How EU-SARAH Is Transforming Maternal, Child And Adolescent Health In Adamawa
By Idris Khalid
The European Union-supported Strengthening Access to Reproductive and Adolescent Health (EU-SARAH) initiative has trained over 1,300 healthcare workers in Adamawa State and recorded significant improvements in maternal, newborn and adolescent healthcare, with skilled birth attendance increasing by more than 100 per cent since the intervention began.
The four-year initiative, implemented by the Adamawa State Government with support from UNICEF and the United Nations Population Fund (UNFPA), is also strengthening health systems, expanding community participation, improving healthcare quality and reducing financial barriers to accessing essential maternal and child health services.
Speaking during a stakeholders’ meeting on the programme, Health Officer, UNICEF Bauchi Field Office, Oluseyi Olosunde, said the intervention was deliberately designed as an “Initiative” rather than a project to ensure sustainability through government ownership and institutional support long after donor funding ends.
He said the programme seeks to reduce maternal, newborn and child morbidity and mortality while addressing the healthcare needs of adolescents and young people, a population often overlooked despite its critical importance to national development.
According to him, while health programmes have traditionally focused on children under five and pregnant women, insufficient attention has been paid to adolescents, whose health outcomes significantly influence future productivity, family wellbeing and economic growth.
“We pay attention to children from birth to five years and then shift our focus to pregnant women. But what happens to adolescents and young people? If we fail to invest in them, the consequences will affect their productivity, family life and, ultimately, the country’s economy,” he said.
Olosunde said the initiative aims to reach about 896,000 children under five years in Adamawa State, adding that implementation has already reached nearly half of that target.
It also targets over 279,000 pregnant and lactating women with quality antenatal care and skilled birth attendance, while approximately 25,000 adolescents and young people are expected to benefit annually through community outreach, reproductive health education and youth-friendly healthcare services.
He explained that adolescent interventions extend beyond treatment to preventive healthcare, including sexual and reproductive health education, life skills, reproductive health rights, menstrual hygiene management and protection from harmful traditional practices.
According to him, investing in adolescent health also helps prevent drug abuse and other risky behaviours that often require costly treatment later in life.
Building Stronger Health Systems
Olosunde said the initiative has prioritised strengthening health governance across participating states through improved coordination, planning and accountability.
He commended the Adamawa State Government for demonstrating exceptional political commitment, noting that the Deputy Governor personally chairs quarterly meetings of the State Task Force on Primary Health Care.
He added that coordination mechanisms have been established at both state and local government levels through the Reproductive, Maternal, Newborn, Child and Adolescent Health plus Nutrition (RMNCAH+N) platform.
The platform brings together the Ministries of Health, Women Affairs, Budget and Planning as well as local government authorities to address maternal and child health, nutrition, gender-based violence and harmful traditional practices through a multisectoral approach.
The programme has also strengthened evidence-based planning and budgeting at the local government level to ensure investments respond to actual health priorities instead of relying on previous budget templates.
According to Olosunde, the initiative has trained over 1,300 healthcare workers on adolescent-friendly health services, quality improvement, infection prevention and control, and other critical maternal and child health interventions.
He noted that every participating local government has at least two trained healthcare workers providing adolescent-friendly services to reduce stigma and discrimination that often discourage young people from visiting health facilities.
“We are changing that by training health workers to provide adolescent-friendly services where young people can access care without fear of discrimination or stigma,” he said.
The initiative has equally institutionalised the Maternal, Perinatal and Child Death Surveillance and Response (MPDSR) system, under which every maternal and child death is reviewed to identify contributing factors and prevent similar incidents.
The programme established Mama-to-Mama Support Groups, comprising influential women who meet monthly in every ward to receive health education on pregnancy danger signs, exclusive breastfeeding, sexually transmitted infections, drug abuse and maternal healthcare before passing the information to women in their communities.
Olosunde explained that the approach was adopted after assessments showed that pregnant women often seek advice first from mothers and friends rather than their husbands.
Complementing the women’s groups is the Fathers for Good Health initiative, which mobilises influential men to encourage husbands to support their wives in accessing antenatal care and delivering in health facilities.
The programme has also established adolescent clubs in every ward to promote increased awareness on reproductive health education and menstrual hygiene management and other positive health seeking behaviours among young people.
According to data from the Nigeria’s District Health Information System (DHIS2), the initiative is contributing to improvements in maternal and child healthcare.
Skilled birth attendance increased from over 117,000 women in 2023 before implementation to over 140,000 in 2024, before rising sharply to more than 200,000 in 2025, representing an impressive increase.
Health facility deliveries, postnatal care attendance also recorded improvements.
Olosunde attributed the achievements to sustained investments in healthcare workers, improved quality of care and intensive community mobilisation.
To address years of staff shortages caused by retirements and inadequate recruitment, the initiative supported the deployment of 336 frontline healthcare workers, comprising 116 nurses and midwives and 220 community midwives, to underserved primary healthcare facilities.
The health workers were strategically deployed to facilities with high maternal health demands and paired with experienced personnel to strengthen service delivery.
Additional personnel were also deployed to 14 high-volume primary healthcare centres, some recording more than 300 deliveries monthly, to reduce staff workload, improve infection prevention and minimise medical errors.
Recognising financial hardship as a major barrier to healthcare, the initiative partnered with the Adamawa State Government to enrol 15,000 poor and vulnerable residents into the state’s health insurance scheme.
Beneficiaries receive health insurance cards enabling them to access antenatal care, skilled delivery, postnatal care, immunisation and other maternal and child health services without paying out-of-pocket.
Health facilities, in turn, receive capitation payments to ensure uninterrupted service delivery.
Olosunde said the intervention is expected to further increase health facility deliveries, improve antenatal and postnatal care attendance and strengthen routine immunisation across the state.
Olosunde reaffirmed that with the ongoing implementation of the EU-SARAH initiative, Adamawa State can continue to strengthen the delivery of quality healthcare to women, children, and adolescents.
