In Diffa, Niger, armed group incursions have deepened a humanitarian crisis since 2015, and the only health centers operating in Diffa municipality close around 2 p.m. for security reasons, leaving women in labor without qualified staff. The IRC’s PRET-SRHR project (Partnering for Resilience to Emergencies through Transformation of Sexual and Reproductive Health Rights) trained matrones, community birth attendants that families already trust, to spot danger signs in pregnant women and newborns and refer them to health facilities.

The project also trained matrones in family planning, post-abortion care and gender-based violence prevention, and trained 88 health workers and equipped health centers. By the end of its second year, 2,922 births had been attended by skilled health personnel in supported facilities (81% of the three-year target), 10,272 women had completed a first antenatal visit (76%) and 309 had received post-abortion care (74%). Matrones also reached 16,505 people through community outreach.

The report concludes that moving care to the community level is possible, and essential, in fragile settings, and that the approach could be adapted across the Sahel. Sustaining it will take continued investment from the Diffa Health District, the regional health directorate and the government of Niger, including how matrone training and supervision will be financed.

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