>> WELCOME, I'M JEFF RESNICK AT
THE NATIONAL LIBRARY OF MEDICINE
AT THE NCH.
THE HISTORY TALKS PROMOTE
AWARENESS AND USE OF LMN FOR
RESEARCH, AND PUBLIC SERVICE FOR
BIOMEDICINE AND HUMANITIES.
WE ALSO SUPPORT THE COMMITMENT
OF THE NLM TO RECOGNIZE THE
DIVERSITY OF COLLECTI COLLEC COT
ORIGINATE FROM EVERY PART OF THE
GLOBE.
WE TALK WITH PEOPLE OF VARIOUS
BACKGROUNDS WHO USE THESE
COLLECTIONS TO ADVANCE THEIR
TEACHING AND LEARNING.
WE SUPPLEMENT WITH TEACHER
INTERVIEWS.
I'LL ADD THAT NLM HISTORY TALK
WITH MADE POSSIBLE BY THE
NATIONAL TEAM OF MEDICINE AND
NCH VIDEO CASTING.
YOU WANT TO THANK EACH AND EVERY
ONE OF THEM FOR BRINGING THIS
PROGRAM HERE TO YOU EVERY YEAR.
AND I WISH TO THANK THEM FOR
ORCHESTRATING THE Q&A AND CALL
YOUR ATTENTION TO THE LIVE
FEEDBACK BUTTON.
PLEASE USE THIS FEATURE TO SHARE
QUESTIONS WITH ME AND I WILL
SHARE THEM WITH THE SPEAKER.
TODAY'S PROGRAM IS BEING LIVE
STREAMED GLOBALLY AND ARCHIVED
BY NLM VIDEO CASTING AND MADE
POSSIBLY BY THE MICHAEL E.DUBEKY
FELLOW SHIP.
THE FELLOW SHIP PROVIDES UP TO
$10,000 TO PROMOTE RESEARCH AND
HISTORICAL COLLECTIONS OF THE
NCH AND INCLUDE PAPERS OF
MICHAEL E E.DIBEKY FROM SURGERYO
HEALTH CARE POLICY AND MUCH,
MUCH MORE.
YOU CAN LEARN ABOUT THE
FELLOWSHIP BY GOOGLING THE
FELLOW SHIP AND YOU'LL FIND THE
SEARCH.
THE GIFT MAKES POSSIBLE THIS
PORTION OF THE NLM HISTORY OF
MEDICINE LECTURE SERIES.
THIS IS OFFERED BY A SELECTED
FELLOW BASED ON HIS OR HER
COLLECTED RESEARCH.
TODAY I HAVE GREAT PLEASURE AND
PRIVILEGE TO INTRODUCE DR.
OGECHUKWU WILLIAMS FROM THE
UNIVERSITY EVER BUFFALO.
DR. WILLIAMS IS AN HISTORICAL OF
MEDICINE IN AFRICAN WITH
EMPHASIS ON MATERNAL HEALTH AND
MEDICAL CINEMA.
THE PUBLICATIONS APPEAR IN
SEVERAL JURCHLS INCLUDING THE
JOURNAL OF AFRICAN HISTORY AND
ART HISTORY AND VISUAL CULTURE.
DRIVEN BY THE DESIRE TO PLOA
MOLT DEBATES ON THE MATERNAL IN
NIEJER JAW.
IT EXPLORES THE LOCAL AND
COLONIAL AND POLITICS OF MID SIN
AND HOW THE INTERNATIONAL
POPULATION CONTROL ORGANIZATIONS
SOUGHT TO ADVANCE THEIR AGENDAS
THROUGH CONQUEST OR BIRTH AND
MOTHERHOOD.
BOOK IS THE FIRST COMPREHENSIVE
HISTORY OF CHILDBIRTH IN NIEJER
YEAH.
THE "DYING TO BRING LIFE" BUILDS
UPON HER FIRST BOOK AND USES
ORAL HISTORIES, MID CAL REPORTS,
AND SAFE MOTHERHOOD REPORTS TO
EXPLORE THE MATERNAL DEATHSES
AND THE WAY THAT POLITICAL
DECISIONS AND CULTURAL ASPECTS
IMPACTED MATERNAL DEATHS SINCE
THE 20TH CENTURY.
TODAY DR. WILLIAMS JOINS US FROM
THE UNIVERSITY OF BUFFALO TO
PRESENT ASPECTS OF HER RESEARCH
IN THE NLM COLLECTIONS AND HER
TALK ON THE PUSH OF THE AMERICAN
COLLEGE OF MIDWIFES FOR MATERNAL
HEALTH CARE ADVANCEMENTS IN
NIGERIA.
DR. WILLIAMS, A WRM WELCOME TO
YOU AND WE THANK YOU VERY MUCH
FOR JOIN US TODAY.
>> I WOULD LIKE TO STOP BY
THANKING THE NATIONAL RESEARCH
OF MEDICINE OVER THE COURSE OF
SEVERAL MONTHS TO MAKE TODAY
POSSIBLE.
THANK YOU, EVERYONE, FOR TAKING
THE TIME ON A BUSY THURSDAY TO
LISTEN TO THIS LECTURE.
I'M GOING IT START WITH A
BRIEFLY DOCUMENTARY ON HOW I
STARTED THIS RESEARCH.
AND ENDED UP WITH THE TIGHT THAT
WILL I DID.
AND I WILL DISCUSS BRIEFLY THE
ORIGINS OF THE AMERICAN COLLEGE
OF MIDWIVES AND THE SPECIAL FROJ
SECTION WHICH I'M GOING TO REFER
TO TO AS ACNM AND ACS
RESPECTFULLY.
I WILL DISCUSS THE PROJECTS FROM
NIGERIA IN DETAIL AND END WITH A
COMMENTARY ON THEIR ATTEMPTS TO
BEGIN SPECIAL PROJECTS AT HOME.
AND YOU'RE GOING TO HEAR ME SAY
IN MIDWIFERY A LOT.
I HAVEN'T GOTTEN AROUND TO THE
U.S. VERSION OF THAT
PRONUNCIATION WHICH IS
MIDWIFERY.
SO BEAR WITH ME.
I BEGAN MY RESEARCH ON MY SECOND
PROJECT IN IF FALL 2022 ON
MATERNAL DEATHS.
IN FALL 2022 AND SPRING 2023 AT
THE NATIONAL LIE BRING OF
MEDICINE AND -- LIE BRING OF --
LIBRARY OF MEDICINE AND ITCHES
INTERESTED IN COLLECTIONS OF THE
ACNM AND ONE OF THEIR FOREMOST
SPONSORS THE NC BOARD IN
NATIONAL DEVELOPMENT.
INSTEAD OF REQUESTING THE
SPECIFIC FOLD THAT ARE I NEEDED
THAT HAD THE DOCUMENTS THAT I
WANTED, I REQUESTED THE ENTIRE
BOXES THAT CONTAIN THOSE
FOLDERS.
AND SO I SPENT THAT VISIT IN THE
FALL JUST GOING THROUGH ACNM
RECORDS AND I TO RETURN IN
SPRING '23 TO LOOK AT THE OTHER
DOCUMENTS THAT I WAS INTERESTED
IN EXPLORING.
WHAT THIS DID FOR ME WAS THAT IT
PROVIDED PR ME AN IN-DEPTH
KNOWLEDGE OF THE NATURE, THE
EXTENT OF ACNM WORK ABROAD BUT
ALSO PROVIDED INSIGHTS INTO THE
POLITICAL CONTEXT THAT THEY WERE
NAVIGATING AT HOME IN THE UNITED
STATES.
THE MATERNAL AND REPRODUCTIVE
HEALTH CARE CRISIS THAT THEY
WERE NEGATING AS WELL AS
QUESTIONS SURROUNDING THE
AUTONOMY AND THE EXTENT OF THEIR
PRACTICE AT THE TIME THEY
VENTURED ABROAD.
SO THESE TWO NEWSPAPER CLIPS ON
THE SCREEN PRETTY MUCH
SUMMARIZES THE HISTORY OF
MIDWIFERY IN THE UNITED STATES.
BEFORE THAT, ONE OF THE
QUESTIONS I BEGAN TO ASK AFTER I
SAW SOME OF THE BACKGROUND
SURROUNDING ACNM WORK ABROAD, I
BEGAN AT THAT ASK WHY THE ACNM
VENTURED BROAD AND THAT'S HOW I
ENDED UP LOOKING AT THE TITLE,
CHAMPION AS BROAD.
THESE TWO IMAGES ON THE SCREEN
IS AN EXCELLENT WAY TO SUMMARIZE
THE HISTORY OF MID WHICHEVER RI
IN THE UNITED STATES FOR MOST OF
THE 20TH CENTURY.
BEGINNING IN THE EARLY 20TH
CENTURY MIDWIFERY WAS A
PROFESSION.
THERE WAS A MOVE PRVEL BY THE
AMERICAN MEDICAL -- ESPECIALLY
BY THE AMERICAN MEDICAL
ASSOCIATION AND GYNECOLOGISTS TO
OUTLAW MIDWIFERY.
THESE WERE ORGANIZATIONS THAT
WERE PREDOMINANTLY MALE AT THE
TIME AND WHITE.
AND SO THE MEDICALIZATION OF
CHILD BIRTH INVOLVED THEIR MOVE
TO TAKE OVER NO MORE
DELIVERIES -- NORMAL DELIVERIES
WHICH AT THE TIME WAS UNDER THE
CONTROL OF MIDWIFES.
BY THE 1930S AND 1940s, THEY
WERE LARGELY SUCCESSFUL, BUT
THERE WAS A CRISIS WHEN IF DIME
MATERNAL HEALTH WITHIN THE
UNITED STATES.
THERE WAS A CRISIS OF MATERNAL
DEATHS WHICH AFFECTED THE
COMMUNITIES OF COLOR, IMMIGRANT
COMMUNITIES WHICH PROVIDED THE
HIGHER NUMBER OF MIDWIVES IN THE
UNITED STATES DURING THE EARLIER
PART OF THE 20TH CENTURY AND
BEFORE THAT.
THERE WAS ALSO A CRISIS OF
PERSONNEL.
THERE WERE NOT ENOUGH DOCTORS TO
PROVIDE MATERNITY SERVICES TO
WOMEN ACROSS THE COUNTRY IN THE
UNITED STATES.
THIS CRISIS WAS EVEN WORSE IN
RURAL AMERICA.
NOW, A NEW CLASS OF MIDWIFES
EMERGED TO FILL IN THIS PERSONAL
GAP AND THESE GAME GNOME AS
NURSE MI WIVES.
THESE WERE NURSES THAT BEGAN TO
PRACTICE MIDWIFERY AND RECEIVING
SOME TRAINING IN MIDWIFERY.
BY THE 1950s, THE NUMBERS OF
THESE NURSE VSH MIDWIFES HAD
INCREASED SUCH THAT AS
ORGANIZATION WAS FORMED TO
PROVIDE SOME STRUCTURE TO THEIR
EXISTENCE.
IN 1955, ACNM WAS FOUNDED TO
PROVIDE STRIK TOUR TO PROVIDE A
MEAN -- PROVIDE A STRUCTURE AND
MEANS OF CERTIFICATION FOR THIS
FIELD OF NURSE MIDWIFES.
BY THE 1970S AND 1980s, ACNM
SIDE OF SIGNIFICANT BOOST IN ITS
MEMBERSHIP.
THE MEMBERSHIP GREW
EXPONENTIALLY.
BUT THERE WAS STILL SPECIAL
NEGOTIATING THEIR AUTONOMY, THE
KINDS OF PRODUCTIVE HEALTH
SERVICES THAT THEY COULD OFFER
TO WOMEN AND THE SERVICES THEY
COULD PROVIDE INDEPENDENT OF OR
IN CLAB -- COLLABORATION WITH
DOCTORS.
IT WAS UNDER THIS DECISION THAT
THEY MADE TS DECISION TO VENTURE
ABROAD TO CREATE THE SPECIAL
PROJECTS SECTION.
PART OF THE IDEA WAS A
RECOGNITION THAT THE STATUS OF
MID WHICH WAS AND MIDWIFERY IN
THE UNITED STATES WAS TIED TO A
GLOBAL STATUS OF MIDWIFE.
NOW, THE SPECIAL PROJECTS
SESSION, ONE OF THE MAJOR GOALS
TWOOS COMBAT MATERNAL AND INFANT
HEALTH, TO IMPROVE THE LIVES OF
WOMEN AND ADVISE THE FIELD OF
MIDWIFERY.
A LOT OF THEIR WORKS WITH
FOCUSED ABROAD.
ALL OF THEIR WORK FOR THE FIRST
DECADE OF THEIR A EXISTENCE WAS
FOCUSED ABROAD.
IN THE 198 OS A LOT OF THIS WORK
WAS ON THE AFRICAN CONTINENT AND
ON THE ASIAN CONTINENT.
ON THE AFRICAN CONTINENT, THE
FOCUS WAS ON ANGELO-FORMED
COUNTRIES.
THESE WERE FORMER BRITISH
COLONIES SO THEY SPOKE ENGLISH
AND THERE WAS A GOOD CHANCE THEY
WOULD HAVE A U.S. PRESENCE AND
CONNECTION DUE TO THAT BRITISH
TIE.
NOW THEY ALSO FOCUS THEIR
PROJECTS ON COUNTRIES THAT WERE
ECONOMICALLY SIGNIFICANT, WHERE
ALSO SIGNIFICANT
POPULATION-WISE.
ONE OF THOSE WAS NIGERIA WHICH
HAD STRATEGIC TWR TO THE UNITED
STATES ESPECIALLY IN TERMS OF
THE COLD WAR POLITICS IN THE
'06S, '70s '80s AFTER
NIGERIA GAINED INDEPENDENCE.
THEY ALSO FOCUSED IN GHANA AFTER
THEY WERE RECOGNIZED AS THE
THIBD LARGEST COUNTRY IN AFRICA.
A LOT OF THEIR PROJECTS WERE IN
KENYA AND EU BEGAN DA.
UGANDA.
THESE WERE TWO MAJOR EAST
AFRICAN HUBS.
ACNM'S INTEREST DID NOT EXIST IN
A VACUUM.
BEFORE THEY SHOWED UP IN 1982,
THERE WERE A LOTS OF NUMBER OF
U.S. ORGANIZATIONS ACTIVE IN
NIGERIA AND PROVIDING
POPULATION-RELATED SERVICES.
AND THESE ORGANIZATIONS -- U.S.
ORGANIZATION PRESENCE IN NIGERIA
BEGAN SHORTLY BEFORE NIGERIA'S
INDEPENDENCE AROUND 1958.
AS A RESULT OF MOSTLY CONCERNS
REGARDING POPULATION.
IN THE MIDDLE OF THE 1950s,
THERE WERE CONCERNS ESPECIALLY
IN THE ROCK FERAL FOUND EDITION
THAT GLOBAL POPULATION WAS
INCREASING.
THE WHEREIN WORLD APART FROM THE
SOVIET UNION WAS DECLINING, BUT
THE POPULATION OF THE SO CALLED
THIRD WORLD, NEWLY FORTUNATELIED
AFRICAN COUNTRIES AND ELSEWHERE
IN THE WORLD WERE INCREASING.
SO THERE WERE CONCERNS OVER THIS
POPULATION GROUP.
BUT THERE WERE ALSO CONCERNS
ABOUT THE KINDS OF ECONOMIC
IMPLICATIONS THAT SUCH
POPULATIONS WOULD HAVE ON THE
WORLD.
THERE WAS THIS IDEA THAT BY THE
19078S, THE PROJECTION THAT BY
THE 1908S THERE WOULD BE AN END
OF THE WORLD KIND OF
REPERCUSSION IF POPULATION
WASN'T CHECKED.
BY 1958 AND DEFINITELY TRUE ARE
THE 1960s.
U.S. ORGANIZATIONS INCLUDING
ROCQUE FELL EXPRT POPULATION
COUNCIL WHICH EMERGED AS A
PROJECT OF OF THE ROCKEFELLER
FOUNDATION BEGAN TO DO WORK
RELATED TO POPULATION CONTROL IN
NIGERIA.
AND THEY IT SPECIFICALLY SINGLE
OUT NIGERIA BECAUSE OF THE SIZE
OF THE COUNTRY.
IT WAS THE LARGEST ON THE
AFRICAN CONTINENT
POPULATION-WISE AND IMPORTANT TO
THE UNITED STATES STRATEGICALLY.
THERE WAS WORK ON
POPULATION-RELATED PROJECTS.
THERE WERE ALSO POPULATION LABS,
DEMOGRAPHIC LABS SET UP BY U.S.
UNIVERSITIES INCLUDING JOHNS
HOPKINS UNIVERSITY POPULATION
LABS.
WHAT THESE ORGANIZATIONS WAS TO
BEGIN COLLECT AND TRAIN NIGERIAN
INSTITUTIONS TO COLLECT
DEMOGRAPHIC DATA AND COLLECT
HEALTH AS WELL.
IT WAS UNDER THIS ENVIRONMENT
THAT ACNM BEGAN ITS WORK IN 1982
IN NIGERIA.
UNLIKE THE ORGANIZATIONS THAT
EXISTED THAT WERE ACTIVE IN
NIGERIA BEFORE THEM, A LOT OF
THE FOCUS WAS ALONG FAMILY
QUALITY SERVICES.
I MENTIONED THAT THERE WERE
POPULATION CONTROL PROJECTS
WHICH CULMINATED INTO FAMILY
PLANNING FLOJTS NIENGERRIA
ALREADY.
PART OF THE PROBLEM WAS ACCESS.
THIS IS WHERE ACNM'S
INTERVENTION CAME IN.
THESE FAMILY PLANNING SERVICES
WERE NOT BEING SESABLE TO A BULK
OF THE NIGERIAN COMMUNITIES.
&PART OF THE PLESM WAS THE WAYS
IN WHICH POSTPARTUM CARE WAS
STRUCTURED IN THE COUNTRY UP TO
THE END MUCH THE 1907S.
POSTPARTUM CARES WITH REQUIRED
FOR WOMEN WITH COMPLICATED
DELIVERIES WAS NOT EXPECTED FOR
WOMEN WHO HAD NORMAL UNEVENTFUL
DELIVERIES.
WHAT THAT MEANT WAS THAT
FAMILY-PLANNING SPONSORS AND
FAMILY-PLANNING PRACTITIONERS
LOST THAT CHANCE, THE
OPPORTUNITY TO OFFER TO WOMEN,
WOMEN WHO HAD JUST HAD BABY AND
VISITED HOSPITAL FOR POSTPARTUM
VISITS TO OFFER THESE WOMEN
FAMILY PLANNING OPTIONS.
BUT THERE WAS ALSO AN ISSUE OF
PERSONNEL.
NIGERIAN DOCTORS WERE STRETCHED
THIN COMPARED TO THE NUMBER OF
PEOPLE THAT THEY HAD TO SERVE SO
THEY COULD NOT TAKE ON IN MANY
CASES THE FAMILY PLANNING
CLINICS.
PART OF THE PROPOSAL WAS TO
EMPOWER MIDWIVES INCLUDING
PRIVATE MIDWIFES TO ACTUALLY
TAKE CARE OF THESE -- THE
FAMILY-PLANS PROGRAMS TO TRAIN
MIDWIFES TO TAKE CHARGE OF THE
CLINICS IN ORDER TO EXPAND
ACCESS.
AFTER A PILOT PROBLEM AT THE
UNIVERSITY TEACHING HOSPITAL WAS
LAUNCHED THAT KIND OF TESTED
OITD EXPANDING POSTPARTUM
PROGRAMS TO THE ENTIRE
POPULATION, YOU WILL BIRTHING
WOMEN, ACNM BEGAN TO WORK TO
EMPOWER MIDWIFES TO TAKE PART 6
THOSE PO POSTPARTUM CLINI CLINID
OFFER PLANNING FAMILY AS WELL.
ONE OF THE ACNM'S CRITICISMS OF
THE ORGANIZATIONS THAT EXISTED
IN NIGERIA PREVIOUSLY BEFORE
THEY JOINED WITH THEIR WORK IN
NIGERIA WAS THAT THE PROJECTS
WOULD COST ALMOST EXPLEUS --
FOCUS ON FAMILY PLANNING.
THERE WAS VERY LITTLE ATTENTION
TO MATERNAL DEATHS.
BY THE 19780S, NIGERIAN DOCTORS
HIM BEGUN TO RAISE AWARENESS
REGARDING THE EXTENT OF MATERNAL
DEATHS.
THE DATA HAD EMERGED ESPECIALLY
AS A RESULT OF DEMOGRAPHIC WORKS
AND THE WORKS BY THE POPULATION
LABS IN THE VARIOUS INSTITUTIONS
ABOUT THE EXTENT OF THE PROBLEM.
AND THE SOCIETY OF OBSTETRICS
AND GYNECOLOGY USED THESE DATA
TO ESTIMATE THEIR SENSE OF
DEATHS AT 75,000 ANNUALLY IN THE
COUNTRY.
THIS WAS CONSISTENT FOR MOST OF
THE 1980s.
SO ONE OF THE THINGS PROJECTS
THAT ACNM TOOK ON BECAME TO
HIGHLIGHT INTERNATIONALLY THE
EXTENT OF THE PROBLEM.
BUT ALSO TO CREATE PROJECTS THAT
ADDRESS THE ISSUE.
BECAUSE THE NIGERIAN GOVERNMENT
COULD DO VERY LITTLE OR WOULD DO
VERY LITTLE AT THE TIME BECAUSE
NIGERIA WAS IN AN ECONOMIC
CRISIS AND RECESSION IN THE '80S
AND THE FEDERAL GOVERNMENT HAD
JUST SLASHED THE NATIONAL BUDGET
ALLOCATED TO HEALTH.
THERE WASN'T ENOUGH FOR HEALTH
AND CERTAINLY NOT ENOUGH TO
PRIORITIZE WOMEN'S HEALTH.
SO ACNM HELPED TO DRAW
INTERNATIONAL ATTENTION FOR THE
NEED TO FUND PROGRAMS IN THIS
REGARD.
I'LL TALK ABOUT THAT FLOJ A
LITTLE BIT.
BUT ONE OF THE THINGS THAT THEY
ALSO FOCUSED IN ON WAS ELEVATING
THE STATUS OF MIDWIVES NOT ONLY
IN NIGERIA, BUT IN
INTERNATIONALLY BECAUSE THEY
REALIZED THAT FOR A LOT OF THEIR
PROJECTS ON MATERNAL HEALTH TO
SUCCEED AND A LOT OF THE PUSH TO
PROVIDE MIDWIVES AS A SOURCE OF
REPRODUCTIVE HEAL HEALTH CARE TO
SUCCEED, THE STATUS OF MIDWIVES
NEEDED TO IMPROVE.
ONE OF THE TECHNIQUES THEY
ADOPTED TO FRY TO CHANGE THE
GLOBAL -- TO TRY TO CHANGE THE
GLOBAL PRODUCTIVE HEALTH WAS TO
SHOW "ALL MY BABIES" THIS IS A
FILM THAT MOST ARE GOING TO
RECOGNIZE.
"ALL MY BABIES" WAS A FILM
PRODUCED IN 1953 BY THE
DEPARTMENT OF HEALTH IN GEORGIA.
THIS FILM TRACKED THE PROFESSION
JOURNEY OF THIS POPULAR BLACK
MIDWIFE WHO HAD DELIVERED OVER
3,000 BABIES IN GEORGIA.
IT TRACKED HER DELIVERING BABIES
UNDER IDEAL CONDITIONS AND LESS
THAN IDEAL CONDITIONS.
THIS WAS A TRAINING MANUAL, IF
YOU WILL, ON WHAT THE SERVICES
OF A LAY MIDWIFE SHOULD LOOK
LIKE AND HOW A LAY MIDWIFE
SHOULD ATTEND TO DELIVERIES
UNDER DIFFERENT CIRCUMSTANCES
AND CONDITIONS.
THEY BEGAN TO SHOW THESE FILMS
TO GOVERNMENTS, INTERNATIONAL
AGENCIES AND INTERNATIONAL
CONFERENCES TO PUSH FOR AND MAKE
AN ARGUMENT FOR WHAT THE
SERVICES OF MIDWIFES WOULD LOOK
LIKE.
ANOTHER FILM THAT THEY BEGAN TO
SHOWAL IS THIS FILM "TRADITIONAL
BIRTH ATTENDANCE" THIS WAS A
FILM CREATED IN CONGO.
THIS FILM BASICALLY CHRONICLED
THE EXPERIENCE EVER DEVELOPING
TRAINING PROGR PROGRAMS AND IS D
SUPERVISIONS FOR MIDWIFE
ATTENDANCE A.
THEY WANTED IT UTILIZED AS A
MEANS OF PROVIDING MATERNAL CARE
ESPECIALLY IN LOW PERSONNEL
SETTING AND LOW RESOURCE
SETTINGS.
THIS PROGRAM IN THE CONGO, WHAT
THEY FILMED IN THE CONGO WAS A
PILOT PROGRAM.
THEY FILMED THIS TO SHOW WHAT A
TRADITIONAL BIRTH ATTENDANT
SERVICE WOULD LOOK LIKE WHAT THE
TRAINING WOULD LOOK LIKE AND
WHAT THE COLLABORATION WITH
DOCTORS AND HOSPITALS WOULD LOOK
LIKE.
ON TH THE ONE HAND, IT WAS ONE F
THE FILMS THAT THEY HAD IN THEIR
TOOL BAG TO CONVINCE THE WORLD
HEALTH ORGANIZATION, DIFFERENT
AGENCIES IN THE UNIT EU NIGHTED
NATIONS IN ENCOURAGING THE BIRTH
ATTENDANCE.
BUT THOUGH ALSO USED IT AS A
PUBLIC HEALTH TOOL TO HIGHLIGHT
TO THE WORLD TO ACNM MEMBERS AND
VARIOUS GROUPS AT HOME IN THE
U.S. THE NATURE OF ACNM'S
INTERNATIONAL WAR.
NOW AS A RESULT OF A LOT OF THE
INTERNATIONAL CONVERSING THAT
THEY ALONG WITH THE WORK IN CLAB
ASCOLLABORATION WITH MIDWIFES.
IN 1987 AT A CONFERENCE IN
KENYA, THE STATE MOTHERHOOD
INITIATIVE WAS LAUNCHED WITH THE
SPONSORSHIP OF U.S. Y USAIDs.
SHORTLY AFTER THE CREATION OF
THE SAFE -- LAUNCHING OF THE
SAFE MOTHERHOOD INITIATIVE, AC
NHL WAS LOOKING AT PROJECTS
SPECIFICALLY TAILORED AT
ADDRESSING MATERNAL DEATHS.
THESE TWO ITCH ON THE SCREEN
WERE TWO OF THE MAJOR PROJECTS
THEY UNDERLOOK IN NIGERIA.
I'M NOT GOING INTO DETAILS ABOUT
MAPS BECAUSE I TALKED ABOUT IT
WILL WITHOUT NAMING IT.
THIS WAS THE PROJECTS THAT THEY
STARTED WITH THE PROJECT THAT
HAD TO DO WITH EXPANDING ACCESS
TO FAMILY PLANNING AND TRAINING
MIDWIVES, STRENGTHENING
MIDWIFERY ASSOCIATIONS, CREATING
THEM WHERE THEY DID NOT EXIST
AND EMPOWERING MIDWIFES TO
INCLUDE FAMILY PLANNING SERVICES
TO WOMEN ACROSS THE COUNTRY.
THE MOTHER CARE PROJECT WHICH I
WILL FOCUS ON WAS SPECIFICALLY
TARGETEDTARGETED AT ARE AT ADDRG
THE PROBLEM OF MATERNAL DEATHS.
THIS WAS A COMPREHENSIVE
PROJECT.
IT INVOLVED THE RECRUITMENT OF
KEY LOCAL STAKEHOLDERS,
RELIGIOUS LEADERS, WOMEN'S
ORGANIZATIONS AND NGOS IN TRYING
TO RAISE AWARENESS ON MATERNAL
DEATHS AND AROUND THE DANGERS
ASSOCIATED WITH PREG NANSLY.
IT ALSO INVOLVED TRAINING
MIDWIFES TO IMPROVE THEIR
KNOWLEDGE OF -- UPGRADE THEIR
KNOWLEDGE AND SKILL SO THEY
COULD RESPOND BETTER TO
OBSTETRIC EMERGENCIES.
NOW THE PART OF THE PROJECT THAT
EXCITES ME MOST IS THE MASS
EDUCATION CAMPAIGN THAT IT
INVOLVED.
THIS PROJECT TOOK THE FORM OF
MASS EDUCATION CAMPAIGN THAT
INVOLVED TV SHOWS, RADIO SHOWS,
MAGAZINES, ALL KINDS OF DRAMA
SERIES ON NATIONAL TELEVISION
AND LOCAL TELEVISION.
ONE OF EVER THE STRATEGIES THAT
ACNM ADOPTED WAS A STRATEGY THAT
HAD BEEN HAD BEEN MARKED OUT BY
OBJECT STRETTICS AND GYNECOLOGY
UNTIL NIGERIA.
THERE WAS A HEALTH ZONE IN
EASTERN PART OF THE COUNTRY.
THERE WAS ANOTHER HEALTH ZONE IN
THE WESTERN PART OF THE COUNTRY
AND TWO IN NORTHERN NIGERIA AND
THEY CITED THEIR PROJECTS FOR
THE MOTHERHOOD PROJECT IN THESE
HEALTH ZONES.
ONE OF THE THINGS THEY DID AS A
WAY TO RAISE AWARENESS WAS TO
BRING IN REPRESENTATIVES OF
INTERNATIONAL AGENCIES TO VISIT
THE SITES OF THEIR WORK TO RAISE
AWARENESS ON THE PROBLEM AND
ALSO ON THE NEED.
I'M HIGHLIGHTING A MAGAZINE
THAT FEATURED PROMINENTLY IN
THIS PROJECT.
IT'S A POPULAR DRAMA MAGAZINE
THAT WAS IN PRINT GAINING IN
1978.
1967.
AND I HIGHLIGHTED NUMBER ONE
BECAUSE IT'S -- I COULD FIND
THAT IMAGE FOR THIS PARTICULAR
MAGAZINE.
SECONDLY, IN ACNM RECORDS, THEY
ACTUALLY TOOK THE TIME, THERE
WAS A LOT OF BUZZ AND EXCITEMENT
AROUND IT AND THEY DISCUSSED IT
EXTENSIVELY.
ONE OF THE H OF THE THINGS
THOUGH DID WAS TO GET THE
PRODUCERS TO DETERMINE VARIOUS
TEAMS AROUND MATERNAL HEALTH,
AROUND MATERNAL DEATHS AND
AROUND PREGNANCY AND TURN IT
INTO A DRAMA.
IT WAS POPULAR IN WESTERN
NIGERIA IN GENERAL AND IT WAS A
MAGAZINE CREATED IN ARUBA.
THE WAY THAT IT WORKED.
THE PICTURE TO THE WAR RIGHT,
THE WAY THAT IT WORKED WAS THAT
THE PRODUCERS ACTUALLY DID A
DRAMA SERIESES, RECORDED THE
SHOW AS YOU WOULD RECORD
SOMETHING FOR TV.
THEY RECORDED THE DRAMA AND
FILMED THE DA DRAMATIZIZATION AD
KRETTED SCREATED MAGAZINE PICTUD
THEY WOULD INSERT THE
APPROPRIATE DIALOGUE NEAR THE
STILL PICTURE.
THIS WAS AN INFORMAL AND A SPACE
FOR PUBLIC DISCOURSES.
THEY IDENTIFIED OTHER VERY
PUBLIC, OTHER VERY PUBLIC
PLATFORMS ACROSS THE COUNTRY IN
THE OTHER HEALTH ZONES.
THERE WERE OTHER MAGAZINES AND
RADIO SHOWS SPECIFICALLY
TARGETED AT PARTICULAR
AUDIENCES.
THERE WERE SHOWS THAT WERE
TARGETED AT MEN AND A LOT OF THE
RESEARCH THIS THEY DID BEFORE
IMPLEMENTING THIS PROJECTS WITH
TO DETERMINE WHAT PLATFORM, WHAT
MEDIA PLATFORM EACH OF THE
TARGET WAS LISTENING TO.
IN NORTHERN NIGERIA, THEY
CREATED RADIO SHOWS AND TALK
SHOWS DIRECTED THE MEN.
BECAUSE PART OF WHAT THEY CAME
UP WITH IN THEIR RESEARCH WAS
THAT THE MEN HAD THE RADIOS.
THE MEN LISTENED TO THE RADIO
SCWS CREATED OTHERS THAT WERE
TARGETED AT WOMEN THAT WOULD
REACH THE WOMEN.
THE GENERAL MESSAGE IN ALL OF
THESE MEDIA CAMPAIGNS LIKE THERE
WAS MUSIC, THEY HIRED MUSICIANS
AND SANG JINGLED AND HIRED
MUSICIANS TO SING SONGS RELATED
TO MATERNAL DEATHS, RELATED TO
PREGNANCY TO GENERATE PUBLIC
DISCOURSE ON THE SUBJECT.
THE MESSAGING IN GENERAL WAS
SURROUNDED THE INCREASE OF
KNOWLEDGE OF THE SCIENCE DURING
PREGNANCY.
IT ALSO INVOLVED INCREASING
AWEARNESS OF CULTURAL PRACTICES
THAT ENDANGERED PREGNANCIES.
BECAUSE IN THEIR RESEARCH IN
DIFFERENT HEALTH ZONES, THERE
WERE PARTICULAR PRACTICES
SPECIFIC TO THOSE PARTS OF THE
COUNTRY THAT WERE ACTUALLY
DANGEROUS TO PREGNANT WOMEN.
THEY PUT OUT MESSAGING THAT
ADDRESSED THOSE THINGS AND THAT
GENERATED PUBLIC DISORS AROUND
THOSE SUBJECTS.
AND THEN THERE WAS AN ISSUE
OF [INDISCERNIBLE] ACROSS THE
COUNTRY ONE OF THE TRENDS THAT
THEY FOUND WAS THAT THE BELIEF
THAT BLOOD DONATION COULD AFFECT
THE DONOR SO THERE WERE NOT A
LOT OF BLOOD SUPPLIES IN THE
BANKS.
A LEADING CAUSE OF BLOOD DEATHS
CROSS THE WORLD WAS HEMORRHAGING
AND STILL IS.
IN THE CASE OF NIGERIA, WHEN A
WOMAN WAS HEMORRHAGING DURING
CHILD BIRTH, IN MANY CASES,
THERE WAS THERE WAS A RELATIVE
WHO MATCHED WAS WILLING TO
DONATE BLOOD, CHANCES ARE THAT
WOMAN'S HEALTH WAS IF DANGER
BECAUSE OF THE LACK OF BLOOD IN
THE BLOOD BANKS.
A LOT OF THE MESSAGES SURROUNDED
BLOOD DONORS AS WELL.
I TALK -- THE MOTHER CARE
PROJECTS HAD A VERY SIGNIFICANT
IMPACTS IN NIGERIA ESPECIALLY IN
THE 1990s.
PROJECT -- THE FIRST PUBLIC
PROJECT STARTED FROM 1991 AND
LASTED UNTIL 1994.
ONE OF THE MAJOR IMPACTS THAT IT
HAD WAS IN DRAWING INTERNATIONAL
SUPPORT TO THE LOCAL AREAS TO
COVER THE DEATHS.
IT WAS INTERESTING TO READ THE
DIALOGUES IN THE DOCUMENTS WHERE
THEY WERE BASICALLY PLANNING TO
FIGURATIVELY DRAG U USAID FOCUSN
THE FAMILY PLANNING AND THE
VOLUNTARY STERILIZATION PROGRAMS
THIS THEY WERE SPONSORING.
THERE WAS A PUSH TO CREATE
INTERNATIONAL ATTENTION
SURROUNDING THE PROBLEM OF
MATERNAL DEATHS AND TO ATTRACT
FUNDING TO DEAL WITH THOSE
PROBLEMS, TO EXPAND THE
PROGRAMMING THAT RELATED TO
MATERNAL DEATHS.
ANOTHER THINGS WITH THE CREATION
OF TV PROGRAMS.
THE 1990s WAS AN ERA OF PUBLIC
AWARE IF HE IS ON THE ISSUE EVER
MATERNAL DEATHS ON SOME OF THE
DANGERS SURROUNDING PREGNANCY.
THERE WAS AN ERA WHERE IT WAS
COMMON FOR INTERNATIONAL HEALTH
ORGANIZATIONS IN NIGERIA TO HIRE
POPULAR NIGERIAN MUSICIANS.
A LOT WERE RECOGNIZE.
IT'S WERE MUSICIANS -- POPULAR
MUSICIANS HIRED TO SING SONGS
RELATED TO REPRODUCTIVE HEALTH
AND GENERATE PUBLIC DISCOVERSES-
DISCOURSES AROUND THOSE
SUBJECTS.
AIRPORTS WERE FLOODED IN
CONVERSATIONS AROUND
REPRODUCTIVE HEALTH IN GENERAL.
THERE WAS INCREASED DIALOGUE
SURROUNDING THE CULTURAL
PRACTICES THAT AFFECTED
PREGNANCY.
THE 20TH CENTURY CLOSED OUT WITH
PUBLIC AWARENESS AND
ORGANIZATIONS AT LEAST IN THE
MAJOR CITIES IN NIGERIA WITH THE
HEALTH ZONE AND NATIONAL LEVEL.
THERE WAS A FORCE THAT HASN'T
BEEN MATCHED EVEN IN THE 21ST
CENTURY.
NOW, I WANT TO CONCLUDE BY
FOCUSING BACK TO THE UNITED
STATES.
IN THE MID 1990s, ACNM BECAME
INTERESTED IN DEVELOPING SPECIAL
PROJECTS IN THE U.S.
ONE WE HAVE THE THINGS THAT THEY
QUICKLY REALIZED WAS THAT THEY
HAD NOT CULTIVATED THEIR
DOMESTIC NETWORKS AS THEY DID
THEIR INTERNATIONAL ONES SO THEY
NEEDED MUCH MORE WORK TO MAKE
INROADS WITH IMPLEMENTING
SPECIAL PROJECTS AT HOME.
PART OF THE PLESM WAS THE
POTENTIAL PUSHBACK THAT WOULD
COME FROM WITHIN THE
ORGANIZATION AND OUTSIDE OF THE
ORGANIZATION FOR ADOPTING WHAT
THEY DESCRIBED AS OVERSEAS MODEL
AS HOME.
THERE WAS THE CONCERN AS YOU CAN
SEE FROM THIS DOCUMENT THERE
WERE CONCERNS ABOUT PUSHBACK ON
SOSHTSING MODELS IMPLEMENTED IN
THIRD WORLD COUNTRIES AND
COUNTRIES THAT ARE SUPPOSED TO
BE BETTER IN THE UNITED STATES
IN THE UNITED STATES AND WHAT
THAT MEANT.
NOW, HOW THIS EFFORT PLAYED OUT
IS OUTSIDE OF THE SCOPE OF MY
RESEARCH AND PRESENTATION, BUT I
BRING IT UP AND I END ON THAT
NOTE BECAUSE I WANT TO MAC A
POINT ABOUT WHAT WE,
PARTICULARLY THE U.S., CAN LEARN
ABOUT AFRICA AND OTHER
DEVELOPING WORDS IN THE FIGHT
AGAINST MATERNAL DEATHS.
ESPECIALLY IN TIMES OF THE
COLLABORATIVE APPROACH OF THE
WORK THAT ACNM DID IN NIGERIA TO
TACKLE THE ISSUE OF MATERNAL
DEATHS.
THE EXTENT OF THE CAMPAIGN AND
COLLABORATION WITH THE
GOVERNMENT AND COMMUNITY LEADERS
AND WITH THE COMMUNITY ITSELF TO
ADDRESS THE ISSUES AND TO
GENERATE CONVERSATIONS AROUND
THE WAYS TO APPROACH THE
QUESTION OF MATERNAL DEATHS.
THERE IS ALSO THE QUESTION OF
DECOLONIZATION OF HEALTH CARE
AND STRUCTURE.
THE EFFORT ABOUT FIXING THE
HEALTHCARE HAS INVOLVED THE
RETURN TO VARIOUS MODELS AND
SYSTEMS.
PRINCE TRADITIONAL MIDWIVES AND
TRADITIONAL ATTENDANTS THAT WERE
DISEMPOWERED AND CRIMINALIZED
DURING THE COLONIAL PERIOD AND
CARRYING OVER INTO THE POST
COLONIAL PERIOD.
WHAT DOES THAT MEAN WHEN WE
THINK ABOUT HEALTHCARE
INFRASTRUCTURE AND WHAT IS
LEGITIMATE HEALTHCARE AND WHAT
KIND EVER HEALTHCARE IS SUITABLE
FOR PEOPLE NOT NOT FOR OTHERS,
FOR THE WESTERN WORLD BUT NOT
FOR THE OTHER PARTS OF THE
WORLD.
I'D LIKE TO START ON THAT NOTE,
THANK YOU FOR YOUR TIME AND I
LOOK FORWARD TO THE INTERACTIONS
IN Q&A.
>> THANK YOU.
WE HAVE A NUMBER OF QUESTIONS
AND I'M GOING TO GET RIGHT TO
THEM BECAUSE THEY ARE EXCELLENT
AS WAS YOUR TALK.
THANK YOU FOR THIS WONDERFUL AND
INFORMATIVE TALK.
YOU BEGAN BY NOTING THAT
MIDWIFERY WAS ILLEGAL IN THE
UNITED STATES IN THE EARLY 20TH
CENTURY.
MY UNDERSTANDING, THIS PERSON
WRITES, IS THE REASON BEHIND IN
RESTRICTIONS WITHS TO AT LEAST
SOME EXTENT THE
PROFESSIONALIZATION OF MEDICINE
AND THE IDEA THAT ONLY GRADUATES
OF ACCREDITED PROGRAMS COULD
PRACTICE MEDICINE.
S THAT BIASED EMERGED IN OTHER
PARTS OF THE WORLD AS THE NUMBER
OF LICENSED PHYSICIANS
INCREASES?
HAS THERE BEEN SIMILAR MIDWIFERY
AND OTHER CARE PROVIDERS?
>> THAT'S AN EXCELLENT QUESTION.
AND I'M GOING TO USE THE EXAMPLE
OF NIGERIA TO ANSWER THAT
QUESTION.
I'LL ANSWER THAT QUESTION IN TWO
PARTS.
ON THE ONE HAND, TRADITIONAL
MIDWIFES ALWAYS EXISTED IN
NIGERIA.
DURING THE COLONIAL PERIOD WHICH
WAS THE FIRST HALF OF THE 20TH
CENTURY, THE SAME PATTERN THAT
PLAYED OUT IN THE U.S., A
SIMILAR THING PLAYED OUT IN
NIERNLGIA AS WELL BUT PERHAPS
FOR DIFFERENT REASONS.
TRADITIONAL MIDWIFES BECAME
STIGMATIZED AND STEREOTYPED AND
DEFICIENCIES WERE BLAMED ON
DEATHS.
INFANT DEATHS AND MATERNAL JETS.
THIS WAS DUE TO MISSION TRIES.
MISSIONARIES SAW CHILD BIRTH AS
AN TEURNT OPPORTUNITY TO CHRIST.
THE LOGIC WAS TO OFFERING THE
SERVICES OF -- OFFERINGEDING AIA
WOMAN DURING LABOR AND DELIVERY
WAS A GOOD WAY TO GAIN ACCESS TO
THE WOMAN AND HER FAMILY BECAUSE
THEN THERE WAS A GOOD SCHANS
TH --CHANCE THAT THE MISSIONARY
DOCTOR, MISSIONARY OFFICIAL WHO
WAS OFFERING THIS SERVICE WOULD
BE ABLE TO BAPTIZE THE BABY.
ABLE TO CONVERT THE WOMAN AND
THROUGH THE WOMAN WOULD BE ABLE
TO HAVE ACCESS INTO HER NETWORK
AND COMMUNITY.
AND ONE OF THE THINGS THAT THEY
DID VERY CLEARLY WAS TO IDENTIFY
TRADITIONAL MIDWIVES, A LOT OF
TRADITIONAL PRACTITIONERS AS THE
OBSTACLE TO THE
CHRISTIANIZIZATION.
THE PEOPLE WHO UPHELD THE
TRADITIONAL STRUCTURES AND
ELEMENTS OF THE RELIGIONS THAT
THEY WERE SEEKING TO UPROOT.
THERE WERE SIGNIFICANT EFFORTS
TO THEN STEREOTYPE MID WHICH MIO
GET THEM OUT OF THE WAY TO GET
BIRTHS INTO THE HOSPITAL.
THIS WAS PARTLY SUCCESSFUL BUT
PARTLY NOT.
WHAT HAPPENED WAS WOMEN BEGAN TO
GO TO THE HOSPITALS FOR THE
PRENATAL VISITS OR WHAT ARE THE
BRITISH WORLD IS CALLED THE
AT-NATAL ADVISORIES BUT THEY
DELIVERED AT HOME WITH THEIR
MIDWIFES OR FAMILY MEMBERS.
THERE WAS THAT DIMENSION TO IT
AND THEN THERE WAS THE ELEMENT
OF THE BRITISH COLONIAL
GOVERNMENT AS WELL.
IT CREATED BIOMEDICAL
ENTERPRISES.
A LOT OF THE FRAMEWORK WAS SET
BY MISSIONARIES.
BECAUSE FOR THE FIRST 20 YEARS
OR SO OF THE 20TH CENTURY, THE
FIRST 30 YEARS, ACTUALLY,
BETWEEN 1900S AND 1930s, THE
COLONIAL GOVERNMENT I GO KNORRED
WOMEN'S HEALTH.
IT WAS LARGELY WORK BY
MISSIONARIES UNTIL THEY IS
DECIDED THAT WOMEN AS HEALTH WAS
IMPORTANT IN TERMS OF LABOR
SUPPLY.
IN TERMS OF SUCCESSFUL CHILD
BIRTH, PROTECTING THE LABOR
SUPPLY WITHIN THE COLONIES.
AND SO, WHAT HAPPENS FROM THEN
IS THAT THERE WERE MORE MOVES
AND POLICIES TO DISEMPOWER
MIDWIVES.
THERE WAS BRIEFLY A CONVERSATION
ABOUT TRAINING -- JUST LIKE WE
TALKED ABOUT CAN THE TBA,
UPGRADING THEIR KNOWLEDGE AND
TRAINING THEM TO UTILIZE THEM
BECAUSE IT WAS IMPOSSIBLE TO
PROVIDE SERVICES TO THE WHOLE OF
THE COUNTRY, TO THE REST OF
NIGERIA.
BUT THAT IDEA DID NOT
MATERIALIZE.
THAT IDEA WAS DROPPED AND THERE
WAS THE PUSH TO JUST MAKE CHILD
BIRTH A MEDICAL THING AND AN
EVENT THAT HAPPENED IN THE
HOSPITAL.
AND THAT BECAME THE TREND.
THERE WAS THE GENERAL STEREOTYPE
AND STEREOTYPING OF TRADITIONAL
MEDICINE INCLUDING TRADITIONAL
MIDWIFES.
THIS PRACTICE CARRIED OVER INTO
POST COLONIALIZED NIGERIA.
THE TRAINING OF MIDWIVES WAS A
DIFFERENT DEVELOPMENT.
THIS WAS PART OF THE BIOMEDICAL
FRAMEWORK.
MOST OF EUROPE DID NOT OUTLAW
MIDWIFERY.
MIDWIFERY BECAME PART OF THE
BIOMEDICAL CARE SET UP.
THE SAME THING PLAYED OUT IN
COLONIAL NIGERIA.
IF A WOMAN HAD ENOUGH EDUCATION
TO TRAIN AS A NURSE OR MIDWIFE
OR NURSE/MIDWIFE THAT'S WHAT SHE
BECAME.
SO THERE WERE TRAINED MIDWIFES
AND TRADITIONAL MIDWIFES TO
SIDELINE THEM.
JUST LIKE IN THE U.S., IN A LOT
OF THE RURAL COMMUNITIES AND
DIFFERENT COMMUNITIES IN
NIGERIA, IT WAS THE MIDWIFE THAT
WAS THEIR OWN RESOURCE.
HENCE ACNM'S EFFORTS WERE TO
TRAIN THESE WOMEN TO UPGRADE
THEIR SKILLS AND TRAIN BIRTH TEN
DAATTENDANTS.
>> THANK YOU.
THANK YOU VERY MUCH.
ANOTHER PERSON HAS WRITTEN IN
WITH THANKS FOR YOUR WONDERFUL
TALK.
I'M INTERESTED IN LEARNING MORE
ABOUT ATOCA AND THAT JANUARY RA
OF PUBLICATION.
I'VE APE SEEN SOMETHING SIMILAR
IN EAST AFRICA.
WAS PART OF THIS APPEAL THAT A
PROJECT CREATED IN ONE LANGUAGE
COULD BE REPRODUCED WITH A
PRINTED DIALOGUE.
IN OTHER WORDS, WERE THERE
EFFORTS IN THESE PROJECTS TO
CREATE TOOLS MORE UNIVERSAL OR
REGIONAL OR DID THEY FOCUS ON
TRAILERING RESOURCES AND
MESSAGES TO SPECIFIC LOCAL
COMMUNITIES 1234.
1234 -- COMMUNITIES?
>> I AM ALSO INTERESTED IN THAT.
THERE WERE MODERN CARE PROJECTS
WAS ACTIVE.
BUT WHAT I CAN TELL FROM THE
DOCUMENTS THAT I'VE REVIEWED IS
THAT -- THERE WASN'T NECESSARILY
AN ATTEMPT TO MAKE THE MESSAGING
UNIVERSAL.
THOSE MESSAGING WAS TARGETED TO
THOSE SPECIFIC AUDIENCES BECAUSE
IN A PLACE LIKE NIGERIA LIKE THE
DIFFERENT HEALTH ZONES THAT I
DESCRIBE, THEY HAD THREE
DIFFERENT LANGUAGES.
IT WAS EBO IN THE EAST, U RABI
IN THE WEST AND [INDISCERNIBLE]
IN THE NORTH.
AND SO, THE LANGUAGES DIDN'T
NECESSARILY SPEAK TO EACH OTHER,
EM SO WITH ATOCA, IT WAS
SPECIFICALLY DIRECTED TO THAT
COMMUNITY.
THE WAY THAT THE MOTHER CARE
PROJECT OPERATED, THE ISSUES
PRINTED IN [INDISCERNIBLE], I I
COULDN'T FIND A RADIO LIABLE
IMAGE FOR THAT ONE.
THE MESSAGE THEY PUT IN THOSE
MEDIA OR THE RADIO SHOWS IN
NORTH WERE TAILORED TO THE
PROBLEMS THEY IDENTIFIED IN
THOSE AREAS.
FOR INSTANCE IN THE NORTH, ONE
OF THE ISSUES THEY HAD TO DEAL
WITH WAS A FEMALE JENT TALL
MUTILATION THAT OCCURRED.
IN THE WEST, THE MESSAGING THAT
THEY PUSHED OUT HAD TO DO WITH
THE A VOIRDENS OF EATING CERTAIN
FOODS LIKE LEAFY GREENS OR EGGS.
THESE MESSAGES WERE TAILORED TO
THOSE PARTICULAR AUDIENCES.
THE VARIOUS MEDIA CHOSEN ALSO
REFLECTED THOSE MESSAGES AND THE
LOCATION WHERE THOSE MESSAGES
WERE BEING PUSHED OUT.
>> THANK YOU.
SO THERE ARE TWO QUESTIONS
SOMEWHAT RELATED.
BOTH OF THESE INDIVIDUALS, THANK
YOU VERY MUCH FOR A GREAT TALK.
THE FIRST INDIVIDUAL TALKS ABOUT
IF YOU COULD TALK ON HOW IF AT
AIL THE ACNM IMPACTED THE BIRTH
OUTCOMES AND I WONDER ABOUT THE
CONVERGENCES IN THE ACNM PROGRAM
OF COMBATING OVERPOPULATION AND
THE PUBLIC HEALTH AGENDA OF
PRETENTING MATERNAL DEATHS AND
ENCOURAGING HEALTHY MOTHERHOOD.
>> EU8 STI WILL ANSWER THE LASTE
AND ASK YOU TO REMIND ME OF THE
FIRST.
THE TENSION BETWEEN, YOU KNOW,
THE EU S EUGENICS OF POPULATION
CONTROL AND CONTROLLING MATERNAL
DEATHS WERE NOT JUST LOCAL IN
NIGERIA.
THIS WAS NOT JUST HAPPENING IN
ACNM.
BY THE 1980s, THERE WAS IN
NATIONAL DEVELOPMENT IN THE
POPULATION CONTROL MOVEMENT
ITSELF.
1980s ESPECIALLY AS A RESULT
OF A LOT OF THE DATA THAT HAD
BEEN GENERATED AS A RESULT OF
THAT WORK RELATED TO PRAKING
POPULATION, TRACKING HEALTH, THE
EXTENT OF THE NATURE OF MATERNAL
DEATHS HAD BECOME OBVIOUS
GLOBALLY.
WOMEN AS ORGANIZATIONS AND
MEMBERS OF THESE -- ALL OF THESE
ORGANIZATIONS THAT WERE ALSO
DOING POPULATION-RELATED WORK,
MOUNTED A REVOLUTION.
THEY BEGAN TO PUSH BACK ON THE
EXTREME FOCUS ON POPULATION
CONTROL.
THE FOCUS ON FAMILY PLANNING
PROGRAMS AT THE EXPENSE OF
MATERNAL HEALTH OR MATERNAL
DEATHS IN TERMS OF IMPROVING THE
OUTCOME OF PREGNANCIES.
ACNM WAS A PART OF THIS
CONVERSATION.
THIS WAS A TREND, A GLOBAL TREND
ACROSS THE WORLD.
WHERE THE NEW
KINDS OF PEOPLE IN THESE
ORGANIZATIONS BEGAN TO PUSH FOR
A LOOK AT MATERNAL HEALTH CARE.
AN APPROACH THAT DID NOT JUST
FOCUS ON FAMILY PLANNING, BUT
FOCUSED ON THE SURVIVAL OF WOMEN
DURING CHILD BIRTH AND DELIVERY
OR POSTPARTUM.
THE FIRST PART OF THE QUESTION
TALKED ABOUT WHETHER ACNM
PROJECTS AFFECTED MATERNAL DEATH
OUTCOME.
>> BIRTHING PRACTICES AND
MATERNAL MORTALITY OUTCOMES,
YES.
>> NOW THIS IS SOMETHING THAT I
HAVEN'T LOOKED AT YET.
ONE OF THE THINGS THAT I HOPE TO
DO AS MY PROJECT PROGRESSES IS
ACTUALLY TO LOOK AT WHETHER
THERE ARE ANY STATISTIC POINTING
TO WHAT MATERNAL DEATHS, WHAT
THE NUMBERS LOOKED LIKE.
WE KNOW A LITTLE BIT OF WHAT THE
NUMBERS LOOKED LIKE IN THE 198
OS BECAUSE NIGERIAN DOCTORS, THE
OBJECT STEK TRICKS IN NIGERIA
WERE DRAWING ATTENTION TO THAT.
I ALSO KNOW FROM WHAT I FOUND SO
FAR THAT THE MINISTRY OF HEALTH
IN NIGERIA UNDER DR.
[INDISCERNIBLE], THE BROTHER OF
THE FAMOUS FELLOW WOULD KNOW, HE
WAS THE MINISTER OF HEALTH AT
THE TIME.
IN 1989 AND 1990, ONE OF THE
THINGS THAT HE IMPLEMENTED WAS
TO REQUIRE HOSPITALS ACROSS THE
COUNTRY TO ACTUALLY REPORT
MATERNAL DEATHS TO THE FEDERAL
GOVERNMENT.
THERE WAS AN EFFORT BY THE
MINISTRY TO COLLECT STATISTICS
ON MATERNAL DEATHS BUT ALSO
INFORMATION ON THE CAUSES OF
MATERNAL DEATHS.
NOW, WHAT I DON'T KNOW AND WHAT
I'M TRYING TO FIND OUT, PART OF
THE DATA THAT I'M TRYING TO GET
AHOLD OF IS THOSE DATA.
WHAT WAS SUBMITTED, WHAT WAS
COLLECTED, WHAT KIND EVER
PICTURE THAT IT PAINTED.
BUT RIGHT NOW, I HAVEN'T TRACKED
WHAT THE OUTCOMES WERE IN TERMS
OF THE NUMBERS.
AND AT THAT POINT, NIGERIA HAD
NOT GOTTEN GOOD AT RECORDING --
THIS WAS A COUNTRY THAT GAINED
INDEPENDENCE IN 1960.
FOUGHT A WAR IN THE '60s AND
IN 1970, THE WAR ENDED AND THERE
WAS A RECESSION IN THE 1908S.
IT WAS -- 1980s.
IT WAS STRUGGLING TO CATCH ITS
BREATH AND HAD DIFFERENT CHANGES
IN GOVERNMENTS BY MILITARY
TAKEOVERS AND PARTICULAR
DICTATOR SHIPS.
THOSE DATA WERE NOT STABLE AND
IT GOT BETTER IN THE EARLY 20TH
SEEN TOURY.
NIGERIA LE RELEASED NUMBERS EVEY
YEAR THAT TRACKED THESE THINGS.
I KNOW THAT THE CULTURAL IMPACT
OF ACNM PROJECTS AND THE
PROJECTS WORKING IN NIGERIA, THE
FACT THAT A LOT OF CONVERSATIONS
WERE BEING HAD.
YOU HAVE TO DESIGN A RESEARCH TO
TRACK THOSE IMPACTS.
BUT THERE WERE PUBLIC
DISCUSSIONS IN A WAY THAT NEVER
HAPPENED PREVIOUSLY ON MATERNAL
HEALTH, ON PREGNANCY AND SOME OF
THE DANGER SIGNS.
HOW TO RECOGNIZE THE DANGER
SIGNS AND THE DANGERS OF CERTAIN
CULTURAL PRACTICESES.
THIS IS WHERE THESE MAGAZINES
AND RADIO SHOWS CAME IN.
THERE WERE DISCOURSES TO THE
EXTENT THAT HAVE NEVER BEEN HAD
PREVIOUSLY AND HAD NEVER BEEN
HAD SINCE THEN EITHER.
THAT'S THE BEST WAY THAT I CAN
ANSWER THAT QUESTION RIGHT NOW.
>> THANK YOU.
SO WE HAVE TIME FOR ONE MORE
QUESTION AND IT DOES PERTAIN TO
THOSE SOURCES THAT YOU ARE
ALLUDING TO THAT WERE PART OF
THE PUBLIC DIALOGUE, THE
TELEVISION PROGRAMS AND VIDEOS.
THE QUESTION IS TO WHAT EXTENT
BEYOND WHAT YOU PRESENTED DO YOU
HAVE A SENSE OF THESE MATERIALS
STILL EXIST?
HAVE YOU HAD CHAMS FINDING THEM?
TO WHAT EXTENT WERE THEY WE FEM
REHE HAVEFEM RWEPHEMERAL.
>> I HAVE COPIES FROM THE
MAGAZINE FLS 1989.
THE MAGAZINE DID GO OUT OF PRINT
IN THE 1990s.
I'M TRYING TO FIND THE COPIES
FROM 1989 UNTIL THEY GO OUT OF
PRINT.
ONE OF THE GOOD SOURCES TO FIND
THINGS LIKE THIS BECAUSE THESE
WERE MAGAZINES, AND PUBLIC
DOCUMENTS, UNIVERSITY ARCHIVES
IN NIGERIA BUT ALSO THE NATIONAL
AARCHIVES TEND TO HAVE MAGAZINE,
POPULAR MAGAZINES IN THEIR
COLLECTIONS.
SO THE NEXT TIME THAT I HAVE THE
OPPORTUNITY TO DO ARCHIVAL
RESEARCH, ONE OF THE THINGS I'M
GOING TO DO IS LOOK AT THOSE
UNIVERSITY ARCHIVES, THOSE LOCAL
ARCHIVES WITHIN THE REGION.
ONE OF THE PLACES WHERE THIS
MAGAZINE WAS POPULAR HAS A
UNIVERSITY, AND THE UNIVERSITY
ARCHIVE AS WELL.
THERE IS A GOOD CHANCE THOSE
WILL BE THERE.
THERE AS IS IS ALSO THE QUESTIF
OF INDIVIDUALS WHO MAY HAVE KEPT
THESE.
THERE IS A GOOD CHANCE THOSE
WOULD BE IN PRIVATE COLLECTIONS.
I'M GOING TO FIND OUT HOW
ACCESSIBLE THESE THINGS ARE
SOONER OR LATER BECAUSE I DIDN'T
KNOW THEY EXISTED UNTIL I
STARTED GOING THROUGH MY RECORDS
AT THE NATIONAL LIBRARY OF
MEDICINE.
I FOUND OUT ABOUT THE EXISTENCE
OF THE MAGAZINE AND SOME OF THE
PROJECTS ACNM DID WITH THE
MAGAZINE A FEW MONTHS AGO.
>> CERTAINLY, IF WE CAN BE A
FURTHER RESOURCE FOR YOU AT THE
NATIONAL LIBRARY OF MEDICINE, DO
BE IN TOUCH.
ON BEHALF OF THE ENTIRE LIBRARY,
I WOULD LIKE TO THANK YOU FOR
THE GREAT LECTURE TODAY.
WE WISH YOU EVERY CONTINUED
SUCCESS WITH YOUR RESEARCH AND
WRITING AND YOUR SECOND BOOK.
LOOK FORWARD TO READING IT.
>> THANK YOU.
THANK YOU VERY MUCH.
>> THANK YOU, HAVE A GOOD
AFTERNOON.
>> THANK YOU EVERYONE.
>> WE'LL KEEP IN TOUCH.
BEFORE WE SAY A FORMAL GOOD-BYE,
I WOULD LIKE TO THANK EVERYONE
FOR TUNING IN TO THIS WONDERFUL
ON HISTORY TALK AND FOR YOUR
PARTICIPATION IN ALL OUR TALKS
DURING THE 2024.
OUR 2025 SERIES WILL BE
ANNOUNCED EARLY IN THE NEW YEAR.
IN THE MEANTIME AND THERE AFTER,
DO BE IN TOUCH WITH US AS IF WE
CAN BE A RESOURCE FOR YOU.
WE WELCOME YOU TO VISIT OUR WEB
TIGHT AT NLM.NCH.gov AND WHAT
WE OFFER TO SUPPORT RESEARCH AND
AS WELL, ANSWER HEALTH-RELATED
QUESTIONS THAT YOU MAY HAVE.
AGAIN, THANK YOU VERY MUCH.
WE WELCH YOU A GOOD DAY WHERE
YOU ARE AND LOOK FORWARD TO SEE
SEEING YOU IN THE NEW YEAR.
THANK YOU.