Maternal and child health care challenges

The recent declaration of a state of emergency on public health in relation to maternal and child deaths occurring at the primary healthcare centres
could not have come at a better time.

Making the declaration in Abuja, the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr.
Fasal Shuaib, said the initiative would be called National Emergency Maternal and Child Health Intervention Centre (NEMCHIC). Dr. Shuaib disclosed that efforts would be geared towards tracking the
phenomenon, assuring that a target would be set to reduce the rate of the
incidents by half in the next two years.

He lamented the appalling health statistics in the country, especially in
the area of maternal and child mortality rate, noting that there was the need to reduce maternal and child care challenges through investigating
deaths of women related to childbirth and provision of toll-free numbers
for Nigerians to supply information to raise the sense of accountability for preventable deaths.

He was particularly enthused by the assurance indicated by the 36 states of the federation and the Federal Capital Territory (FCT), Abuja, to buy into the initiative to achieve its purpose.
The step taken by the NPHCDA is coming a couple of years after a renowned professor of obstetrics and gynaecology, Abiodun Aboyeji,
called for a declaration of a state of emergency in the sector to address
the issue.

The professor was speaking on the issue of high maternal mortality rate
in the country at the 150th inaugural lecture of the University of Ilorin, entitled “Pregnancy: The Burden of Womanhood”. He stressed the need
for the political prioritisation and commitment to safe motherhood. According to Prof. Aboyeji, Nigeria was losing an average of 40,000
women annually to the health challenges. He was of the opinion that the use of modern contraceptives would reduce maternal mortality by 30 per cent.

He said, “It is regrettable that the practice had not progressed as expected in the last 10 to 15 years, in view of the fact that about 70 per
cent of victims are young people hovering around 18 years and below.

“It goes without saying that these young girls should be discouraged from getting pregnant. This could be achieved by educating them on how
to manage their fertility, get pregnant when they want and stop child
bearing when they want as a way of reducing the scourge considerably. “Indeed, how else can we describe a condition that is responsible for
the deaths of 3,333 women every month in Nigeria, 769 every week, 109 every day and five every hour, leaving between 800,000 and 1.2m others
with permanent disabilities?”

The professor hit the bull’s eye when he stressed that “Nigerian
women are at a disadvantage. They are unable to use modern contraceptives because of non-availability and inaccessibility as well as a male dominated society not approving legal abortion services
because of restrictive abortion laws and sheer hypocrisy.

Even when the pregnancies are intended and wanted, health facilities across the
country are mal-distributed, poorly equipped and understaffed to take care of them. Eventually in the process of delivery, thousands die
which in itself is a tragedy as most of the deaths are avoidable”.

The scourge now being addressed by the NPHCDA is a corollary
of the deplorable state of the nation’s healthcare delivery system. It is regrettable that maternal mortality rate has remained high and
worrisome in the face of the advancement of modern medical science which those charged with the country’s health management have
failed to tap into owing to poor policies and programmes as well as
their implementations across the board.

Aside from the reasons advanced above, other factors fueling these preventable deaths include ill-disposition of some religious leaders and
socio-cultural stance against contraceptives, inaccessibility to good medicare, delivery through unskilled birth attendants, patronage of
traditional midwives, poverty and ignorance.

Then there is the spiritual angle. Many women have thrown their lives away while exercising
their faith on the orders of their pastors for natural delivery when it was obvious that a caesarian section would be the best option.
Moreover, the healthcare policy of the government at all levels is not citizen-friendly and does not favour the average Nigerian woman who
depends on the public hospitals and clinics to access medicare. Besides,
owing to congestion in public healthcare destinations, deplorable service delivery and high charges, many have surrendered their fate to
patent medicine dealers, hospital/clinic attendants masquerading as
midwives in their neighbourhoods and quack healthcare givers.

In the build-up to delivery, some women do not attend ante-natal clinics regularly either out of ignorance or poverty especially in the
rural communities where maternal mortality rate is very high. It is during this gestation period that the health condition of the mother
and the unborn baby is monitored to ensure safe delivery.

Blueprint commends the initiative of the NPHCDA. We also urge the various state governments and stakeholders to key into the new
project by putting in place free medical programmes as a deliberate attempt to address the needs and challenges of maternal and child
care. Child bearing should not be a matter of life and death. The joy of motherhood is not only to have a safe delivery but also to stay alive.

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