Improving reproductive health services through task shifting in conflict-affected Rann. The project aims to respond to the needs of the targeted community 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 lots of experience in caring for pregnant  labour and Community Health Extension Workers CHEWs are lay health workers trained by the government 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.  During the insurgency in Rann in January 2019, all healthcare workers stationed in the area left, leaving a massive gap in the delivery of maternal health care interventions and programs by trained health care professionals.  

Due to the security situation in Rann, it is currently impossible to both station health care professionals, such as doctors and midwives, in Rann and provide bulk medical equipment and large quantities of consumables and supplies in the area as movement to the area is predominantly through air.  This component caters for those reproductive health gaps that were created and still exist after the January 2019 attack, by preparing the community to provide women with uninterrupted basic maternal health services through a form of task shifting. Registered midwives will conduct practical training of Traditional birth attendants (TBAs) and Community Health Extension Workers (CHEWS) whilst conducting basic antenatal and postnatal care, detection and recognition of danger signs of pregnancy and delivery.  A doctor will visit the area once or twice a week depending on the security situation to certify medical evacuation through UNHASS and treatment if appropriate medications are available. 

The midwives will focus on enhancing access to skilled health while training and mentoring TBAs and CHEWs during their time in Rann before returning to Maiduguri by the helicopter the same day.  TBAs and CHEWs will be provided with UNFPA’s 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 post-natal period and encourage exclusive breastfeeding for at least six months as a minimum standard.  

As the security situation in Rann is still volatile, the possibility for women to leave the area due to an 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 women are also likely to take it with them if they have to move quickly. 

2.	Support the community to prevent excessive amount of anticipated cholera disease outbreak cases during the rainy season that may threaten and further destabilise the area’s already severely deteriorated health care and water supply system. 

The area’s prevailing health and WASH situation is aggravated by continued lack of security and it’s inaccessibility.  With the rainy season fast approaching, an outbreak of communicable diseases such as cholera is almost inevitable, given the overcrowding conditions and limited access to proper water, sanitation and hygiene situation in the camps in Rann. This component seeks to enhance hygiene promotion for cholera prevention through awareness raising campaigns in the community.  Hygiene measures are currently being tackled by Tdh’s WASH team who will be joined by the Health team to provide enhances hygiene and health messages in a bid to preventing high case load of cholera should there be an outbreak.