This story was cross-posted with permission from USAID’s flagship Maternal Child Survival Program.
A newborn’s first haircut is more than a beautiful tradition in Bauchi state. It’s an innovative way to save lives.
In this northeast state, where only 13% of children are fully immunized by their first birthday, the obstacles to improving newborn health are enormous. A weak health system, low awareness and demand for immunization, lack of trained health workers, and vaccine shortages conspire to leave the northern region with the lowest rates of vaccination in the country.
Combating these dire statistics means reaching even the most remote families with lifesaving newborn health messages and shifting community norms. But how?
Locating newborns is the first challenge to improving their care. USAID’s flagship Maternal Child Survival Program (MCSP) is capitalizing on the contacts traditional barbers (wanzams) have with families in the region to turn newborn hair-cutting ceremonies into opportunities to identify, refer and track children as their families seek health services.
After two years – and countless haircuts – these barbers have proved invaluable in engaging communities and increasing acceptance of routine immunization (RI) in the region.
Abdulaziz Lawn arrives to the home of Nafisatu Bilyaminu (in blue) in Wandi village. Her family is preparing for Abdulaziz to shave the hair of her newborn, Abubakar Nafisatu – a joyous, day-long ceremony performed on the seventh day of a child’s life throughout northern Nigeria.
In collaboration with Nigeria’s State Primary Health Care Development Agency, MCSP is training traditional barbers like Abdulaziz to share lifesaving health messages with families during the rite-of-passage ceremony.
As he prepares to shave her son, he stresses to Nafisatu the importance of RI, adhering to the timing and schedule of vaccinations, and keeping a vaccination card for each child.
A key to acceptance of these messages is debunking rumors – such as links between immunization and sterilization – which Abdulaziz does while also counseling on vaccine side effects and safety. He explains the difference between preventative and curative services, and why it’s critical to have all babies registered at the health facility.
After the shaving ceremony is over and Abdulaziz has counseled the family on the RI schedule and benefits, he prepares the newborn’s referral card, encouraging them to take Abubakar for immunization at the nearby health facility. He also enters the newborn’s information into a tracking sheet, which he will use later during follow-up visits.
Once women are given the yellow referral card and instructions on getting their newborns vaccinated, navigating the health facility is an easier task. Above, Kayya Abdulkadir arrives to Wandi Clinic with her newborn son, Mohammed, with the card she received during his shaving ceremony.
Armed with the yellow card issued by her family barber during Mohammed’s shaving ceremony, she waits to have her baby vaccinated.
The RI In Charge, Ahmed Umar, administers the vaccinations to little Mohammed, while explaining key messages about the vaccines and the importance of follow-up visits to complete the immunization series.
In addition to immunizations, women bring their children to the clinic for general checkups.
After Mohammed is vaccinated, he is given a green card, showing his referral for immunization was completed. He is also issued a child health card, which includes information on the vaccines he has received to date as well as when he is due for his next round of immunizations.
To ensure families have completed their referral, barbers like Abdulaziz check in on babies a few weeks after their shaving ceremony. They collect green cards from those families whose children have received their vaccinations, and let local leaders and service providers know about those families who have not.
In Bauchi state, saving newborns from preventable illness and death is happening one household at a time. Since the initiative began, referrals have swelled to 4,000 a quarter, and the approach continues to improve linkages between communities and the health system.
By training barbers – trusted members in nearly every community in northern Nigeria – MCSP is innovating to reach families where they are.
"We accept their advice,” one father said of the barbers. “We trust them and know they would not bring any harm to our families.”
MCSP supports high-impact health interventions with a focus on 25 high-priority countries with the ultimate goal of ending preventable child and maternal deaths within a generation. JSI leads MCSP’s work in the areas of child health, immunization, and pediatric HIV. Our staff also contribute technically to MCSP’s cross cutting functions of measurement, monitoring, evaluation and learning, community health, and health systems strengthening, with a focus on the strengthening of routine health information systems and supply chain management.