Background:Behaviour Change Communication (BCC) is a key component of the roadmap adopted by the Nigerian government to address the high maternal and child mortality in the country.Objectives:The purpose of the study was to appraise the participation of midwives in BCC at the first level of health care in Kaduna State, Nigeria before planning a context specific and sustainable BCC capacity building programme.Materials and Methods:In-depth interviews were conducted with nine midwives selected by maximum variation technique across Kaduna State. Content analysis of the interviews was performed using a priory codes derived from the integrative framework.Results:The integrative framework provided a comprehensive appraisal of BCC in the facilities. Health talks were unplanned, difficult and more task-oriented than being behaviour change focused. The required skills, integrated services to enhance behaviour change by clients, and enabling environment, were missing. The findings were used, in collaboration with the midwives to develop and implement a context specific and efficient capacity building programme.Conclusions:The framework was adequate in identifying the gaps in the BCC activities of midwives at the facilities. There is a need to understand and support midwives with their BCC activities. Government policies should be brought closer to frontline staff who would implement them, by engaging such staff all through the process of developing the policies.

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"Get the nurses to go back to work" was the directive, after two years of intermittent labour strikes and consequent shutdown of the Federal Medical Centre, Owerri, South Eastern Nigeria. It was assumed that, since nurses constituted the largest percentage of health workers, their resumption would frustrate and end the strike. However, studies have shown that the use of force rarely worked. This study examined the nurses' perception of causes of the strikes and the government interventions. The WHO healthy workplace framework was adapted in recommending strategies to prevent reoccurrence. Exploratory research design with mixed method sequential exploratory data collection strategy was utilized. Findings from focus group discussions in first phase were used to develop Likert scale self-administered questionnaire at second quantitative phase. One hundred and thirtynine and 461 nurses participated in the qualitative and quantitative phases respectively. Epi Info statistical package was used for data entry and analysis of the quantitative data. Frequencies and percentages were calculated for all the items, and Chi-square was calculated between the senior and junior nurses' responses. The responses of the senior and junior nurses were similar on the items. All sixteen causes of the strike identified by participants were within Psychosocial Work Environment of the WHO framework. Disparity in salary was highest (443(96.1%), followed by highhandedness of the chief executive (436(94.58%). Participants opined that insincerity of the investigation panel (369(80%) and seriousness of the crisis led to the shutdown (341(73.97%) of the facility. Suggested fifteen preventive strategies against strikes covered two of the WHO's workplace environments. They included, the psychosocial environment: effective communication (450(97.61%), promotion of nurses as and when due (447(96.96%), harmonization of salaries (445(96.53%), change of chief executive (442(95.87%); and the physical environment: provision of materials to work with in the hospital (406(88%). Accurate reports by panels of enquiry (448(97.18%), appropriate prompt attention to the causes (447(96.96%), and avoidance of sentiments (446(96.75%) could prevent repeat shutdown of the facility. Chi-square showed no significant difference in the responses of the senior and junior nurses. According to the WHO healthy work place intervention model, elimination, substitution and modification of contents and processes in the workplace may be required. Stakeholders should avoid factors that hinder appropriate interventions; and uphold values that protect workers and the benefitting communities.

Most women perceive labour pain and childbirth as the most severe and agonizing event in a woman’s life. Midwives play critical role in supporting women through the painful birthing process, to the desired favourable outcomes for mother and baby. The primary objective of this study is to evaluate the practices and challenges of pain management during the initial stage of labour among midwives at the University of Medical Sciences Teaching Hospital Complex in Akure. From July to October 2021, a facility-based descriptive cross-sectional study was conducted with 72 midwives employed at the University of Medical Sciences Teaching Hospital Complex in Akure. The first stage of labour pain management practices and challenges were evaluated among the study participants using a questionnaire. SPSS (version 23.0) was used in processing the data. In the first stage of labour, environmental pain management approach was shown to be the most used (95.4%), followed by psychospiritual pain management approach (91%); while the least employed was the pharmacological approach (63.4%). Effectiveness of the approaches were perceived to be in the following order: psychospiritual, environmental, physical, pharmacological and social. Lack of resources (84.7%) and understaffing (33.3%) were cited as part of the challenges associated with pain management. It is important for the government to provide adequate staff, equipment and conducive birthing environments; while the midwives continually educate patients on available non-pharmacological and pharmacological labour pain management approaches during their prenatal care visits, to enhance their self-efficacy and cooperation in labour.

Nursing reforms in Nigeria took a quantum leap in 2018 with the alignment of nursing education with the mainstream of tertiary education in the country. Year 2023 has been scheduled for full implementation of the reform. The ultimate goal of reforms in nursing education is delivery of quality nursing care. This review was undertaken to highlight the critical roles of nursing leaders in Nigeria towards ensuring that the reforms in nursing education translate to quality nursing practice. The six critical roles discussed in the paper are expected to stimulate necessary activities towards maximizing the gains of nursing education reforms in the interest of the citizens.