What comes to your mind when you hear that approximately 700 newborns die every day in Nigeria? What would you do?
Nigeria is not alone. Globally, about 6,200 newborns die every day, roughly 98% of them in low- and middle-income countries (UNICEF; National Library of Medicine). The drivers behind these tragic numbers are complex but familiar: severe shortages of trained professionals and medical supplies, long travel distances to clinics, high transportation costs, poor infrastructure, regional insecurity, and deeply rooted traditional practices.
That is why I was drawn to Midwifery Ventures when I first heard about it from Dr. Kate Tulenko, a pediatrician, global health workforce training expert, and social entrepreneur. The vision: equips midwives in Africa, particularly in under-resourced rural areas, with the business skills to run their own independent, sustainable practices. Done well, this model supports midwives’ families, creates local jobs, saves the lives of mothers and babies, and strengthens community health safety nets. I offered to help, and I was honored that Kate asked me to lead the initiative.
Over nine months, we built local partnerships in Nigeria, South Sudan, and Ghana, and learned about current practices, cultural norms, regulations, and operational hurdles. I was moved by the midwives’ pride in their work and devotion to mothers and babies, despite supply shortages, deaths caused by delayed transport or lack of blood, low pay (sometimes unpaid for months), and the need to seek work far from home. We pivoted our pilot design, set resource targets, and refined our team’s communication and collaboration. Practitioners and educators embraced the concept enthusiastically. Yet the projects are on hold, pending funding.
What we would do differently
Though the outcome was disappointing, the experience yielded meaningful lessons that I’d love to share with you:
- Be there. Even with strong local partners, being on the ground matters. It’s how you navigate competing local dynamics, build genuine relationships, and adapt your products and processes in real time as you learn.
- Secure resource commitments early. Buy-in from beneficiaries is essential but not enough. Lock in funding, materials, and expertise as early as possible.
- Understand every influencer’s motivations and constraints. Identify your allies and skeptics, and align interests so your progress doesn’t depend on people’s spare time or accidentally collide with someone’s priorities. Build in income-generating opportunities rather than relying only on grants, aid, or goodwill, so every party sees what’s in it for them and the model can last.
Was it a waste?
Did we waste nine months? That is for each participant to decide. I’m grateful for the people and the experience. We learned from one another and shared tools, frameworks, and ideas that can be adapted and extended for future initiatives.
Whether or not Midwifery Ventures come to life, I hope every social innovator, change maker, and community health and education practitioner holds on to this: what you do matters, even when the progress feels impossibly slow or difficult. I hope our journey helps you navigate your ventures more effectively.
What was helpful here? What would you have done differently?
I’d love to hear your thoughts. Together, we continue working toward a healthier, more equitable world.
Reference
Nigeria maternal & newborn health: Africa Independent Television, UNICEF
Neonatal motality: UNICEF, National Library of Medicine
Part of the Scars & Seeds series — Lessons from setbacks, failures, and challenges