Transforming Rural Healthcare through GEANCO’s Modular Clinics

Tzar Oluigbo (Lead Writer)

One day at a time, one community at a time, GEANCO Foundation is driving down maternal and child mortality in the rural and urban poor communities where they work.

When you walk into any community where the GEANCO Foundation is scaling up healthcare with its modular clinic model, what you find is cutting-edge technology in these remote communities. These clinics are fitted with 24-hour solar power and an electronic patient record system (EPRS). This EPRS can be made accessible to medicals doctors and health professionals based in any part of the world to consult on a patient’s issue.

The modular clinic can be easily scaled up, if the same approach is used. In just four years, they have grown from one location to six and each of these locations is designed to be sustainable, affordable, solar-powered and equipped with an electronic records system.

Image credit: Nigeria Health Watch

Maternal and infant mortality account for a significant portion of Nigeria’s mortality statistics, with over 61% of women in Nigeria still giving birth outside healthcare facilities. Providing quality care during pregnancy continues to be a significant challenge, especially in rural communities.

GEANCO is supporting birthing centres in remote and urban poor areas by supporting them with clinics and technical support. Their intervention aims to reduce mortality rates by providing quality health care, skilled health workers, effective procedures, accountability and well-equipped facilities.

The Geanco modular clinic maternity ward. Image credit: Nigeria Health Watch

A model for expansion

One of the major factors contributing to high maternal morbidity and mortality in Nigeria is the lack of access to skilled maternal healthcare services, as women who own birthing homes continue to serve as the main providers of maternal healthcare in many rural and urban poor communities.

“Originally our work was more with established government hospitals as well as government Primary Healthcare Centres (PHCs) but we quickly realized that the most vulnerable in our society do not go to those locations. People at that vulnerable level value dignity and they are often treated very badly so they don’t patronize them, and they also don’t have the money to do so. They operate at the periphery of society and many of the PHCs are not equipped, or prepared, and do not treat them well. At the very heart of their preference for birthing centres is Dignity and affordability,” Obi Okoye, the Country Director of GEANCO Foundation.

Image credit: Nigeria Health Watch

GEANCO does not own these clinics, they identify a birthing centre with a very high volume and go there to help the owners modernise and bring in trained health workers, nurses and midwives.

“All we do is bring modern medical approach and skilled workers to those locations to improve the outcome for them. We follow the women to the very place where they prefer to go. This is the very core of our strategy. Places where they are treated with dignity and have access to payment plans. They do not ask to be treated free of charge they just ask for allowance to pay within what they can afford, Okoye noted.

Chikeluba Ngozika Elizabeth, who accessed medical care in one of GEANCO’s facilities noted that, “since I found out about GEANCO I always prefer here because my heart is here. The other birthing homes I used to go to or hospital, sometimes shout and slap during the delivery process. But here they treat me with care. Here they give us money for fruits and even drugs. That’s why we are full here because they take care of us well. I’ve given birth to two, I’m pregnant with the third one.”

Midwife at the Robin and Estelle Clarke Fanily center during immunization. Image credit: Nigeria Health Watch

“My name is Happiness Agbo. This is the perfect place, the dream place for any pregnant woman to be. This is my second issue and the first one I had here, I’ve never experienced that kind of love before”.

GEANCO operates a swift referral system where women are trained with a prompt referral system. In four years across its six clinics, GEANCO has facilitated over 1400 deliveries without a single recorded mortality.

Tambourine Family Healthcare Centre

GEANCO’s modular clinic was initially designed with a single maternity ward, an examination room and a post-natal ward. However, the growing number of patients seeking quality care highlighted the need for additional capacity to manage multiple deliveries and recoveries effectively.

Mrs Ani Sarah, a midwife at the John and Terry Family Centre in Ishiagu Akwunanaw, Ugwuaji, Enugu State, mentioned that they often faced overcrowding, including a high number of outpatients. She noted that the primary challenge was the lack of space, with the centre handling an average of 12 to 20 deliveries each month.

The Julia Burke Maternity Center, Enugu State. Image credit: Nigeria Health Watch

Umumbo in Umuezechi Village, Anambra State has a population of approximately 10,000 people and is home to the Tambourine Family Health owned by Mrs. Umeadi Ifeoma. This clinic is the sixth clinic established by the GEANCO Foundation. The Julia Burke Centre, located in Enugu’s Coal Camp, stands as a symbol of women’s empowerment in the community, thanks to the dedicated efforts of the Foundation.

The Tambourine Family Health Centre operates on land owned by the clinic owner, while the Julia Burke Centre is built on land leased by birth attendants with support from the GEANCO Foundation. After the Tambourine modular clinic was established, the clinic owner was encouraged to expand the facility. Since the land belonged to her, she was advised to use block work for the expansion, ensuring a durable and sustainable addition to the clinic. The expansion included two fully equipped wards to accommodate more patients.

Mrs Umeadi, a mother of three, two daughters and a son received training as a birth attendant from 2010 to 2012. In 2017 she established her birthing centre where she served as a birth attendant for seven years before receiving donations from GEANCO to support the clinic’s growth.

Mrs Umeadi Ifeoma, clinic owner and Midwife Udodirim Adaeze at the Tambourine Family Health Center, Umumbo, Anambra. Image credit: Nigeria Health Watch

Looking Ahead

The use of birthing homes remains prevalent in rural communities, particularly among communities with limited access to education, and is often associated with maternal complications. Providing training for the women who own birthing homes and integrating them into the formal healthcare system, along with ongoing public education about their roles and limitations, could significantly reduce the maternal morbidity and mortality associated with untrained attendants.

“We provide training on a continued basis to help change the mindset and skill level. Mindset change of the local women who have not been exposed to modern things is a challenge,” Peace Agbo, clinic supervisor at GEANCO Foundation

“It’s difficult to stop these women, if you drive them, one will open in the bush and these women will still go to her in the bush because they prefer them. Let us encourage them to do the right thing, know their limitation and know when to refer”. CEO Redeemers Hospital. Mrs Charity Ibe (RN/RM)

Image credit: Nigeria Health Watch

Nigeria has a mortality ratio of 1,047 per 100,000 live births. We should start looking at locally developed solutions that leverage the resources we have, while considering our unique context. Let us take the solutions to where the people are and where they prefer to access care.