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Aminu Magashi Garba

GFMER Coordinator for Nigeria

Dr. Aminu Magashi Garba, MD, MPH
Evidence Advisor in a DFID funded project in Nigeria ‘Evidence for Action in Maternal and Newborn Health (E4A)'
E-mail: gamagashi@gmail.com

Aminu Magashi Garba is born on the 17th October 1973. He graduated from University of Maiduguri, Nigeria in 2001 with Bachelor of Medicine, Bachelor of Surgery (MBBS) and obtained Diploma and Masters Degree in Public Health from London School of Hygiene and Tropical Medicine in 2006/7. He held the position of Executive Director of Community Health and Research Initiative, an NGO based in Kano, Nigeria (April 2002- Dec 2009).

He was awarded with the following:

1. 2003 Fund for Leadership Development of MacArthur Foundation.
2. 2005 Sexuality Leadership Development Programme, Africa Regional Sexuality Resource Centre, Lagos, Nigeria.
3. 2006/7 British Chevening Scholarship.

He was part of the national team that worked with National Agency for the Control of HIV/AIDS in Nigeria as Thematic Consultant (Policy, Advocacy, Legislation and Human Rights) for the development of HIV/AIDS 2010-2015 National Strategic Framework and Plan He maintains a weekly health column in a Nigerian Newspaper ‘Daily Trust’ that answers readers’ questions on health particularly Sexual and Reproductive Health as well as write a weekly health column that engages policy makers and development partners with evidence for action and change in Maternal and Child Health. During his undergraduate course, he was actively involved in student unionism and rose to become Vice President of Nigerian Medical Students Association (NIMSA) in 1997/8.

He was among the first set of the GFMER’s 6 Months Online Sexual Reproductive Health Course ; From Research to Practice in 2010 and was among the 10 best participants that attended the face to face research methodology course in Geneva in June 2011.

He worked from January 2010 – April 2012 in a USAID funded project in Bauchi and Sokoto States of Nigeria ‘Targeted State High Impact Project (TSHIP) ’ that aimed at improving Integrated Maternal, Newborn and Child Health as the Senior Operations Research Advisor and was the principal investigator to its 3 operations research as follows:

1. Operational Barriers to Distribution of Insecticide Treated Bed Nets in Bauchi and Sokoto States. This Operations Research has provided some useful information to USAID with respect to informing Presidential Malaria Initiative as well as relevant areas were used in drafting TSHIP Malaria Strategy.
2. Factors influencing the use of long acting contraceptives methods in Bauchi State. This Operations Research has provided relevant baseline information to TSHIP/MSN collaborative project which is about to take up soon.
3. Measuring the Effectiveness Oral Rehydration Therapy Corners for Simple Management of Diarrheal in Bauchi State. It is ongoing now and findings will be use by TSHIP to redesign its support to the 2 states on provision of ORT corners in addressing diarrheal diseases and reduction of underfive mortality.

He also led the support in establishing and strengthening Bauchi and Sokoto Health Research Ethics Committees (HREC) which were not in existence before the coming of TSHIP in the 2 states. The Committees currently provide oversight, ensuring that all health research to take place in Bauchi and/or Sokoto States are in compliance with national and international standards.

Currently he is the Evidence Advisor in a DFID funded project in Nigeria ‘Evidence for Action in Maternal and Newborn Health (E4A)'.

He is widely travel and married with 2 children.

Nigeria’s Health at a glance

With a population of about 140 million, Nigeria is home to more than one-fifth of the entire population of Sub-Saharan Africa. During the past decade or so, Nigeria signed on to a number of regional and international conventions focusing specifically on the welfare and health of young people and women. Sexual and reproductive health among adolescents (15–19-year-olds) has become an area of focus of the Federal Ministry of Health.

Official policies at both the national and state levels in Nigeria now promote the goal of improving adolescent sexual and reproductive health. Added to these political developments, the declaration of the United Nations Millennium Development Goals has given momentum to efforts by international and national stakeholders to rise to the development challenges facing the world’s less developed regions, particularly Sub-Saharan Africa.

The United Nations’ goals underscore the importance of women and children for any country’s improved future. Worldwide, but particularly in countries where poverty is widespread, as it is in Nigeria, motherhood at a young age jeopardizes women’s health, their economic prospects and the health and well-being of their families.

Some young women, especially unmarried ones, who experience an unwanted pregnancy, seek induced abortions to resolve the situation. However, because abortion in Nigeria is highly restricted by law, the procedure is often performed clandestinely and under unsafe conditions. Such procedures pose serious health and social risks for all women, but particularly for young and disadvantaged women, who may not have the means to obtain a safe abortion. Low level of knowledge of reproductive health among adolescents and limited access of young people to youth-friendly health services have been identified as underlying factors contributing to the rising trend of HIV/AIDS in Nigeria.

Maternal Mortality in Nigeria

Nigeria still maintains a high maternal mortality ratio of about 545 deaths per 100,000 live births which serves as a threat to the attainment of Millennium Development Goal 5 of reducing by 75% of maternal mortality by 2015 in the country. In line with that Nigeria has commit itself to the United Nations Secretary General’s Strategy on women’s and children’s health which affirms that the initiatives is in full alignment to our existing country-led efforts through the National Health Plan and strategies targeted for implementation for the period 2010 – 2015, with a focus on the Millennium Development Goals (MDGs) 4 and 5 to reduce child and maternal mortalities respectively.

Nigeria has committed itself to fully funding its health program at $31.63 per capita through increasing budgetary allocation to as much as 15% from an average of 5% by the Federal, States and Local Government Areas by 2015. Also Nigeria has agree to work towards the integration of services for maternal, newborn and child Health, HIV/AIDS, Tuberculosis and Malaria as well as strengthening Health Management Information Systems and introduces a policy to increase the number of core services providers including Community Health Extension Workers and midwives, with a focus on deploying more skilled health staff in rural areas.

Contraceptive Usage in Nigeria

Available information from NDHS 2008 has shown that knowledge of any contraceptive method is widespread in Nigeria, with 72 percent of all women and 90 percent of all men knowing at least one method of contraception. Modern methods are more widely known than traditional methods; 71 percent of all women know of a modern method while only 36 percent know a traditional method. Among modern methods for women, the male condom is the most commonly known method (58 percent). The contraceptive prevalence rate for modern methods has increased from 6 percent in 1990 to 13 percent in 2003 and to 15 percent in 2008.

HIV/AIDS in Nigeria

Available information from NDHS 2008 has shown that the first case of AIDS in Nigeria was identified in 1985 and reported at an International AIDS Conference in 1986. A sentinel surveillance system conducted among pregnant women age 15-49 attending antenatal care (ANC) has been used to track HIV prevalence in the country since 1991. Information obtained from the ANC surveys shows that, nationally, HIV prevalence increased from 1.8 percent in 1991 to 4.6 percent in 2008. In 2008, state HIV prevalence rates ranged from 1.0 percent in Ekiti State to 10.6 percent in Benue State (FMOH, 2008).

UNAIDS in its 2008 global report stated that although HIV prevalence is much lower in Nigeria than in many other African countries such as South Africa and Zambia, the large size of Nigeria’s population meant that by the end of 2007, there were an estimated 2,600,000 people infected with HIV in Nigeria and approximately 170,000 people died from AIDS in 2007 alone (UNAIDS, 2008). In recent years, life expectancy in Nigeria has declined partially as a result of the effects of HIV and AIDS. In 1991, the average life expectancy was 53.8 years for women and 52.6 years for men (UNFPA, 2005). The 2007 estimate had fallen to 50 for women and 48 for men (WHO, 2009).

Poverty, low literacy levels, high rates of casual and transactional unprotected sex in the general population, particularly among youth between the ages of 15 and 24, low levels of male and female condom use, cultural and religious factors, as well as stigma and discrimination are major factors in the transmission of HIV in Nigeria (NACA, 2007).

In 1999, the Federal Government of Nigeria began implementing a multi-sectoral approach, followed by the establishment of the National Action Committee on AIDS (NACA) in 2000 to coordinate the national response and to ensure multi-sector and multi-level participation. In 2007 NACA was transformed from a committee to an agency—the National Agency for the Control of AIDS (NACA)—by an act of parliament, for the purpose of sustainability and improving the effectiveness and coordination of the national HIV response. There are also State and Local Government Action Committees on AIDS (SACAs and LACAs), with 12 state committees already transformed into agencies between 2003 and 2008 by acts of parliament.

The future course of the national response to the HIV and AIDS epidemic depends on a number of factors including levels of HIV and AIDS-related knowledge among the general population; social stigmatization; risk behavior modification; access to quality services for sexually transmitted infections (STI); provision and uptake of HIV counseling and testing; and access to care and anti-retroviral therapy (ART), including prevention and treatment of opportunistic infections. The principal objective of this chapter is to show the prevalence of relevant HIV and AIDS-related knowledge, perceptions, and behaviors at the national level and by residence and by selected demographic and socio-economic characteristics of the population.

GFMER in Nigeria

The Oxford Maternal and Perinatal Health Institute (OMPHI), Oxford University in collaboration with Geneva Foundation for Medical Education and Research (GFMER), a WHO Collaborating Centre in Education and Research in Human Reproduction and Community Health and Research Initiative, Nigeria had organized a free training for health professionals to improve their knowledge on Evidence Based Management of Pre-eclampsia and Eclampsia.

The training took place on Saturday 10th December 2011 and covered 3 - 4hours computer - based programme and multiple choice questions. 35 professionals that included doctors and midwives participated and 34 successful ones were issued with certificates in a pilot training in Nigeria that was held in Sokoto State. It was funded by MacArthur Foundation through the Maternal Health Task Force in Engender Health.

At an evening reception on the same day, a recommendation by a senior medical colleague observed that the organizers should initiate series of meetings with Nigerian Medical Association, Ministries of Health across states and National Association of Nurses and Midwives to make the training part of the ‘Continuum Medical Education (CME)’.