Sokoto State in northern Nigeria has the country’s poorest maternal and child health indices. The “one main primary health care facility per ward” in only 46 of Sokoto’s 240 wards meets the recommended requirement of two midwives and two community health extension workers (CHEWs), according to the Reaching Every Ward with a Skilled Birth Attendant (REWSBA) strategy published by Nigeria’s National Emergency Maternal and Child Health Intervention Centre (NEMCHIC). The availability of trained health care professionals with tailored life-saving skills is critical to address the country’s high maternal mortality rates.

The USAID/Nigeria Health Workforce Management (HWM) Activity supported the Sokoto State Government to implement a Cadre Conversion Initiative (CCI), aimed at converting its untrained health workforce into SBAs through enrollment into the Community Nursing, Community Midwifery, and CHEW training programs, to better meet the needs of pregnant women and their families and reduce maternal, infant, and child mortality. This technical brief describes both the implementation of the CCI and lessons learned by the HWM Activity with the hope of further refinement and scale-up.