Nutrition Interventions Securing Livelihoods in Hard-to-Reach Areas of Borno

Kano State's Zero Dose Learning Hub Community of Practice on Immunization is tackling the crisis of over 280,000 unvaccinated children in the state by coordinating across government ministries, the State House of Assembly, and community leaders to ensure immunization commitments translate into actual funding and vaccine delivery. Its effectiveness is reflected in a dramatic rise in immunization budgets. On the ground, Voluntary Community Mobilizers have helped dispel myths about vaccines.

Traditional birth attendants provide maternal care to women in hard to reach areas. With government help through the Mama2Mama program, several TBAs are undergoing training to provide safer, more effective maternal care.

Being in a conflict zone, primary healthcare in the state of Borno in Nigeria has suffered in recent years. In response to the crisis, Community Management of Acute Malnutrition (CMAM) centers provide Ready-To-Use Therapeutic Food (RUTF) to treat children with severe acute malnutrition (SAM). The centers also work in tandem with Community Nutrition Mobilizers (CNMs) to follow up with mothers to ensure that the children are taking the medicine, to educate them on malnutrition in children, and to offer other primary care provisions like immunizations.

Facing a measles outbreak in a vaccine-hesitant community, Shasta County public health officials contained the spread by routing their response through trusted local intermediaries, including school principals, church leaders and clinic managers, rather than just relying on government messaging. The approach combined rapid contact tracing with a non-judgmental communication strategy designed to work with, rather than against, residents skeptical of government authority. Within two and a half months, the outbreak was declared over, with only nine confirmed cases total.

The Taimaka Outpatient Clinic operates a community-based malnutrition treatment model that brings severe acute malnutrition care closer to families. Since 2019, Taimaka has treated over 12,000 children and currently cares for more than 10,000 children annually.

Jacquelyn Alvarado, a certified nurse midwife with the Texas A&M Rural and Community Health Institute, travels across Texas to teach rural hospital staff how to deliver babies. Using a mannequin, she runs simulations covering both routine and complicated deliveries for ER nurses, paramedics, and other non-obstetrical staff who may be the only help available when a rural patient goes into labor.

Community health workers are stepping in to deliver essential healthcare services where conflict has destroyed local health facilities. These locally-trusted health workers conduct door-to-door visits to provide immunizations, screen children for malnutrition, refer emergency care and offer mental health support to those who need it, bridging gaps where traditional services can’t operate.

In 2025, Bauchi State launched the Impact Project to address Nigeria's maternal health crisis by deploying 100 Skilled Birth Attendants across 20 Local Government Areas, alongside free delivery kits and regular salary payments to increase access to professional childbirth care.

The Bauchi State Impact Project aims to improve maternal and newborn health by training 100 people to become skilled birth attendants. Despite infrastructure challenges, the Project not only provides work and purpose to those trained, but also helps make childbirth safer by providing much-needed care.

In Bauchi, Nigeria, Community Health Influencers, Promoters and Services (CHIPS) conduct home visits, screen for hypertension, and detect tropical diseases in communities where healthcare is hard to access. In Bauchi alone, the program has screened over 1.2 million people, identified approximately 54,000 hypertensive patients, and treated 67 cases of neglected tropical diseases within a single year.