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Supporting Social Service Workers to Promote Better Health Outcomes

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by Carol Bales, communications officer, IntraHealth International

Mohammed Adamu Adangba, a social service worker in Nigeria, was getting his bachelor’s degree when a professor approached him about helping children who had lost parents to HIV/AIDS.  

“That was 2002 and stigma of HIV and AIDS was very, very high,” he says. “The prevalence rate was over 5% and a lot of people were in denial, not going for testing. And the children that had lost their mothers and fathers were neglected and treated terribly.”

At the time there wasn’t a lot of funding support for child protection at the local level in Nigeria. But Adangba signed up immediately as a community volunteer and received specialized training. He worked with community members to identify children in need, report cases of abuse and neglect, help children access care, and initiate a local response.

A shortage of social service workers to provide services for children in need

In 2014, there were 17.5 million orphans and vulnerable children in Nigeria. There’s also a shortage of trained social service workers like Adangba, who help these children receive the services they need. In Nigeria, 95% of orphans and vulnerable children do not receive any type of medical, emotional, social, material, or school-related assistance.

According to the most recent Nigeria Demographic and Health Survey, HIV/AIDS is still a major reason for the high number of orphans and vulnerable children. These children often lack basic support, like access to education and health care. Many are abused and neglected, affected by violence or trafficking, and struggle with mental, emotional, and physical health challenges.

And while the roles of doctors, for instance, are understood across countries, the roles of social service workers are often misunderstood and under-recognized. Social service workers often do not receive the support they need to carry out their jobs well and grow professionally, including appropriate and ongoing training.

Adangba has experienced this firsthand. “It’s overwhelming when you go to communities and the resources are not there to help as many people as you want,” he says. “The government ministries responsible for taking care of orphans and vulnerable children are grossly short of social workers, and those that are there lack capacity and need additional training.”

Mohammed Adangba talks with girls who are out of school“Social service workers are often transferred whether they have competencies or not,” he says. “They can be moved from one department or job to another without the proper background.”

The Nigerian government has committed to helping these children and established the Orphans and Vulnerable Children Division in the Federal Ministry of Women Affairs and Social Development to provide integrated services for vulnerable children, focusing on the community level.

An important part of health teams

At IntraHealth International, where I work, we see social service workers like Adangba as an important part of health teams and vital to improving the population’s health.

To quote my colleagues, “Social service workers form a vital safety net for children and families made vulnerable by the HIV epidemic and other circumstances, providing access to an array of services to promote well-being and protection from harm, including referrals for primary health services such as family planning and maternal and child health care.”

Although IntraHealth’s work focuses on health workers, we’ve applied our health workforce expertise and approaches to strengthen the social service workforce. Together, frontline health workers and social service workers can identify and provide holistic care to more families in need.

We’ve even worked with Adangba.

Adangba worked with us on our global USAID-fundedproject, CapacityPlus—as well as the Ministry of Women Affairs and Social Development, UNICEF, and other partners—to coordinate the mapping of the state child protection system in Federal Capital Territory State. The goal was to strengthen the overall child protection system at the state level, improving the case management and referral processes so that children affected by HIV/AIDS and other vulnerabilities are identified and cared for in a timely way.

Part of a larger mapping activity in six states, the process involved identifying the laws, policies, and structures for child protection that currently exist in each state, assessing the system to see what needed to be improved, and identifying and costing priority changes. Nigeria now has a clearer picture of its social service workforce, and state governments are using the findings to improve services for vulnerable children.

IntraHealth has worked in other countries and at the global level to strengthen the social service workforce. For example, we’ve helped Malawi and Tanzania implement our iHRIS open source HR software to better manage and deploy their social service workforces; documented the composition of the social service workforce to move toward a common understanding of the functions, education, and training typically associated with different types of workers; and refined a framework for professionalizing the social service workforce. IntraHealth is also the fiscal sponsor and host of the Global Social Service Workforce Alliance.

Strengthen the system, so more children receive care

While some social service workers provide direct support to vulnerable children (like social workers) or focus on national-level policy and government coordination, Adangba continues to mobilize efforts at the community level. He’s now a protection manager with the International Rescue Committee in Nigeria.

Over the years he’s worked with traditional leaders, religious leaders, teachers, and health workers to organize efforts that recognize and respond to children’s needs.

Through his work, and community structures he helped set up, Adangba learned about four children who were living with their grandmother. Amos, Christiana, Elijah, and Wei (ages 2–17) lost their mother to HIV/AIDS. They have two different fathers, one is absent and the other died of HIV/AIDS.

“When I first met them, none of the children were going to school,” Adangba says.

He’s since enrolled all four children, and 300 more in similar situations, in school. He arranged for waivers for their school fees and worked with the community to provide books and uniforms.

For children with HIV and other health issues, he works with local health workers to get the medical care they need. 

This week IntraHealth is joining the Global Social Service Workforce Alliance to participate in Social Service Workforce Week to celebrate the social service workforce and highlight promising ways to strengthen this vital workforce.

Learn about other social service workers like Mohammed Adamu Adangba. We’d like to introduce you to:

The Alliance has a wealth of information available on this topic, including this Webinar: Strengthening Social Service Systems through Cross-Sectoral Collaboration: Multidisciplinary teams in communities and local health facilities.