Executive Summary

The Meeting Targets and Maintaining Epidemic Control (EpiC) project is a global project funded by the United States Government to provide high-quality technical support at the community, health facility, state, and national levels to improve outcomes in HIV, Global Health Security, Malaria, Nutrition, and Maternal, Newborn, and Child Health (MNCH).

In Bauchi State, EpiC is supporting the government to prevent, detect, and respond effectively to health threats, and to improve access to medical oxygen systems through liquid medical oxygen infrastructure (LOX), while enhancing access to and the quality of essential health services, with a focus on Maternal, Newborn, and Child Health and Nutrition (MNCH+N) interventions in 16 priority LGAs.

 The objectives of the MNCH+N interventions are to;

• Strengthen service availability for essential services (ANC, delivery, PNC, newborn and child health) in the supported facilities and align Nutrition 774 (N-774) implementation within PHC platforms.
• Support on-site mentorship and supportive supervision for providers.
• Strengthen community–facility linkages, referral, follow-up, and community-based delivery of Nutrition Services
• Strengthen the use of Health Information System (HIS) data and analysis for improved PHC oversight and performance management across priority LGAs.

In February 2026, EpiC conducted onboarding and site visits to assess MNCH+N readiness across supported PHC facilities in 16 high-burden maternal death LGAs in Bauchi State. Following critical gaps noted during the visits, EpiC engaged a team of trained mentors made up of retired midwives, quality improvement (QI) officers, health system strengthening (HSS) experts, as well as monitoring and evaluation officers from previous MNCH programs to address critical gaps through mentorship and supportive supervision in the facilities.

Despite significant progress achieved by the Bauchi State Primary Healthcare Development Board (BSPHCDB) in mitigating health workforce shortages, there are still some gaps regarding the round-the-clock availability of skilled birth attendants at healthcare facilities. On 13th March 2026, a pregnant woman in active labour arrived at Melandige Primary Healthcare Centre, a Primary healthcare facility facing critical workforce shortages. The skilled birth attendant employed in the health facility was away on a state assignment at the time.  With only the officer-in-charge available at the facility, and referral not immediately feasible due to time constraints, an EpiC mentor (state-trained SBA) present in the facility stepped in to support the delivery. Drawing on recent training, the mentor guided the delivery process while ensuring infection prevention, monitoring for danger signs, and providing timely post-delivery care. The mother delivered safely, and both mother and newborn were stabilized and monitored. This experience demonstrates how targeted capacity strengthening can enable safe, lifesaving actions in low-resource and human-resource-constrained settings.

Background

Melandige PHC serves a largely rural community and surrounding villages within Itas/Gadau LGA of Bauchi State (one of the priority high maternal mortality LGAs) with a catchment population of approximately 229,000 people across a landmass of about 1,398km². The facility routinely experiences staffing gaps, particularly during night shifts, weekends, and leave periods, as only one SBA currently works there. The SBA is usually supported by volunteers who come sporadically.
On the 13th of March 2026, the skilled birth attendant was engaged with other activities in the State when a 23-year-old woman at term (39 weeks gestation) presented in active labour with the baby’s head at the perineum. Immediate referral was challenging due to time constraints, increasing the risk of maternal and neonatal complications. The healthcare worker in charge of the facility, who was available at the time, was overwhelmed attending to several other patients but opted to attend to the emergency. However, the woman in active labour refused to be attended to by the busy male healthcare worker due to cultural reasons. Hence, the EpiC mentor stepped in to assist.