Improving reproductive health services through task shifting in conflict affected Area (Rann-Kala balge) The aim of the proposed project is in the continuity of the first allocation, to provide life-saving sexual and reproductive health care services to IDP, host community and new arrivals in kala-bale LGA and more particularly Rann, the only town in the capital that is accessible to humanitarian actors. 

The project aims to contribute to responding to the needs of the targeted communities in terms of reproductive health in Rann (Borno state) through two main components:

1. Support the community through Registered Midwives Practical Observational Skills Training of
Traditional birth attendants (TBAs) and Community Health Extension Workers (CHEWs) to provide safe
clean delivery services and support for exclusive breastfeeding to women in a bid to reduce maternal
and neonatal mortality and morbidity.
TBAs (usually untrained but with a lot of experience in caring for pregnant women during childbirth) and Community Health Extension Workers (CHEWs) are lay health workers trained by the Ministry of health (MoH) to carry out healthcare delivery through a task-shifting model. Both are usually in the center of delivering modern, traditional and cultural maternal health-related interventions and are usually well respected in the community.
The insurgency in Rann during the first quarter of  2019 led to the departure of all healthcare workers stationed in the area, creating a massive gap in the delivery of maternal health care interventions and programs by trained health care professionals. Registered midwives will conduct practical training to TBAs and CHEWS, whilst conducting basic antenatal and postnatal care, detection, and recognition of danger signs of pregnancy and delivery. TBAs and CHEWs will be provided with clean delivery kits, registered and mentored on how to use the kits for optimum coverage of clean safe deliveries. Midwives will also mentor TBAs and CHEWs to take on case management of women during the post-natal period and encourage exclusive breastfeeding for at least six months as a minimum standard. A doctor will visit the area once or twice a week to provide supportive supervision and treatment for complicated cases if appropriate medications are available or certify medical referrals depending on the security situation to the secondary health care.

As the security situation in Rann is still volatile, the possibility for women to leave the area due to
attack is high. Therefore, Tdh will provide culturally appropriate Mama kits (as designed by UNICEF) for
visibly pregnant women. This does not only serve as an incentive for women to access services, but also women are likely to take it with them if they must move quickly.

2. Support the community to prevent an excessive amount of anticipated Measles disease outbreak cases
during the harmattan season that may threaten and further destabilize the health care system of the area.
This is coupled with a lack of security and access that aggravates the health situation of the area. With the cold season approaching, an outbreak of communicable diseases such as Cholera and Measles can happen, given the overcrowding conditions and limited access to proper Shelter and ventilation in the camps in Rann. This component seeks to enhance health promotion for disease prevention through awareness raising campaigns in the community.