Nursing Education and Workforce Development: Implications for Maternal Health

Sunday, 17 November 2013: 11:20 AM

Mabel Ezeonwu, PhD, RN
Nursing and Health Studies, University of Washington Bothell, Bothell, WA

Learning Objective 1: The learner will be able to describe the relationship between nursing, nursing education and maternal health services provision in Nigeria.

Learning Objective 2: The learner will be able to identify major challenges that impact nursing education and workforce development in Nigeria

Background: Nurses in Nigeria play significant roles in maternal health services provision. The high maternal mortality ratio (MMR) in Nigeria – estimated at 630 per 100,000 live births (World Health Organization [WHO], 2011) is an indicator of serious maternal health needs. Training, recruitment and retention of appropriate number of health personnel, particularly nurses and midwives are crucial for maternal death reduction. Nurses and midwives direct and provide most obstetric care more than any other providers, and they are highly preferred in Nigeria (Ezeonwu, 2011). Although Nigeria has a relatively high number of nursing personnel – a pool of 210,306 nurses compared to other African countries (WHO, 2006), there is still a significant shortage of nurses required to meet the health needs of a country of over 154.7 million people (WHO, 2012), that lags in positive maternal health outcomes.. Emphasis on nursing education and workforce development presents legitimate policy discussions in efforts to improve maternal health.

Methods: For this descriptive study, face-to-face interviews were conducted with nurse experts and leaders in Nigeria. Qualitative content analysis was used to analyze the data.


  1. As mandated by the Nursing and Midwifery Council of Nigeria, nursing schools have competitive admission requirements, and rigorous and integrative curriculum.
  2. Pedagogical and multi-faceted health systems issues including unemployment, lower wages and migration plague nursing workforce development.
  3. The quality of instruction, the number and quality of nurse graduates, and the quality of care delivered, impact maternal health outcomes.

Conclusion: Nursing schools in Nigeria continue to graduate competent nurses despite tough challenges. The workforce is highly volatile with inadequate number of nurses available to care for the growing population, including women. Broader training and retention policies are needed to improve maternal health outcomes.