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Monday, August 23, 2010

Mothers Urged to Breastfeed Their Babies


Nursing mothers have been encouraged to strictly comply with the Ten Steps to Successful Breastfeeding to ensure that their babies survive and develop adequately.

Dr. Phillipah Momah, Head of Family health, in the Ministry of Health made the assertion at the University of Abuja Teaching Hospital, Gwagwalada during the Baby Show event in commemoration of the 2010 World Breastfeeding week celebration.

She explained that the Ten Steps to Successful Breastfeeding were designed to help mothers to initiate breastfeeding within the first 30 minutes of delivery, and breastfeed without adding water, food or drink during the first six months of the baby's life and to continue breastfeeding with adequate nutritious complementary foods up to two years and beyond.

To this end, health facilities that have efficiently implemented these ten steps were designated baby-friendly and were recognized while several community support groups have been established.

She enumerated the benefits of breastfeeding to include improvement of both child and maternal health while promoting the bond between mother and child, saying, "breastfeeding confers strong immunity on the child and helps in intellectual capacity development" and also reduces the chances of the mother having ovarian or breast cancer.

UNICEF recently noted that the reduction of child death from 13 million in 1990 to 8.8 million in 2008 was partly due to adoption of basic health interventions such as early initiation and exclusive breastfeeding.

Dr Momah who was represented by an assistant director in the ministry, Mrs. E.O.Njoku, noted that the theme of this year's celebration is significant to Nigeria due to the decline in exclusive breastfeeding rate from 17% in 2003 to 13% in 2008 which was attributed to inadequate promotion and support of breast feeding and the effect of HIV/AIDS among others.

Earlier, the representative of UNICEF, Miss Tolulope Adeniyi said that the World Breastfeeding week serves as a reminder to Nigeria as a signatory to the United Nations Millennium Development Goals pact, particularly goals 4 and 5 which are to reduce child mortality and improve maternal health.

She said that 'Innocenti Declaration' in 1990 at the WHO/UNICEF meeting called upon countries of the world to fully implement the Ten Steps in all maternities.

The declaration affirmed that improved breastfeeding practices are a means to fulfill a child's right to the highest attainable standard of health.

She observed that one of the easiest ways to gain grounds on MDG 4 and 5 was to continue to create awareness for the need for mothers to breastfeed their children exclusively for the first six months of life or to continue to breastfeed for at least two years with appropriate complementary foods.
http://allafrica.com/stories/201008200440.html

Nigeria unlikely to meet MDG goals by 2015, says report


Abuja, Nigeria - A report by the Millennium Development Goals (MDGs) has said that that Nigeria is unlikely to meet the 2015 goal for poverty eradication, stating that five out of every 10 Nigerian still live in poverty.

The report, made available in Abuja, the Nigerian federal capital, during a workshop on the validation of the 2010 MDGs report and the five-year countdown strategy for Nigeria, also doubted the ability of the country to also meet the target on improved maternal health and environmental sustainability.

The report also did not give a qualified satisfaction to the implementation of MDG in the country, saying it had been a mixed-bag of modest and steady progress on many goals and a slow progress on a few others.

The report further noted that out of the eight goals, Nigeria had recorded an average performance on five MDGs with less satisfactory performance on three others.

Listed under the less satisfactory performance are Goals 1, 5 and 7.

On Goal 1, which is to eradicate extreme poverty and hunger by 2015; the report noted “although poverty has been reduced since 2000, the reality is that among every ten Nigerians, five still live in poverty. Growth has not been sufficiently equitable or generated employment' The report added, however, that nutrition had improved significantly.

On Goal 5, which is improvement on maternal health, the report noted that there was a sizeable reduction of maternal mortality ratio from 800/100,000 (2003) to 157/100,000 (2008). Proportion of births attended by skilled health personnel increased slightly from 36% (2003) to 39% (2008). The report also noted increase in contraceptive prevalence rate from 8.0% (2003) to 10.0% (2008).

The last goal that was listed as unlikely to be achieved was that of environmental sustainability (goal 7).

According to the report, access to safe water and sanitation had not improved significantly and other environmental challenges such as erosion, coastal flooding and climate change are growing.

On the other five goals, the report noted that the country had made significant progress. The goals are universal primary education, gender equality, reduced child mortality, combat HIV/AIDs, malaria and other diseases and global partnership for development.

The report also attributed the modest progress recorded to the gains of debt relief.

While blaming the long period of military rule in the country for the loss of a disciplined culture of generating reliable and consistent baseline date for national planning and development, the report also noted that human capacity and implementation challenges and weak coordination among the tiers and arms of government had reduced the implementation rate of MDGs over the years.

The report, however, noted that there were mitigation efforts to overcome these challenges.

Speaking on the occasion, the Special Assistant to the President on MDGs, Hajiya Amina Az-zubair, said that the overarching objective of this countdown strategy (CDS) was to outline the roadmap to accelerate progress towards Nigeria’s achievement of the MDGs by 2015.

She further said that the objectives of the CDS were to identify the most effective mechanisms and interventions that had made progress against the MDGs; to re-emphasise the constitutional roles and responsibilities of each tier of government and the need for stronger partnership with key stakeholders; to guide the institutional improvements, policies and human resources required; to chart the trajectory of MDGs financing and investment to 2015; and to interface with vision 20:2020 and the 7-point agenda.
http://www.afriquejet.com/news/africa-news/nigeria-unlikely-to-meet-mdg-goals-by-2015,-says-report-2010082054753.html

Maternal Mortality: 2,819 Midwives Assigned To Nigerian Villages

2,819 midwives have been assigned to rural communities in Nigeria as part of efforts to reduce the current high rate of maternal mortality in Nigeria by the The National Primary Healthcare Development Agency (NPHCDA ).

The midwives who are trained on life saving skills, integrated management of childhood illnesses and other initiatives to improve quality of care. Mothers will be empowered through the provision of “mama” kits that will include a very innovative personal health record book to allow them to control their health information.

The NPHCDA Executive Secretary, Dr. Muhammad Ali Pate said that the midwives were deployed under its Midwives Service Scheme to 652 primary health care facilities which were linked to 163 general hospitals in all the 36 states and the Federal Capital Territory, Abuja.

The agency stressed that, the loss of the lives of mothers and newborn babies could be linked to three delays including the inability to recognize that there was a problem and that health care must be sought ,often due to lack of access to the right information.

Other delays he said include those due to lack of means to access health care which could be physical and financial as well as the non-availability of needed service and skilled manpower to provide the services.

Pate argued that two of the delays occurred at the primary health care and community level and could be minimized and mitigated through an effective primary health care system.

He said that the MSS was an important entry point for delivering better maternal and newborn health outcomes as well as for revitalizing the primary health care system.

The midwives, he said, were posted to primary health care facilities in rural areas throughout the states and the 774 local government areas, and therefore urged them to work at the various facilities they had been posted to in the various rural communities, stressing that they must collaborate with the ward development committees.

While advising them to compile community profiles and report maternal/child health indices, Pate described maternal and newborn deaths as a national tragedy, adding that every life lost negatively affected the nation’s human capital.

“The agency is working closely with the Nursing and Midwifery Council of Nigeria and appreciates the support of the registrar of the council and her team. We have mutual responsibility for the survival of mothers and children in Nigeria,” Pate said.

http://www.canyoubebought.com/maternal-mortality-2819-midwives-assigned-to-nigerian-villages.html

Friday, August 20, 2010

MDGs: Nigeria may not meet targets before 2015 deadline



INDICATION emerged Thursday that Nigeria may not meet the major targets under the Millennium Development Goals (MDGs) by the 2015 deadline.

A report released Thursday showed that the country is unlikely to meet the deadline for poverty eradication as five of every 10 Nigerians are said to live in poverty.

The report doubted the ability of the country to scale the deadline on improved maternal health and environmental sustainability.

The government released the report at a workshop in Abuja on the validation of the 2010 MDGs report and five-year countdown strategy for Nigeria.

The report noted that the implementation of the MDGs in the country in the past years is a mixed-bag of modest and steady progress on some goals and slow progress on others.

The report said of eight goals, Nigeria has recorded an average performance on five with less satisfactory performance on three others.

Listed under the less satisfactory performance are goals 1, 5 and 7.

Under Goal 1, the report noted that "although poverty has reduced since 2000, the reality is that among every 10 Nigerians, five still live in poverty. Growth has not been sufficiently equitable or generated employment."

But it said nutrition has improved.

On Goal 5, which is on improve maternal health, the report noted that though there is sizeable reduction of maternal mortality ratio from 800/100,000 (2003) to 157/100,000 (2008), proportion of births attended by skilled health personnel increased slightly from 36 per cent (2003) to 39 per cent (2008).

It said there was an increase in contraceptive prevalence rate from 8.0 per cent (2003) to 10.0 per cent (2008).

The report said environmental sustainability, which is Goal 7, may not be achieved.
http://thenationonlineng.net/web3/news-update/10324.html

At least 150 Nigerian women die every day from complications arising from pregnancy and childbirth, says the Lagos State Commissioner for Health.

At least 150 Nigerian women die every day from complications arising from pregnancy and childbirth, says the Lagos State Commissioner for Health, Dr. Jide Idris, quoting from the World Health Organisation current statistics.
With 150 Nigerian women dying daily from complications arising from pregnancy and childbirth, this translates to 54,750 women dying annually from the same cause.
Speaking at a news conference heralding the first round of the 2010 Integrated Maternal, Newborn and Child Health (IMNCH) Week in Lagos State, Idris said the statistics depicting maternal and child health status in Nigeria were not cheery.
“True, every minute in a day, somewhere in the world, a woman dies due to complications arising from pregnancy and childbirth such that this represents the leading causes of deaths among women of reproductive age.
“In Nigeria, 150 of such women die daily, with haemorrhage, for instance, post-partum bleeding, infection such as sepsis, malaria, anaemia, obstructed labour, unsafe abortion and toxaemia/eclampsia representing the leading cause of death,” he said.
According to him, “this translates to Nigeria constituting only two percent of the world’s population and accounting for 10 percent of global maternal mortality burden. For every death, there are 25-30 morbidities, four percent of which are severe and crippling, such as uterine prolapse, fistulae, pelvic inflammatory disease and infertility.
“The tragedy is that these women die not from disease but during normal, life-enhancing process of procreation. Even more tragic is the fact that most of these deaths and morbidities are avoidable if preventive measures are taken and adequate care available.”
He stated that maternal and pre-natal health had emerged as the most important issue that determined global and national wellbeing, stressing that this was because every individual, family and community was, at some point, intimately got involved in pregnancy and the success of childbirth.
Idris added that global statistics for child health did not fare better, as each day, 528 newborns died with 74 percent of these deaths occurring in the first week of life, while 2,700 under-5s died, with malaria and neonatal causes accounting for over 50 percent of these deaths.
“Loss of a child increases the tendency of a woman to want to get pregnant again, hence the adoption of IMNCH Strategy at the 51’st National Council on Health held in Lagos in 2007 essentially to simultaneously tackle issues relating to neonatal, infant, child and maternal mortality,” he said.
The IMNCH comprises high impact intervention packages that address the main causes of maternal, newborn and child deaths and health facility levels and also focuses on integrating maternal, newborn and child health services along the life cycle at all levels.
It thus represents a paradigm shift-changing the way we do business to foster a continuum of care for mothers, neonatal and child morbidity and mortality in line with the Millennium Development Goals (MDGs) four and five.
According to Idris, with the full implementation of the IMNCH strategy, 72 percent of neonatal deaths; over 75 percent of under-5 deaths and two-thirds of maternal deaths could be prevented, adding that “in absolute terms, more than 200,000 mothers and six million children lives can be saved by 2015.”
However, the commissioner disclosed that the IMNCH Week with the theme: Partnering for Improved Nutrition for the Mother and Child with the slogan Ensure Adequate Nutrition for Mother, Newborn and Child kicked off today and would end on 27 May, 2010.
He said screening for malnutrition and Vitamin A and micronutrient supplementation would be given prominence during implementation, adding that the Week would be flagged off simultaneously in all the 20 Local Governments and the 57 Local Council Development Areas (LCDAs).
He appealed to the council chairmen to be extremely committed and go the extra mile in ensuring the success of this week’s celebration and promote good health of “our mothers and children.”
“The responsibility is not that of the parents/care givers alone. It rests on everybody to ensure that our pregnant women, children and in deed the whole family take full advantage of the week-long services.
“I am therefore pleading with all our leaders in the state – politicians, councillors, traditional leaders, and religious leaders to take full responsibility in ensuring that all targeted groups are reached and effectively mobilised,” he stated.
—Kazeem Ugbodaga. http://pmnewsnigeria.com/2010/05/21/150-nigerian-women-die-daily-from-pregnancy-complications/

The Federal Executive Council approves 63 Ambulances


The Federal Executive Council (FEC) has approved the procurement of 63 ambulances at the total cost of ₦458.49 million in a bid to stem unacceptably high infant and maternal mortality rates, particularly in the rural areas.
Minister of State for Information and Communications, Mr Labaran Maku, made the disclosure at a media briefing on the outcome of the week’s Council meeting on Wednesday, 18th August, 2010 at the State House, Abuja.
Giving the details of the procurement, Maku stated that each of the ambulances was valued at ₦7.27 million, are to be distributed to 20 states of the federation as part of the Federal Government’s efforts towards meeting the Millennium Development Goals (MDGs).
He listed the states as: Bauchi, Benue, Borno, Cross River, Delta, Enugu, Ondo, Osun, Rivers, Taraba, Zamfara, Sokoto, Niger, Nasarawa, Lagos, Kwara, Kano, Jigawa, Imo, Gombe, and the Federal Capital Territory (FCT).
According to him, the move was initiated by the Minister of Women Affairs, Mrs Josephine Anenih, hence that Ministry was given the responsibility of supervising the ambulances and ensuring optimal and appropriate use and maintenance.
He noted that in July, the First Lady, Mrs Patience Jonathan launched the first phase of the scheme in Abuja, which covered 16 states of the Federation and involved about 49 ambulances.
HTTP://WWW.NIGERIANINQUIRER.COM/2010/08/19/MATERNAL-HEALTH-FG-PROCURES-63-AMBULANCES-FOR-RURAL-HOSPITALS/

Friday, August 13, 2010

Fresh Battle for Better Hospitals

The deplorable state of public hospitals in Nigeria has always been a major source of worry. But when human rights lawyer, Femi Falana filed a suit at a Federal High Court seeking an order to compel the Federal Government to equip public hospitals, he opened a new vista in the battle for better hospitals. DAVIDSON IRIEKPEN writes

Two weeks ago, Human rights lawyer, Femi Falana filed a suit against the federal government (FG) at the Federal High Court in Ikeja seeking to compel the FG to equip public hospitals in the country. Falana, in the documents obtained by THISDAY, argued that government has failed to ensure that there are adequate medical and health facilities for all Nigerians. He wants the FG to take necessary measures to protect the health of the people and ensure that they receive medical attention when they are sick.

He claimed that only few public officers are allowed to receive medical treatment at public expense in foreign hospitals whenever they are sick and that the public hospitals and health centres patronised by the majority of Nigerians are neither equipped nor staffed.

According to the human rights lawyer, “Many public officers are taken abroad for medical treatment at public expense from time to time and top public officers and private citizens who can afford overseas medical attention now travel to the United Arab Emirates, Saudi Arabia and India for medical check up and treatment while millions of poor Nigerian citizens die of preventable diseases in the local hospitals because they cannot afford the exorbitant costs of medical treatment in foreign hospitals.” He contended that Nigerians doctors, pharmacists and nurses who left the country due to the neglect of the health sector by the government, man several foreign hospitals patronised by privileged Nigerians.

The applicant also argued that contrary to its obligations under the law and in spite of the abundant resources of the country, the federal government has refused to equip public hospitals and medical centres located in Lagos and other the various parts of the country and that many countries that are less endowed than Nigeria have well equipped hospitals with qualified specialists many of whom are Nigerians.

He averred that the 469 members of the National Assembly have just demanded for increase in their allowances to N47 million per House of Representatives member and N60 million per Senator per quarter and that in the 2010 Appropriation Act, the defendant has budgeted N57 billion for entertainment and N27 billion for travels by members of the National Assembly. He noted that the FG also proposed N6.6 billion for the celebration of the country’s 50th Independence anniversary on October 1, 2010.

While many Nigerians are anxiously waiting to see how the case would go, Falana’s lamentation is not new to Nigerians. For sometime now, many analysts have been wondering when the deplorable state of the country’s healthcare would improve if those in government who are supposed to ensure that the country’s hospitals are well equipped and functional can at the slightest opportunity, jet out to seek medical attention abroad for even minor ailments.

It has been argued that the sustainability and viability of a country’s economic and social growth depend largely on a vibrant healthcare sector and that no country can maintain a steady economic growth in the absence of an adequate healthcare system. Yet, poor healthcare has remained an issue in the country. While Nigeria is believed to have a birth rate of 40.6 births per 1000, the infant mortality rate is 98.8 deaths per thousand live births with a life expectancy of 46.7 years.
Recently, Governor Liyel Imoke of Cross River State was rushed abroad for medical attention after an accident at the Obudu Ranch Resort. Before the trip, he was flown to a hospital in Abuja where doctors recommended his treatment abroad.

Last year, former Governor of Jigawa state, Senator Saminu Turaki was involved in an auto-crash and was flown to Singapore for further medical care. Turaki was involved in the auto-crash on his way to Abuja from Birnin Kebbi where he had attended a wedding ceremony. As soon as the accident occurred, the former governor was admitted at the Intensive Care Unit (ICU) of the National Hospital, Abuja. But he was later flown to Singapore, which had always been his preference. Not many Nigerians were happy to hear the news. After all, the man ruled Jigawa for eight years and was in charge of billions of naira, some of which he could have invested in a world class hospital,.

As Governor of Katsina State for eight years, late President Umaru Musa Yar’Adua also sat on billions of naira, but he constantly visited foreign hospitals. And as President, he made about four trips abroad for medical treatment. The last was on November 23, 2009 when he was admitted at King Faisal Specialist Hospital in Jeddah, Saudi Arabia for acute pericarditis. All through this period, no extraordinary effort was made to improve the country’s hospitals.

As a result of sustained decay in the country’s health sector, seeking medical assistance abroad is now a necessity for the wealthy. Last year, while the wife of the Speaker of the House of Representatives, Dimeji Bankole, gave birth to a baby girl in a Ghanaian hospital, the wife of the governor of Bauchi State, Isa Yuguda gave birth in America.
Incidentally, these are public officers who have the power to ensure that standard hospitals are built and equipped in their respective domains. But they could not entrust the delivery of their babies into the care of any Nigerian hospital. This is because they do not have confidence in the country’s hospitals.

Many observers have argued that the frequent trips abroad by those who are supposed to help refocus attention on the sorry state of the country’s healthcare delivery system do not give hope to others in the country that something is being done. They wonder what the poor would be going through if those in power do not have confidence in the country’s healthcare sector.
While for the wealthy, the alternative is to seek medical attention for chronic and severe ailments in foreign countries, the masses who have no choice or means, are left at the mercy of the near comatose 53 tertiary health institutions, 23 federal medical centres, 37 teaching hospitals and over a thousand general hospitals in the country.

Unfortunately, the sorry state of the country’s health institutions seems to have defied all forms of government intervention. In the twilight of the President Olusegun Obasanjo regime, he initiated a N17 billion equipment standardisation scheme. The intervention was aimed at upgrading the state of public teaching hospitals. About eight teaching hospitals benefited from the intervention programme. However, some of the equipment said to have been installed through the intervention are said to be malfunctioning already. Years after, nothing seems to have changed.

In spite of the annual budgetary allocations to the health sector at the federal and state levels, infrastructure and healthcare delivery remain paralysed in the country. In 2008, N89.45 billion was appropriated at the federal level for the health sector. A break down of this appropriation shows that N29.12billion was meant to take care of some 700 capital projects. By the close of that year, about N11.344 billion of that sum was returned as unspent fund. In addition to this, N138.17 billion allocation and N161.8 billion proposed allocation for 2009 and 2010 respectively grossly fell short of the World Health Organisation (WHO)’s recommendation that 11 per cent of a country’s budget should be dedicated to its health sector. At the state and local government levels, billions of naira has also been allocated to the health sector but the monies tend to end up in private pockets and accounts.

In the developed countries of the world, the sanctity of human life is given priority and that is why they have the best hospitals in the world. Also, they have the best health insurance schemes and have so much confidence in their healthcare system. So, nobody; whether a pauper or a president needs to travel abroad for treatment except for alternative medicine in China or India.

Contrary to WHO’s standards, the doctor-patient ratio of a doctor to 3000 persons is exceeded. In Nigeria, a doctor attends to more than 4000 patients; the country has the highest poliomyelitis burden in the world and it also records one of the worst maternal mortality rates in the world. Medical researchers are almost non-existent and many doctors who practice in government hospitals have no grants to attend capacity building courses abroad. The statistics are pathetic and undoubtedly scary.

The continued stagnation of the healthcare sector in Nigeria is of great social and economic consequence. Access to quality healthcare is either limited in Nigeria or non-existent with staggering financial burden to families and the nation. While the prevalence of fake drugs and substandard products are compounding the problems, the AIDS epidemic and unhealthy lifestyles of many individuals are making matters worse.

Milicent Obajinmi, a senior staff in the radiography department of UCH says the mammography machine installed in the hospital in 2005 is yet to be calibrated. The cassettes meant to complement the equipment are not compatible. Also, the erratic power supply to the hospital is adversely affecting the equipment.

Lamenting the state of the teaching hospitals, Francis Faduyile, former chairman, Association of Resident Doctors, LUTH chapter, recently said public health facilities are “almost in a pathetic state. We don’t have up-to-date equipment. In advanced countries, a lot of treatments are not invasive, that is, you don’t need to cut or traumatise a patient. The equipment for non-invasive surgeries is not available to our medical personnel in Nigeria. The federal government has been upgrading some teaching hospitals but it is not enough. It is a far cry from what is needed. Some of the available equipment spoil easily. There is no power supply. Power is a major issue and medical personnel are not well motivated.”

Also, in an interview he granted a national magazine recently, Chief Medical Director (CMD) of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Professor Olusanya Adejuyigbe, wondered what manner of a country would continually run a big institution such as a teaching hospital on generator. Adejuyigbe who is a professor of paediatric surgery said, “A hospital that runs on generators cannot get to where it should be. Everybody knows how much we buy a litre of diesel in this country. In other countries, teaching hospitals are on national grid. We should be able to do that here.”

This seems to be the bottom-line in Falana’s recent suit; the FG needs to do better. With the suit, the legal luminary has opened a new vista in the battle for better hospitals in Nigeria. The outcome of the suit would no doubt become a watershed in efforts to give Nigerians better healthcare services.
http://www.thisdayonline.com/nview.php?id=180337

Maternal mortality: ‘Nigeria needs 30,000 midwives’

Nigeria currently needs a total of about 30, 000 midwives to effectively stem the tide of maternal mortality in the country, Executive Director of the National Primary Health Care Development Agency (NPHCDA) said yesterday.

Dr Muhammad Pate also said that the involvement of community health extension workers in the midwives service scheme was due to the dearth of midwives to attend to dying women.

He said whatever decision taken by the agency was borne out of the Federal Government’s desire to save the lives of women and not to undermine the authority of the National Association of Nigeria Nurses and Midwives (NANNM).

Pate, who was represented by the Director, Primary Health Care System Development, Dr. Mohammed Abdullahi, spoke during a consultation visit to the leadership of the NANNM at its headquarters in Abuja.

He observed with concern the acute dearth of midwives particularly in the northern parts of the country as evidenced by the insufficient number of applicants to the scheme.

Responding, the General Secretary, National Association of Nurses and Midwives, Mr. George Ayua, said the problem of insufficient number of participants arose because of what he called non-involvement of the association in mobilizing its members for the scheme.

http://www.dailytrust.com/dailytrust/index.php?option=com_content&view=article&id=855:maternal-mortality-nigeria-needs-30000-midwives&catid=1:news&Itemid=2

Saving lives in Nigeria


I’m wrapping up my visit to Nigeria where I provided support to the health programme team. We’re updating the Saving Newborn Lives report and I came over to research and develop content on maternal, newborn and child health.

The capital, Abuja, is sprawling and the skyline is dotted with tall buildings, a grand mosque and big churches. The roads are wide and nice houses can be seen in the residential areas, giving an impression that all is well.

A visit to Kuje General Hospital in the outskirts of Abuja shows a different picture, however. In the children’s ward, toddlers were recovering from measles, diarrhoea and malaria. From my knowledge of Nigeria’s health indicators about child mortality, I know too well that these diseases are the most common causes of under-five deaths in the country. The children in the hospital were lucky that their parents could pay the minimal admission fee and received treatment.

Millions of Nigerian children die each year before reaching their fifth birthday due to preventable and treatable causes. About a quarter of these deaths occur during the first 28 days of life.

With a high under-five mortality rate and a huge population Nigeria and India account for nearly a third of all under-five deaths globally. Children’s chances of surviving to five years of age is largely unequal. Those coming from the poorest households are 2.5 times more likely to die before their fifth birthday than those from the richest households. Children in the north-west are also over two times more likely to die than those in the south-west of the country.

Our report, which we aim to launch later this year, will look at the key interventions in maternal and child health that prevent newborns and children from dying from preventable causes. Some of these interventions, such as antenatal and post-natal care, exclusive breastfeeding and immunisation are inexpensive and can be rolled out widely in developing countries.

Bangladesh and Eritrea, which are on-track to meet the Millennium Development Goal 4 by 2015, have shown that it is possible for low income countries to improve child survival. Nigeria, which has more resources, could and should do more to prevent children from dying. We hope to use our report to lobby the government and other groups to do just that. Watch this space.
Wednesday 4 August 2010
http://www.savethechildren.org.uk/blogs/2010/08/saving-lives-in-nigeria/

‘Ondo State ‘ll lead others in the next three years’


Ondo State governor, Dr Olusegun Mimiko, recently spoke with a group of journalists in Akure, where he X-rayed his 17 months in office. Yinka Oladoyinbo was there. Excerpts:

How have things been in the last one year?
They have been challenging and, at the same time, exciting. You know the circumstances in which we came in; we were confronted with challenges of local government elections, which we said were not properly conducted and we also had the challenge of an initially hostile House of Assembly and, of course, the challenge of the expectations of our people. Before we came on board, everybody believed that ‘’whenever Mimiko comes on board, even if your wife has been barren for 20 years, he has a magic wand .’’ So, we had a challenge of such proportions. And I must thank God that, down the line, we have been able to prove again that our people are people of reasonable expectations, they know the limitations of government and appreciate the little honest effort being made to improve their lives.

As a medical doctor, what informed the policy thrust of your administration in the health sector of the state?
When we came on board, we identified our point of intervention that would have maximum impact on the lives of our people. We looked at the vulnerable groups in the society and we picked the pregnant women and children under five years. You are all aware of the fact that Nigeria has the unenviable record of being the country with the largest maternal mortality rate in the world and this, in our opinion, is very unacceptable and must be reversed.

Before our intervention, we carried out a base-line survey and we went on facility tours all over the state. The first shock we had was that only 16 per cent of pregnant mothers who registered with health facilities ended up giving birth in those places, meaning that 84 per cent are out there whom we cannot track. So, whatever statistics is based on such information cannot be correct; if only 16 per cent eventually give birth, it means that whatever mortality rate you are calculating will be on the 16 per cent, which will be a very far cry from the real situation on ground. We have, for so long, relied on external bodies for planning data and we thought that ‘’look, we need this base line study to know where we are and to be able to measure our intervention down the line, we said that the best way to do it is to ensure that every maternal death is registered in the state and we came up with the confidential enquiry into maternal death. Simply put, it means any death of a pregnant woman must be reported ; otherwise,there will be sanctions ranging from fines to jail terms, or even the closing down of health facilities which refuse to report such deaths.

One big achievement of your administration is the Mother and Child Hospital, can you give us more insight into the operations of the hospital?
The Mother and Child Hospital is part of our integrated maternal and infant care programme, which starts from primary care level. As a matter of fact, we’ve taken care of community and household levels. In our pilot programme, all pregnant women got registered and we have health personnel who we designate as health rangers. A health ranger is allocated to a group of 50 pregnant women; they are people who are equipped to take care of emergency situations at the home level, but they visit the pregnant women allocated to them at home, interface with them, educate them on nutrition, anti-natal care, what to do in case of emergency, and so on. Of course, this also includes improvement of health care facilities and designated health facilities allocated to women. We have also tried to use information technology to actually facilitate health care; each of these pregnant women is armed with a mobile phone, belongs to a caller user group. She has free access to a health ranger, midwife, doctor and health facility.

The Mother and Child Hospital is a referral centre. It is supposed to take care of complicated cases that cannot be handled at the primary level and, to some extent, secondary facility level. So, we have to establish a whole Mother and Child Hospital dedicated entirely to our mothers and children and under our social and democratic responsibility, health care is free of charge. Yes, the hospital is state-of- the-art; I usually boast that if you go anywhere in the world, you can’t have better facilities than we have here.Those down the ladder of socio-economic struggle in this place also deserve good things, so we have state of the art medical equipment, obstetricians, and a good environment, but they are free of charge. The whole idea is to arrest maternal death at the most critical stage. There is just a thin line between life and death, when you need skilled hands to make decisions and choices that would determine whether the woman lives or not.

What are the moves being made to change the status of Ondo State from a rural to a developed state?
Let me just say this, Ondo State is not a rural state; the state has rural population like any other state. For so long in this country, we have been the state that produced the manpower in this country. Look at the Nigerian Merit Award winners up till now; the majority of them are Ondo State indigenes. Ondo State people are professionals, but the problem with this state is that we produce the professionals and they service other climes, but that is changing now and we are attracting our professionals back home. Look, in terms of the opportunities we have, people have said ‘let’s find empirical evidence for it’, but in terms of quality manpower, we probably have the best and highest in this country.

In terms of natural resources endowment, we are probably second to none in this country. What we need is to put all of these together and that is what we are doing. It is like you want to cook. What do you like? You like pepper soup and have all the ingredients. All you need is put all of these together and you have an exciting pepper soup. We have all the ingredients to make Ondo State the number one state in the country. Let us talk about rural development. We have our own share of rural population, and, for so long, government had pretended that people in the rural areas did not really matter. But I was at a seminar recently when people said that for every man who eats food in Nigeria, we are being subsidised by the rural community because if they actually charge the labour cost for the food they produce, we will not be able to afford it.What we have done actually is to put together a programme that will ensure that the people take over their own development and they take ownership of programmes and projects that will develop their capacity. That is what we call 3Is initiative. These I’s stand for infrastructure, industry and institutions in the rural areas.

This is exactly what we are doing in our pilot programmes in 80 communities. We tried to allow people to identify their priority projects and we have executed 80 of such projects in the areas of health facilities, markets, cottage industry, and town halls all over and now. We are in 150 communities in the state, meaning that we are back in those 80 pilot communities to build the capacity of the existing governance institutions and train them in financial management and project assessment and all those 80 communities now take up the project themselves and execute them, with technical backing from the state government. It has been an exciting and impactfulexperience.

What is the policy thrust of your administration on education?
As I said, we’ve been the breeding house of quality education or manpower in Nigeria, but I must confess that in the last few years, we have not been happy with the products of our schools, the state of the schools and the level of incentives for teachers, among others. Therefore, our focus is to ensure that we continue to produce globally-competitive students out of our institutions. It is also very important to ensure that socio-economic factors do not deprive people of quality education. As it is today, public schools can no longer compete and what we are doing is to re-create our public schools. We are coming up with what we call mega-schools at the primary level and these are the state-of-the-earth schools. For instance, we have 1,140 primary schools in Ondo State, some of them merely in name, so the first mega school we are building in Akure will have a population of 1,250 pupils, meaning that five schools will collapse into one school.

So, are you planning to reduce the number of schools?
Yes, we are reducing the number by building one real school with state –of-the-art equipment and this is targeted at children who cannot afford private institutions. I hope we won’t run into problems of people withdrawing their children from private schools to public institutions. In fact, at the site of the school located in the Iro area of Akure, there used to be about three schools there with a combined population of 400 or so. The Caring Heart Mega School we are building, which is well under way, is going to have 1,250 students. That means about five, six schools have collapsed into the mega school. But the whole idea is to have proper schools with administrative structures, with good offices for the teacher, arts rooms, resource centre, sporting facilities, information communications technology (ICT) centre, computers, laboratories, so that those children can, from the beginning, be in the position to compete with their mates all over the world. We hope that they will graduate into our secondary academy. In the first phase, we are hoping to build nine of state-of-the-art secondary academies. The public schools have broken down completely.

Should we expect the same treatment for secondary schools, because there are so many of them?
In secondary schools, in terms of number, they are not even up to that. What we want to do in secondary schools is to rehabilitate the facilities that exist in the first phase. We hope that we will be able to start on three senior academies for secondary schools and rehabilitate the existing facilities. If we do a study, there is hardly anybody in our Public Schools that gain admission into the University in Nigeria to read Medicine or Engineering, most of them come from private schools because the public schools have no laboratories. They have been run down. So we are improving on facilities and incentives to teachers and that informed the approval and payment of 27.5 % increment to our teachers despite the fact that we came on board when the state revenue was low.
http://www.tribune.com.ng/index.php/politics/9024-ondo-state-ll-lead-others-in-the-next-three-years

MDGs: N1 trillion with little value added

RECENTLY the Federal Government announced that over a trillion naira had been spent on the Millennium Development Goals (MDGs). This was stated to buttress the government's commitment to achieving the goals. The government, however, failed to tell Nigerians the record of achievements in concrete terms. In fact, it has become a habit by government officials to announce the commitment or release of funds to Nigerians as if financial commitment to problems automatically solves those problems.
IN the case of the MDGs, we task the government to go beyond announcing the expenditure on the MDGs and the need for more funds to see the process through. The government must tell Nigerians how fund so far committed to the goals were spent and actual records of achievement. The overall objective of the MDGs is the reduction of the proportion of people living on less than $1 a day to half the 1990 level by 2015. The government needs to tell Nigerians each time it reports on the goal how their country is doing in this regard. The need to have clear idea of achievements is further underscored by the fact that an enduring fiscal space was created by the foreign debt deal of 2006 and recovered looted funds stashed in foreign banks were allocated to the achievement of MDGs and poverty reduction. Besides, there are monitoring arrangements involving the World Bank and Department for International Development and civil society groups which make it important that the funds must be subjected to proper use.


THERE are eight MDGs. These are to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empowerment of women, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases; ensure environmental sustainability, develop a global partnership for development.


THE first five goals have very clear measurable indices. This means that progress in those areas can be measured. For instance, an assessment of Africa's progress towards the achievement of the MDGs as made by the United Nations Economic Commission for Africa published in 2008 shows that progress has been slow in achieving a significant number of the targets. Africa has made some progress in aggregate school enrolment but school completion rates remain on average at 60 per cent. Eleven countries in Africa had achieved gender parity in primary school enrolment in 2005. There is still significant under representation of girls at the secondary school level.


NORTH Africa has met the first target to reduce hunger by half in 2015. Child mortality rate is still very high in Africa. Malaria accounts for the high rate of child mortality in West Africa while HIV/AIDS is responsible for the high level of child mortality in Botswana, Lesotho, South Africa, Swaziland and Zimbabwe. The report observed that progress is slowest in health-related MDGs. Nigeria's official poverty line is put at 54.4 per cent. This is below the levels in Benin, Burkina Faso, Mauritania and Cameroon.


THERE is no evidence that significant achievements have been made in the health and education sector. For instance, Nigeria still does not have the kind of public health system that a country like it needs. Life expectancy is about 46.8 years. This is very poor compared to the average in high income countries. Adult literacy is 69.1per cent. Only 48 per cent of the population have access to clean water and maternal mortality is 1,100 per 100,000 live births.


WHILE the investment of funds in the MDGs is a mark of commitment to the goals, the government must recognise and admit that the overall performance in the achievement of the goals is below expectation. That acknowledgement is necessary in order for the government to reassess the implementation process in a candid manner.


GIVEN the reality of the global economic meltdown and the resultant fall in government revenue, the government must enforce its value for money policy in prosecuting the MDGs. Henceforth, concern over the MDGs must focus on clear benchmarks for monitoring and accessing progress. The government must strengthen the monitoring process by empowering the non-government actors to be effective in providing reports and advic e to improve on the implementation process.
http://odili.net/news/source/2010/aug/2/615.html

A tragedy that doesn't have to happen...


Kano -- Nineteen-year-old Maryam Audu became pregnant in 2006. She was in labor for three days at home with a traditional birth attendant because her mother had no money to take her to hospital. She had a stillbirth, and later discovered that her body was painfully damaged. Maryam, not her real name, had a fistula, a severe childbirth injury that leaves its victims constantly leaking urine and feces. As a result, she was shunned and abused by former friends and others in her community. She could not leave home for social events, to look for work or even to go to the mosque. She became depressed and contemplated suicide.

She was just one of the more than 500 women and girls in the North who suffere from obstetric fistula. Unless it is surgically repaired, it ruins their lives. With the G-8 planning to discuss maternal health at its summit meeting this week in Canada, I can't help but think of how these girls' and women's lives would not have been torn apart if they had access to appropriate health care, including family planning services, at the time of their pregnancy and childbirth.

--
AMIHIN INTERNATIONAL.
Giving mothers and newborns a surviving Chance!
amihn2000@gmail.com

Tuesday, August 3, 2010

African CSO’s urge the AU “No woman should die while giving life”

August 2nd, 2010 · by Ishmael Kindama Dumbuya·

Despite the political commitments made by African leaders at the AU summit in Sharm el Sheikh on water and sanitation, Africa continues to lose hundreds of women and newborns everyday due to poor health systems including access to clean water, improved sanitation and hygiene.
In her presentation on revisiting the Sharm el sheikh Commitments, Jamillah Mwanjisi, Executive Secretary of African Civil Society Network on Water and Sanitation (ANEW) said that while there has been an increase in momentum and new initiatives to accelerate the achievement of MDG targets, poor access to improved sanitation and hygiene continue to undermine the achievement of all the other MDG targets particularly targets on maternal, newborn and child health in Africa.
Jamillah, who was presenting at civil society meeting organized by the African Union Commission in collaboration with the Economic, Social and Cultural Council (ECOSOCC) of the AU, noted that 18 % of child deaths in Africa are caused by diarrhoea and nine out of ten cases of diarrhoea could be prevented by access to sanitation and water. Despite this, only four in ten Africans have access to a safe toilet, and only six in ten to safe water.
The meeting which brought about 75 civil society organizations in the continent was organized in the wake of the AU summit to discuss Maternal, Infant and Child Health and Development in African –the theme for this year’s AU Head of States and Governments Summit.
Jamillah said for Africa to make sustainable progress in curbing maternal and child mortality it is important to ensure the health and well being of women and children is prioritized at the national level and commitments are met. “It is important for African governments to recognize the correlation between lack of clean water and improved sanitation to maternal, newborn and child health,’’ she said.
Recent studies indicate that Africa continue to lose an average of 800 women due to pregnancy and child birth-related complications and 13,000 newborns every day – a situation that undermines the achievement of the other MDG targets thus slowing development progress on the continent.
In their statement to the AU Summit the CSO urged African governments to Integrate previous commitments on water, sanitation and hygiene (WASH) with maternal and child health, and ensure that they are prioritized and adequately resourced at national level.
In addition, CSO highlighted the need to strengthen systems and accountability mechanisms to support citizens’ participation, leading to improved governance in WASH and maternal and child health.

Tags: · African CSOs, AU, IshmaelKIndama Dumbuya
http://inwent-iij-lab.org/Weblog/2010/08/02/african-cso%E2%80%99s-urge-the-au-%E2%80%9Cno-woman-should-die-while-giving-life%E2%80%9D/