Akwa Ibom, Nigeria – When word went out for volunteers to help prevent malaria in her home state of Akwa Ibom in Nigeria, Uduak Imo Bob responded to the call. How could she not? For years, she worked as a traditional birth attendant for a church group, delivering babies in the community of Atiamkpat in southeastern Nigeria. She had witnessed firsthand the devastating effects of malaria on pregnant women. Death was not uncommon in the women she knew who had acquired the mosquito-borne disease. She, too, had become ill with the fevers and headaches—but survived.
The malaria in pregnancy program introduced by Jhpiego and funded by ExxonMobil offered Uduak a chance to keep others safe. She signed up with 38 other women to serve as a CDD (community-directed distributor) in the villages surrounding the Atiamkpat Clinic, providing malaria prevention services and treatment.
Her neighbors knew they could count on her. “Uduak has been resourceful in the past and always committed in whatever assignment given to her,” one community leader commented about the 47-year-old mother of six.
With Jhpiego’s support, Uduak learned the skills and protocols to deliver malaria in pregnancy services to women, including distributing insecticide-treated bed nets and administering intermittent preventive treatment of malaria in pregnancy (IPTp). She is part of a frontline network of volunteers and health care providers who deliver services from home to health facility in the Onna local government area and help direct community malaria-fighting projects. Uduak and her CDD colleagues have provided malaria prevention and treatment services to 12,106 pregnant women.
Uduak showed such exceptional skills and promise during her training that colleagues chose her to be the chief volunteer coordinator. “Uduak is responsible and one who respects other people’s opinion,” said one co-worker.
In this role, she supervises and coordinates the other women volunteers and ensures their antimalarial drug stocks are adequate and their community registers are updated for accurate service provision.
Uduak understands the threat that malaria poses to Nigerian women and families—malaria causes the deaths of 4,500 pregnant women a year and accounts for one in four cases of anemia in pregnancy. Malaria also causes low birth weight in one in 10 Nigerian infants. On her own initiative, Uduak decided to organize and mobilize traditional birth attendants in her community, persuading them to send their clients for prenatal or antenatal care (ANC), where pregnant women receive malaria prevention services. The nursing officer at the Atiamkpat Clinic and the traditional ruler in the community supported her in this life-sustaining effort.
Without any financial reward or personal gain, Uduak carries out her duties responsibly and enthusiastically. As she explains: “The life and survival of pregnant women is my concern and much more important than money. There is an inner joy in providing quality community service, and this motivates me.”
As part of her work, Uduak delivers health talks to women in her church and offers group counseling sessions on malaria to pregnant women in her community. And she is not shy in her efforts to convince women to protect themselves from malaria. Consider her outreach to one woman who received an insecticide-treated bed net:
“Without Uduak I would not have started using the net,” said the woman who participated in the ExxonMobil-funded program. “Her consistency and persistence in reminding me to use the net prompted and encouraged me to do so.”
The work of Uduak and her fellow community volunteers is improving health services in other important ways. Before the ExxonMobil-funded program began, pregnant women were not patronizing the Atiamkpat health facility and its clinics. Women complained that they couldn’t count on staff being on duty when they visited a facility—there are about six clinics in the district. Uduak and her colleagues met with the health providers and got their commitment to staff the facilities. This coincided with Jhpiego’s training of health staff to improve the quality of ANC and malaria control services they provided.
Now women are coming to the facility to receive ANC. The number of clients has increased from just two pregnant women in the three months preceding the discussions with health staff, to 50 pregnant women in the first three months of staff reporting to the facility. And now women also give birth at the health center. As a result of efforts made by Uduak and her group of CDDs, on average 43% more pregnant women in the Atiamkpat Clinic catchment area are receiving the required two doses of IPTp as compared to pregnant women in three other local government clinics/catchment areas.
Uduak has been a role model to her fellow volunteers and a source of support. “We would have stopped this work since we are not paid, but Uduak has continued to encourage and motivate us,” said one colleague.
The pregnant women Uduak serves also recognize her contributions. “Uduak is selfless and committed to helping people. Her life is a testimony and a challenge to us,” said one program beneficiary.