In July 2016, global leaders gathered for the second annual Safe Mothers and Newborns Leadership Workshop hosted by the Maternal Health Task Force (MHTF) in partnership with the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University and sponsored by the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.
Dr. Nosa Orobaton, one of the faculty at the workshop, is originally from Nigeria. He has worked all over the globe in leadership capacities at the World Health Organization (WHO), John Snow, Inc. and The Global Fund and has served in consulting roles for numerous nonprofits, businesses and governments. Dr. Orobaton is now Deputy Director of Maternal, Newborn & Child Health at the Bill & Melinda Gates Foundation.
S: Tell me about yourself and the work that you do.
N: I’m a public health physician. Over the past five years I’ve helped lead a team of 150 people to implement and scale a maternal child health and family planning program in two states in Northern Nigeria with USAID funding. We’re trying to do things holistically and at scale, looking at the entire spectrum of how programs work in particular contexts and health systems. Prior to this project, I worked with the UN and WHO to help countries use health metrics for measurement and before that I worked at the Global Fund managing the operations group that was responsible for a $10 billion portfolio of grants for HIV, malaria and tuberculosis projects.
S: What is the biggest challenge for maternal and newborn health in Nigeria?
N: We need to work harder on strategies to deliver proven, scalable interventions to those in need. Nigeria’s maternal mortality ratio is among the highest in the world. We are the second largest contributor of maternal deaths globally. But there are proven interventions like misoprostol to prevent postpartum hemorrhage. Misoprostol is available in country, and the policies allow it to be used in facilities and communities. There are government guidelines on how to initiate community-based work—but we still need to bring these elements together to create results at scale. So I believe the main issue is how to develop evidence-based interventions and bring them to scale.
S: What is being done to address that challenge?
N: It requires a consortium of actors, including at the federal level in terms of policy guidance. The government initiated the introduction of a simple antiseptic for application to freshly cut umbilical cords. Nigeria has successfully taken this idea from concept to action, creating local manufacturing capacity in just over a year. As a result, the antiseptic is now available around the country. What remains to be done is getting the state governments to take these programs and run with them. The federal government needs to offer the technical support and guidance necessary for state governments to implement programs at the local level.
S: What kind of leader do you aspire to be?
N: I aspire to help contribute to growing networks of actors and agents who can bring about lasting change. The Sustainable Development Goals (SDGs) require a certain kind of leadership mindset. The SDGs have some very specific technical areas, but to achieve the longer-term outcomes and the durability of those outcomes, an integrative approach is needed. For example, if you invest in handwashing with soap, which applies to SDG 6, this investment has implications for SDG 3, particularly for neonatal health, since a critical aspect of neonatal health is handwashing with soap before the umbilical cord is cut. We need to see the connections between the various SDGs and take an approach that brings them together, mutually reinforces them, accelerates change and ensures the durability of those changes.
S: What would you like MHTF readers to know?
N: The presence of problems is not an excuse to not make progress. It is incumbent on us to use what we have and develop solutions. We should use those problems as triggers to become more innovative in how we produce results.
Check out the other interviews in the Global Leaders in Maternal and Newborn Health blog series.
Read a guest blog post written by Dr. Orobaton about giving birth in Nigeria with no one present.
Watch the video and access presentations from the MHTF’s Advancing Dialogue on Maternal Health Series event, “Emerging Priorities for Maternal Health in Nigeria.”