beneficiaries are selected from each of the identified community. The successful candidates are supported with an extensive coaching class of up to six (6) months on the basic science subjects (Mathematics, English, Chemistry, Physics, and Biology) and other basic Nursing, Midwife and Health technology subjects, before finally getting them admission and enrolling them into School of Nursing and midwife science and also Colleges of health technologies to study same health related courses as in the earlier approach mentioned. In view of the above, Nana focuses on producing midwives, female nurses, community extension workers and their deployment in rural health facilities for maximum impact and reduction of maternal mortality. At the successful completion of their studies and been confirmed certified health workers, based on the bond agreement, they are to return to their various locality and serve their people for a minimum of two (2) years.