Using maternal, new-born child health interventions to save lives, especially for the returning IDPs in Yobe state, MUSA M. BUBA, who attended a workshop recently, reports that the state government had to evolve the strategy to stop maternal and child deaths, either as a result of ignorance or neglect by past governments
Overview Nigeria despite its wealth, has the highest number of maternal and child deaths in Sub-Saharan Africa, with an estimated 40,000 maternal deaths and 827,000 child deaths between 1990-2013. To reduce maternal mortality which was stagnant some years ago and also address the issues, the Maternal, New-born and Child Health Programme MNCH2 was created in June 2014, to improve maternal newborn child health and routine immunization in northern Nigeria.
But at a recent workshop, strategies were evolved on how MNCH2 will save thousands of lives, especially the returning IDPs in Yobe state. It is also aimed at improving health system coordination through health sector planning and improves demand for access to high quality services.
Interventions by MNCH2 in Yobe The MNCH2 in Yobe has renovated dozens of health facilities at Ajiri in Bursari local government, Dikumari and Murfa-kalam in Damaturu local governments, made outreaches, supply of equipment among others apart from the strengthening of manpower. It has been meeting regularly to review health issues, built capacity and make recommendations to government especially in regards to maternal deaths, immunization through creating awareness and provide manpower packages that will attract and retain health workers in the system.
With the influence of MNCH2 in Yobe, during the first quarter of 2018 17,703 assisted skilled personnel was recorded, 521,908 pregnant women made at least 4 AntiNatal Care (ANC) visits. Newborns and mothers who received care within 24 hours of delivery by skilled health care provider stood at 59,673, children fully immunized against vaccine-preventable diseases were 644,251, while additional women who accepted family planning were 193,715.
Government’s budgetary allocation With the gap identified and declining trend of budget allocation to health sector in which Federal Ministry of Health had directed all states to allocate atleast 15 percent budgetary allocation to health sector to fight killer diseases, Yobe state governor because of its commitment to the wellbeing of the citizens went an extra mile by approving N 1 3 , 6 8 9 , 2 1 4 , 0 0 0 . 0 0 representing 15.3 percent in the 2018 budgetary allocation to health sector in order to silence the maternal deaths.
Maternal deaths in Yobe Despite the Yobe state Multibillion naira budget in the health sector, 171 maternal deaths were recorded in 10 hospitals of the state in the 2017 which translates approximately into 14 deaths per month.
The YOSAMM after review of 2017 said, “most of the maternal deaths occurred were as result of delay in reaching health facility, while some are still of the culture of home deliveries which called for more awareness campaigns.
Review of 2015-2017 fi scal year The Yobe State Accountability Mechanism YOSAMM supported by MNCH2 during a three day meeting in Damaturu, after painstakingly review the health budget from 2015-2017 commended efforts of Yobe state government for giving priorities to health sector saying, Yobe is one of the leading states in the country in terms of healthcare delivery. Vox-pop with beneficiaries/official Maryam Ilu Bayamari, “I never attended ANC services during my previous pregnancies, Feature but now after being a member of the young women support group, I understand the benefits attached to the ANC services and I have attended twice”. Bilki Mohammed Dikumari“Although this is my third child, I am proud to be the first woman in this community who attended ANC and delivered in the health facility on a new delivery bed”.
Dr. Hauwa, ES, PHCMB, “I would like to appreciate the efforts of MNCH2 in introducing the organizational capacity tool. This tool has been helping this organization in reviewing and updating our processes”.
Results The efforts by MNCH2 have brought strong collaboration between government and other agencies with increased number of women with pregnancy related complications to respond to health facilities. The conduct of mop-up exercises has gone a long way in improving late reporting on MNCH outcomes.
Also frequent engagements and collaboration between service providers and medical records officers had led to improvement in recording of antenatal (ANC) and essential care services provided immediately after delivery.
Sustainability During a two day workshop held recently, a University Don, Professor Muhammad Bello Shitu, an MNCH2 Consultant and Vice President, International Association for Community Development, Glasgow, United Kingdom, said MNCH2 would be winding down its activities in 2019, and there is a thinking that it should be sustained even after the expiration of the programme. “This is an opportunity to look inward and outward to come-up with an opportunity that is aimed at supporting the programme to carry forward with its work”, he said.
This can only be achieved when the state government and stakeholders come together to know the immense contribution the MNCH2 has done in order to discuss its sustenance.
Improved quality of life for women, children The existence of the programme in the past four years has saved lives and improved quality of life for women and children through the empowerment of communities and strengthening of health system in Yobe. It has also created a quality continuum of care from prepregnancy through life of a child to reduce maternal and child mortality