Gaps in the health care system are a reality in the world’s poorest countries. Doctors and nurses are scarce and medical facilities are often far from where people live. For family planning programs to be effective, they must draw on the resources and networks that exist.


Many countries rely on community health workers (CHWs) to deliver family planning services. CHWs are not medical professionals; they are local residents—usually women—who are trained to provide basic health care, information and referrals. As members of the communities they serve, CHWs establish relationships of trust with their patients, making them ideally suited to provide family planning information. CHWs are often volunteers, but in some countries they are regular salaried employees of the government.




When Daniel Nanshep Gobgab was in medical school, his mother almost died from a miscarriage. She had already borne eight children including Daniel, but with her ninth pregnancy something went terribly wrong. She nearly bled to death before she reached the hospital. After the crisis had passed, Daniel persuaded his parents to agree to a tubal ligation.


Today, 30 years later, Dr. Gobgab is the Secretary General and Chief Executive Officer of the Christian Health Association of Nigeria (CHAN), the largest faith-based health consortium in the country. And his mother is still alive and enjoying her grandchildren.


As a doctor and a Christian, Dr. Gobgab feels strongly about the importance of family planning. He knows that women, children and families all benefit when women are able to take charge of their fertility. And he is confident that family planning is in line with the values of his faith.


“The same Bible that says we should multiply and fill the earth also says that he who does not take care of his family and provide for their basic needs is worse than an infidel,” he points out. In Dr. Gobgab’s view, Christians are called to be good stewards of God’s creation. That means they should use resources wisely, take care of their own health and have only as many children as they can responsibly support.


It’s a message that CHAN promotes through its network of health facilities, mobile clinics, and outreach programs. There are some 500 member institutions under the CHAN umbrella, ranging from large hospitals to tiny mission posts. Twenty-three Christian denominations are represented, both Protestant and Catholic. Their motto is “Reaching the Unreached.”


In the varied landscape of Nigerian health care, these faith-based institutions play a crucial role. Dr. Gobgab estimates that at least 40% of medical services in Nigeria are provided by CHAN’s member institutions. In remote areas, the figure is closer to 100%.


For rural villagers living far from any government medical facility, CHAN is a lifeline. Mobile clinics bring medicines, vaccines and antenatal care. Outreach lessons at the local church or community center provide important information on health and hygiene. Wherever possible, family planning information and supplies are part of the package.


“We’ll start with a word of prayer, letting them know that we are trying to do our best, but it’s God that helps to heal people,” Dr. Gobgab explains. “And after the prayer session, we give a 10-, 20-, 30-minute at most health talk. And family planning is usually one of the topics that is considered.”


CHAN institutions are active throughout Nigeria, offering health care to everyone regardless of religious faith. In the far north, where most people are Muslim and there are very few Christians, CHAN mobile clinics bring much-needed supplies and medical attention.


“We are not establishing the facilities for fellow Christians, but for everybody,” says Dr. Gobgab. “We don’t discriminate in our services.”


Learn more about expanding service in Ethiopia and Pakistan, the role of faith-based organizations and task-shifting in our full progress report.


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