A root cause analysis of the health-workers crisis in northern Nigeria conducted in 2011 revealed the emergency proportions of the human resources for health (HRH) shortage with only 5,452 nurses and midwives available; a ratio of 0.16 to 0.27 nurses and midwives per 1,000 population, as against the 44,873 minimum number needed for a target of 1.73 per 1,000 population. The study revealed that “massive underinvestment in pre-service education is the single greatest driver of the health-workers shortage in northern Nigeria”. For ongoing interventions to substantially close this gap, the study recommended “transformational investments” in HRH and a paradigm-shift to strengthen pre-service education of health-workers.

This presentation outlines the response delivered by the W4H programme. A core area of W4H support targets health training institutions (HTIs), strengthening 16 HTIs in five northern states.

Key results to date include: A total of 7 HTIs (43.8%, n=7/16) now have full accreditation status compared with the national figures of 21.3% (n= 32/150). Full accreditation of 7 HTIs is a significant increase when compared with just one HTI (6.6%, n=1/16) at baseline.

All the five HTIs that had been denied accreditation at baseline had received provisional accreditation. A total of 11 (69%) HTIs are currently on provisional accreditation compared with only 10 (62.5%) HTIs in 2013, while only one (6.6%) HTI is on denied accreditation, compared with a total of 5 (33.3%) HTIs that had no accreditation at baseline.

Prescribed numbers of tutors set by the regulatory-bodies have been met by 13 HTIs compared with zero at baseline.

A total of 7 HTIs now have full accreditation status, this is a significant increase when compared with just one fully accredited HTI at baseline. Four state governments were supported to establish new HTIs and additional programme (Community Midwifery). All the newly established HTIs have been given provisional accreditation status by the regulatory bodies.

The improvement in accreditation status, and the establishment of new HTIs and programmes have led to significant increase in the number of students recruited and indexed by the HTIs, from 943 at W4H inception to 1613 in 2015.

Strengthening pre-service education of health-workers is crucial to reducing the critical shortage of HRH in sub-Saharan Africa.

This improvement in accreditation status and the establishment of new HTIs and programmes have led to significant increase in the number of students recruited and indexed by the HTIs, from 943 at W4H inception to 1613 in 2015.

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