Professional governance ensures that healthcare practitioners provide safe, ethical, and competent care to the public. In Nigeria, midwifery practice does not exist in a vacuum; it is guided by laws, regulations, and collective bodies that maintain standards. Professional governance means the nursing and midwifery workforce takes responsibility for regulating its own conduct, defining its scope of practice, and disciplining erring members.
Without a strong professional body, standards would fall, leaving mothers and newborns vulnerable to poor care. The Nursing and Midwifery Council of Nigeria (NMCN) sets the legal rules for training and licensure, while professional associations unite practitioners to protect their interests and uphold professional ethics. Understanding how these bodies govern practice is essential for every student midwife entering the Nigerian health system.
The National Association of Nigeria Nurses and Midwives (NANNM) is the umbrella trade union and professional organization representing all nurses and midwives in Nigeria. Its creation unified various fragmented colonial-era nursing associations into a single, formidable voice. Structurally, NANNM operates hierarchically from the grassroots up to the national level:
This structured approach ensures that the challenges faced by a midwife in a remote primary health clinic can reach national policymakers.
NANNM serves a dual mandate as both a professional association and a trade union. This means it protects professional standards while fiercely defending the economic and working rights of its members.
Midwives frequently work in high-stress environments with staff shortages, lack of basic equipment, and personal security risks, particularly in rural postings. NANNM plays a critical role in safeguarding practitioners against unjust treatment, arbitrary deployment, and unsafe workloads. When hospital managements subject midwives to hostile work environments or demand they practice outside their legal scope due to staff deficits, the association steps in to defend them.
Furthermore, NANNM collaborates with legal experts to provide defense support when members face unfair disciplinary measures or legal battles arising from clinical practice. Promoting a safe working environment directly translates to better protection for childbearing women, as exhausted and unprotected midwives cannot deliver optimal care.
The healthcare landscape changes rapidly with new clinical guidelines, pharmacological treatments, and technological advancements in maternal care. NANNM works alongside regulatory bodies to promote Continuing Professional Development (CPD) among its members. Through workshops, scientific conferences, and specialized updates, the association ensures that midwives keep their skills sharp long after graduation.
While the NMCN mandates CPD points for license renewal, NANNM actively organizes affordable educational sessions across various state chapters and specialty groups—such as the National Association of Paediatric Nurses and Midwives and the Midwives Association of Nigeria (a professional specialty subgroup within NANNM). This commitment to lifelong learning bridges the gap between basic training and modern evidence-based midwifery practice.
No professional association can achieve its goals in isolation. NANNM maintains active partnerships with the Federal Ministry of Health, state health boards, and legislative committees to influence health policies. When bills affecting maternal and child health or nursing education are proposed in the National Assembly, NANNM provides expert memoranda and legislative advocacy.
On the international stage, NANNM collaborates with global organizations such as the International Confederation of Midwives (ICM), the International Council of Nurses (ICN), and the World Health Organization (WHO). These partnerships align Nigerian midwifery standards with global best practices, ensuring that local practitioners contribute to international health targets like reducing maternal mortality.
Despite its long history and vital contributions, NANNM faces significant hurdles in fulfilling its mandate. The persistent brain drain (locally known as *Japa* syndrome)—where skilled midwives migrate abroad for better pay—has stretched the remaining workforce thin. This creates severe burnout, increased error risks, and immense pressure on association leadership to negotiate better retention packages.
Other challenges include bureaucratic delays in government negotiations, underfunding of primary health care, and occasional internal administrative friction. Looking to the future, NANNM must embrace digital transformation in its union operations, strengthen young leadership mentorship, and relentlessly champion task-shifting policies that empower midwives to practice to their full capability in reducing maternal mortality across Nigeria.