The Resource Center for Human Rights and Civic Education (CHRICED) has continued to advocate for the rights of citizens as they intensify call on all to join hands in holding government accountable for use of maternal health resources. ENE OSANG writes.
As argued by CHRICED, with the Nigerian economy only recently managing to crawl out of serious recessionary period, the key questions that has agitated the minds of citizens and development partners alike is how to ensure proper use of available resources to ensure the realisation of developmental goals.
The centre expressed concerns on how to address the unending problem of maternal and child mortality in the country, saying the huge governance challenge has led to the absence of credible data and reliable information on budgetary allocation to health.
A recent report it launched recounted the chilling story of a pregnant woman in labour that was abandoned in the hospital by her husband and left to die.
The report stated that, “The husband to the pregnant woman finally took his wife to the hospital after protracted labour at home and eloped under the excuses of getting blood for the wife.
“When the man failed to show up after almost two hours, the hospital management mobilised to get the required blood in order to rescue the woman and her unborn baby.
“To the surprise of the hospital, the man returned the next morning with a car and a casket to evacuate the corpse of the wife expecting the poor woman to have died from the protracted labour and childbirth related complications.”
These sad narratives are expressions of the everyday challenges facing women and children in the country.
Baseline study
CHRICED further shared a baseline study it published in 2019 while briefing the media on the state of the nation in Abuja on Monday, stating that there was the need for Nigerians to stop the blame game and begin to tackle the menace of maternal and child deaths in Nigeria.
The baseline study titled “Towering Hopes and Aborted Dreams” assesses the efficiency and effectiveness of government spending on maternal, newborn and child health care in Kano state.
The study shows that Nigeria is one of the most dangerous places in the world for a woman to give birth, adding that the WHO statistics ranks Nigeria fourth on the global ranking of countries with the highest maternal, newborn and child mortality.
“Did you know that in Nigeria, Kano state has the highest maternal mortality rate in the country with 576 out of every 100,000 women in Kano state dying during or immediately after childbirth, and only 5.1 per cent of children born in the state we are delivered y health professionals.
“113 out of every 1, 000 children born in Kano state die during or immediately after childbirth, yet the state receives the highest percentage of budgetary allocations to the health care sector in Nigeria, including other donations.
“Year-in, year-out, Kano state government, supported by noon governmental organisations and international development partners commit huge amount of resources to maternal, newborn and child mortality health care in the state.
“If international development partners, donor agencies and the government of Kano state are committing so much money and resources into maternal newborn and child health care in Kano state, why are women and children in the state still dying everyday before, during or shortly after childbirth?
“Why is Kano state primary healthcare system unable to meet the healthcare needs of its people, and why do they still have large shortage of essential healthcare workers to attend to women and children.”
Budgetary allocation
Unlike the norm where most policies are not implementing for the lack of adequate financial allocation, CHRICED stated that its research team found out that Kano state has sufficiently prioritises its budgetary allocation to the healthcare sector as at the time of the research.
“There is adequate government policies on health care generally and primary healthcare in particular. These include state policy on free maternal health and ante-natal care, free immunisation, free vaccination and free emergency health care, health contributory scheme for financing health, health trust fund, and functional drugs revolving funds in health care facilities.
“The research team found that the state sufficiently prioritised its budgetary allocations to the health sector in line with the national commitment during the three year period which is the focus of the research. Why then has maternal, newborn and child mortality persists?”
According to the study, the research team found out that no adequate provision was specifically made for primary health care issues which are expected to address the health needs and other medical issues that directly impact on the common population especially women and children.
“Primary health care is under one roof, furthermore most of the stakeholders have no input in what was budgeted as allocations were only made based on resources available without necessarily considering the critical need of the different sectors and facilities.
“The most disturbing issue is the discovery by the research team that about less than 30 per cent of the funds budgeted for capital projects were released to the relevant sectors and facilities. This has seriously impacted negatively on the performance of the budget as implementation of the budget has left so much to be desired.”
CHRICED’s findings
In a bid to proffer solution to the unending maternal, child mortality the centre found out that the money budgeted by the government for maternal health are not completely released, and the amount released not properly utilised for taking care of pregnant women and new born babies.
“We found out that only 49.91% of the total Kano state budgetary allocation to the health sector was actually released. Also, there is weak accountability mechanism for tracking the utilisation of budgetary allocations, which leaves room for mismanagement and misplacement of priorities in health budget and implementation.”
CHRICED, therefore, tasked citizens to speak up and take action to draw the attention of the relevant information or agency responsible for the provision of health care services to the problems in the primary healthcare centers in communities.
“You must know that your right to quality health care comes with responsibilities. If government awards a contract for a health project in your community, you must be interested in ensuring the contractor delivers the right to quality work.
“Join other citizens in your local community; form yourselves into an advocacy group that will take up the responsibility of monitoring how the money allocated to the primary health center in your community is spent.”
Recommendations
Amongst the solutions proffered for a quality health care delivery CHRICED said there was need for adequate government policies and budgetary allocation on health. Improvement of infrastructure, staffing, accountability mechanism, performance review, timely release of funds for project, amongst others.
It further argued that the right to health care in Nigeria is guaranteed fundamental right that is why Nigeria is signatory to relevant policies to ensure that every citizen is given adequate opportunity to enjoy the protection of his human rights to health.
“Since the dawn of civilisation, the quest for good health and well-being has remained one activity, which has engaged the attention of man. For human beings, the pursuit of good health and well-being has always tasked the knowledge and resources of modern communities.
“Health is so critical to societal progress that regardless of age, gender, socioeconomic or ethnic background, it is considered to be a person’s most basic and essential asset. It is for this reason that nation’s and societies across the world are willing to make many sacrifices, in financial, material and moral terms to commit themselves to the notion’s and principles supporting the right of citizens to quality and affordable health care.
“The right to health is a fundamental aspect of globally sanctioned body of human rights. As enshrined in various international, and national rights instruments, the right to the enjoyment of highest attainable standard of physical and mental health, is a goal that government across the world have continually committed resources to,” the baseline study stated further.
