The maternal mortality rate in northern Nigeria is one of the highest in the world. In Bauchi State, women bear an average of eight children in their lifetimes, yet only 45 percent of them receive prenatal care. Less than 1 percent of Bauchi’s children under age one are fully immunized. Bauchi is one of the last places where the wild polio virus is still a threat. And the average person living in Bauchi experiences two malaria episodes a year—with pregnant women and small children affected the most.


Overcoming the extraordinary health challenges for women and children requires commitment and partnership at all levels, particularly with traditional and religious leaders, who can use their trust and authority to change health behavior.

USAID’s Targeted States High Impact Project (TSHIP), a five-year maternal, child, reproductive health and family planning initiative, is engaging traditional and religious leaders to change community behaviors and perceptions about health care. TSHIP strengthens community-based organizations, making them more responsive to the basic health requirements of members of their communities, especially women and children. TSHIP collaborated with the Bauchi government to host a two-day meeting to enable these leaders to discuss with health officials how they can improve health outcomes in their communities. The group explored issues such as the health status of girls and women, birth spacing options, and the importance of children receiving immunizations on schedule.

Change is never quick or easy; but because traditional and religious leaders have longstanding relationships with their communities based on trust, they are in a strong position to help overcome the cultural barriers preventing health-seeking behavior.

Traditional and religious leaders are now engaged in improving community health through advocacy. Interestingly, the meeting also illuminated that the concept of safe motherhood is entrenched in Islamic tradition that states that the shortest period between the births of two babies should be two years, and women are advised to breastfeed for two years. This changed many attendees’ perceptions, and leaders acknowledged that women should be empowered to seek medical services when needed.