As 2020 began, 125 “mentor mothers” were helping to build healthy communities in southwestern Nigeria — explaining where to go for an HIV test, sharing information about family planning, emphasizing the benefits of antenatal care and more. They took particular care to ensure their outreach sessions were accessible to everyone in the community, using local languages as well as sign language for the hearing-impaired.

Then COVID-19 struck and Nigeria locked down. “All our community outreach took place in groups, in crowded areas,” says Obatunde Oladapo, Executive Director of Ibadan-based PLAN Foundation, which trained and supported the mentor mothers. “With COVID-19, we couldn’t go on as before.”

But Oladapo knew the impact of suspending this work could be severe. Since the start of the pandemic, nearly 12 million women worldwide have lost access to contraceptives, and experts have projected that COVID-19 could set back the fight against HIV by more than a decade.

Ensuring that people with HIV were able to keep taking antiretroviral medication during the lockdown was a top priority for PLAN. Some mentor mothers stepped up to become community-based distributors, delivering HIV medications and other essential supplies including condoms and other contraceptives directly to their clients’ doorsteps. This service was critical in plugging immediate gaps. But it couldn’t replace the day-to-day outreach the mentor mothers had been providing in their communities.

So PLAN launched Happy Mother / Abiyamo Alayo, a weekly hour-long bilingual (Yoruba and English) radio show that currently airs on local radio stations in Oyo State and Osun State. Each week, a different guest (often a mentor mother or community healthcare worker) shares information on a particular women’s health issue and takes calls from listeners with specific questions. In addition, the show offers a hotline number that listeners can dial to receive information privately. PLAN refers those callers to their closest mentor mother for personalized assistance.

Happy Mother / Abiyamo Alayo has been a hit, attracting callers from across the two states where the radio stations broadcast – far beyond the communities where PLAN mentor mothers typically operate. To offer individualized support, PLAN compiled a database of community health workers and primary care facilities spanning the breadth of both states.

“Now, when someone calls we can refer them for care based on their address,” Oladapo explains. “We’re actually reaching more people than ever before. Thanks to Happy Mother, we managed to convert the adversity of COVID-19 to our advantage.”

For PLAN, turning adversity into advantage is nothing new – for instance, when they saw people at risk for TB turning to local drug vendors rather than primary clinics, PLAN decided to enlist the vendors as allies, teaching them to identify individuals in need of treatment and make referrals to TB clinics.

Similarly, knowing that many pregnant women rely on community birth attendants (CBAs), PLAN enlisted CBAs when first setting up the mentor mother program in 2017. Most CBAs are very experienced in supporting uncomplicated births, but may not know how to respond to or even recognize more complex needs, and typically do not offer the range of related services a woman would receive at a formal clinic. After going through PLAN’s training, in addition to supporting pregnancy and childbirth, CBAs are now able to advise their clients on sexually transmitted infections, HIV prevention and treatment, and other important sexual and reproductive health issues.

Mentor mothers also learn how and when to refer women to health clinics for additional services – and to make the most of these clinic visits, PLAN has enlisted health care workers to serve as “facility focal points,” a woman’s first point of contact when she visits a clinic. They assess her health needs and refer her as needed within the facility to ensure comprehensive care.

“We used to see the community birth attendants as obstacles, but now they’re our allies,” says Oladapo. “Especially during COVID-19, many women don’t need to go to a clinic for antenatal care. They can get what they need right in the community. But if a woman does need clinical care, now the birth attendants and facility focal points work together to make sure she gets it.”

Because PLAN already recognized and invested in community resources and expertise, like CBAs and informal drug vendors, when COVID-19 struck the organization was able to draw on the community to deliver health supplies to those in need. Now Happy Mother/Abiyamo Alayo and its related referral database are expanding PLAN’s reach, connecting women to support in their communities and in clinics across Southwestern Nigeria.

“The community is in the driver’s seat here – our job is to build the community’s capacity to address problems and to help them take advantage of the facilities that are here to serve them,” says Oladapo. “COVID-19 makes everyone’s work harder, for sure. But it’s also pushing us to think bigger than ever before.”