Rhoda Robinson

Rhoda Robinson is redefining the role of traditional birth attendants to improve maternal healthcare in Nigeria. By reestablishing a structured framework for equipping traditional birth attendants with the skills and systems to save lives, she has created a sustainable support network that extends from pregnancy to two years postpartum.

In the most difficult rural areas to access, where the distance from a community to a primary health care centre is 5-10 or more kilometres away, on narrow dirt roads or only on foot, Rhoda Robinson has shown how to bring modern medical care to these pregnant women and drastically reduce the rate of infant mortality. Her work not only safeguards the lives of mothers and their newborns, but also leverages the trust built through this process to expand care into the postpartum period for up to 2years.
Rhoda began developing her idea while she was a basic medical student living near rural communities, working to transform the relationship between traditional birth attendants and the broader medical system—from one of isolation to full integration into primary healthcare systems. Through a structured framework that redefines the role of TBAs, provides them with new professional identities, standardized training, and simple yet effective referral systems, Rhoda has successfully positioned TBAs as essential contributors to the formal healthcare system.
After completing her studies at the college of medical sciences, she launched a pilot of this new approach in Ogun State, a state that had limited rural medical infrastructure, and, when that was successful, a second pilot test in Oyo State, which had more advanced medical infrastructure. The success of both pilots has now spurred public health authorities to replicate the system in 16 more states across Nigeria. There has also been independent replication of the system in South Africa and four other African countries, namely Ghana, Kenya, Uganda, and Zambia, as well as in India.

Rhoda’s next new idea is to expand the concept of postpartum care beyond the conventional 6 to 12 months, where it typically is focused solely on immediate medical needs. She envisions a two-year model that supports new mothers with preventive, long-term family healthcare. This includes access to health insurance, financial literacy training, such as setting up savings accounts, and participation in a peer-based accelerator where they can learn how to launch and grow small businesses together.

Nigeria is grappling with one of the most alarming maternal health crises in the world. According to the Nigeria Demographic and Health Survey (NDHS), Nigeria accounts for nearly 20% of global maternal deaths, with rural infant mortality rates up to 700% higher than the national average. In these rural areas, women face formidable barriers to maternal healthcare: long distances to facilities, high costs, and severely under-resourced Primary Healthcare Centres (PHCs). Although PHCs are officially tasked with providing maternal services, they often struggle with staff shortages, inadequate supplies, and inconsistent care. Without standardized protocols or reliable referral systems, access to life-saving treatment frequently depends on chance or the discretion of individual health workers.

As a result, many women rely on Traditional Birth Attendants (TBAs)—community caregivers who are trusted for their cultural relevance and accessibility but generally lack formal medical training and essential equipment. Operating outside the formal health system, TBAs remain the primary maternal care providers in many regions, perpetuating a fragmented and unsafe healthcare environment.

A critical flaw in this system is the lack of coordination between TBAs and PHCs. Without structured collaboration, TBAs work in isolation, often unable to identify or manage complications such as postpartum hemorrhage, obstructed labor, or neonatal distress. High-risk cases are frequently referred too late—or not at all—leading to preventable maternal and infant deaths. TBAs also typically do not maintain records or report outcomes, resulting in scarce maternal health data. This gap hampers efforts to monitor trends and develop targeted interventions. Postnatal care is especially neglected; in rural communities, fewer than 15% of women receive follow-up services after childbirth. Most new mothers lack medical checkups, counseling, or support, leaving them vulnerable to infections, postpartum depression, and untreated reproductive health problems.

At the heart of this crisis is the failure to integrate TBAs—vital to rural maternal care—into the formal healthcare system. Often dismissed or mistrusted by medical professionals, TBAs are excluded from training and collaboration. This exclusion not only sustains unsafe practices but deepens community mistrust of formal health services. Compounding the problem, societal norms prioritize newborn health over the mother’s wellbeing, and healthcare systems focus primarily on infants after initial immunizations, leaving maternal health concerns largely ignored.

Ultimately, Nigeria’s maternal health system is failing women and infants—not from lack of effort or cultural commitment, but because of fragmented services, insufficient resources, and poor coordination. Closing these gaps requires integrating TBAs into the formal system through comprehensive training, clear referral pathways, and ongoing support. Extending care beyond childbirth and connecting community and formal health actors can save lives and improve outcomes for mothers and babies alike.

Rhoda's approach is changing how traditional birth attendants are perceived—restoring their dignity, reinventing their role, reinforcing their contribution and reintegrating them into the formal healthcare system. She equips them with necessary training and builds a structured referral system between them and nearby clinics, ensuring they have the support they need to provide safer care. Rhoda understood that her strategy had to be based on the insight that, in rural communities where the formal health system is far or absent, women still seek care, but they just turn to trusted, familiar faces. Recognizing this, Rhoda identified three key groups already supporting maternal health: traditional birth attendants (drawing on lived experience and local customs), faith-based caregivers who integrate prayer and spiritual teachings, and retired midwives, matrons who may no longer work formally but still have the skills. By starting from the most localized networks of care, she builds on their strengths, scaling up to reshape national policy to make these informal actors a part of the official health response.

In her early pilots, Rhoda brought all these groups under one unified designation— “Community Birth Attendants” (CBAs)—a powerful shift in identity that signaled dignity, legitimacy, and purpose. She equipped them with medical training, diagnostic tools, and structured care protocols—not only to manage safe deliveries but, more crucially, to detect danger signs and to be able to refer high-risk cases swiftly and accurately. She then partnered with local government leaders to institutionalize the role of CBAs within the Local Community Development Area (LCDA) primary healthcare framework—ensuring they are not just trained but recognized and supported as frontline providers.

The first pilot in Ogun State revealed what real integration could look like. Rhoda and her team relied heavily on training manuals, explainer videos, and role-play exercises to walk CBAs through the new system—how to take and file consultation notes, how to schedule center-based births, and how to maintain a two-way communication line with health centers. Over two years, they trained both CBAs and PHC staff to work as a unit. Each CBA was now responsible for documenting every interaction with a pregnant woman—either by writing notes or dictating them through a trusted family member. These notes, brought to health center visits or shared during check-ins, formed the backbone of a live, shared patient file. Health workers and CBAs were expected to pick up each other’s calls—turning communication into commitment and referrals into a functioning bridge between community and clinic.

To reinforce this system, Rhoda partnered with the University of Ibadan and other technical collaborators to build a digital platform connecting CBAs, PHCs, midwives, and tertiary hospitals. This web-based system introduced real-time patient filing and referral alerts, enabling hospitals to receive critical case updates even before a woman arrived, enabling a swift, informed response. Emergencies like postpartum hemorrhage or neonatal distress could now be flagged early, and community liaison officers were assigned to each cluster to handle logistics—from emergency transport to facility coordination. The model spread quickly in Ogun and Oyo States, demonstrating that decentralized actors, when connected by clear systems and mutual accountability, could transform maternal care from the bottom up.

Rhoda’s model goes far beyond ensuring safe delivery—it redefines what true continuity of care looks like. Rather than ending care at childbirth, each Community Birth Attendant (CBA) provides personalized support for up to two years after birth. This includes regular home visits, nutritional monitoring for mother and child, early childhood development assessments, emotional support, and timely referrals to healthcare and early education services. By embedding this long-term, relationship-based care into the heart of her model, Rhoda transforms maternal health from an episodic service into a sustained support system that follows women through one of the most vulnerable phases of life.

This continuity is made possible through a tightly coordinated system. CBAs remain in close communication with Primary Healthcare Centres (PHCs), using shared records, regular check-ins, and scheduled calls to ensure that no mother or child falls through the cracks. Health trends can be tracked in real-time, early warning signs flagged, and interventions made before issues escalate. This two-way, community-to-clinic bridge ensures that rural women receive the same continuity of care expected in high-functioning urban systems—personalized, proactive, and accessible.

To address one of the most persistent barriers—financial exclusion—Rhoda introduced co-health savings schemes, developed in collaboration with Access Bank and local microfinance institutions. These low-barrier, group-based models enable women to pool small contributions (as little as ₦50,000, or $60 USD) and unlock access to emergency health services and subsidized insurance. Integrated within community networks and directly tied to local health infrastructure, these schemes decentralize financial power and place it firmly in the hands of women—making healthcare both affordable and dignified.

But Rhoda didn't stop at maternal health alone. She recognized the postpartum period as an untapped window for both health and economic transformation. She next pioneered Postpartum Accelerators—structured, peer-led programs that combine mental health support, financial literacy, and entrepreneurship training. Facilitated by CBAs and local women leaders, these accelerators allow new mothers to co-create microbusinesses that generate income while reinforcing community bonds. Through this model, postpartum care becomes not just a medical necessity but a launchpad for women’s economic empowerment and social leadership.

Taken together, these elements form a self-reinforcing system: access to care fuels financial confidence; economic agency sustains long-term health outcomes. Rhoda is shifting the maternal health paradigm—from reactive, facility-based interventions to a proactive, community-driven movement that restores power to women as changemakers in their own lives and communities.

Growing up in a single-parent household in a rural Nigerian community, Rhoda experienced firsthand the stark health disparities that plague underserved areas—high maternal mortality rates and widespread neglect of women and girls. Limited access to healthcare, education, and economic opportunities deepened these challenges, fueling Rhoda’s determination to address the root causes of health inequities, including gender inequality, lack of education, and economic disempowerment that trap communities in cycles of poverty and poor health.
As a teenager, Rhoda took initiative by founding the “To Be Done” Club, rallying her peers around shared goals. She was given an hour each week to manage the school library and launched a book club to inspire learning. At her church, she took charge of children’s programs, creating classes and supporting teachers. Later, while studying physiology, Rhoda formed a theatre group to raise awareness among her peers about the health challenges faced by the impoverished communities where she chose to live—opting out of campus dormitories to immerse herself in their realities.
In 2007, while at university, she launched the HACEY Health Initiative. Initially, it mobilized fellow medical students to provide healthcare services in nearby rural communities. As Rhoda’s understanding of the complex health issues facing rural women grew, so did the mission of HACEY. Today, the nonprofit she founded leads efforts to improve the health and wellbeing of women, girls, and young people across Nigeria and five other African countries.
Beyond transforming rural healthcare delivery in Africa and India, HACEY champions broader campaigns addressing the challenges rural women face. It launched the ‘Hands Up for HER’ initiative, which has empowered over 150,000 young women across Africa by promoting gender equality and reproductive health rights. Through its coordination of the Salvus Project, HACEY supports women survivors of sexual violence and female genital mutilation via a network of community-based advocates in rural areas.