Against Maternal and Infant Mortality They Gather

Ruby Leo and Rakiya A. Muhammad
Sokoto — High maternal and infant mortality rates remain a sore point in Nigeria's health delivery system which professionals discuss with passion whenever they meet, such as during a recent ceremony marking Maternal and Child Health Week in Sokoto, always in the hope that the authorities will one day learn to provide the right solution.

Maternal and infant mortality rates remain worrisome in Nigeria, especially in the northern part where the rates are particularly high. A Maternal and Child Health Week held last month in Sokoto State once again brought to the fore this concern as several factors identified as responsible for the maternal and child heath situation in the country resonated as the week was marked.

On hand to highlight the factors that can mitigate maternal/infant mortality rate was Professor Taofiq Ibrahim of Usmanu Danfodiyo University Teaching Hospital Sokoto. "One of these factors include women of reproductive age group getting access to essential care, especially obstetric care, the availability of infrastructure at the health facilities, and having well equipped anti-natal care centre where women could deliver safely," Professor Taofiq who is of the Community Health Department of the university said.

He asked rhetorical questions indicating that in reality those are not the indices to be found: "Are facilities well established with equipment that are necessary; are personnel trained to deal with the major causes of deaths in these women? When you talk about access, is the centre close to the people; is it easy for them to reach, especially in rural communities; is the road network good?"

For Luba Musa Argungu, a zonal officer of the National Primary Healthcare Development Agency (NPHCDA), northwest zone, though the maternal health situation in Sokoto has improved from 2009 due to the deployment of midwives under the MSS to various facilities, issue of delivery in hospital remains a major concern.

Argungu said, "Our women don't enjoy coming to deliver in hospital unless they are in serious emergency situations like bleeding in labour and retained placenta upon child delivery. On normal conditions, they don't come for delivery. I think lack of awareness and poverty can hinder them but gradually if they are fully aware of the importance of hospital delivery, they will embrace it. We need to educate the in-laws because some of the women are prohibited by their in-laws from going to health facilities. Others are scared of the charges despite the free medical programme of the state government. They are not sure that it is really being implemented."

The official mentioned the problem of birth delivery assistance manpower shortage, particularly midwives: "We have the traditional birth attendants some of who are trained and others not. Maybe if we complement their efforts by giving outreach services, it will help us drag to hospitals women who are supposed to deliver in hospitals."

According to her, they are also battling with retaining the midwives and meeting their accommodation and general welfare needs. She stated that under the federal government Midwives Services Scheme, they have 112 midwives out of 144 that were allotted to the state operating in 36 health facilities in nine cluster local government areas of Sokoto State.

She said, "The greatest challenge is that we are not everywhere yet, not all the facilities in Sokoto have midwives because midwives are very scarce in the country but the federal government is trying its best to complement things. Because once the skill attendants are at the sight of delivery there is every possibility for that labour to be normal and the dying of neonates will be reduced. For example, haemorrhage can be arrested by administering some medication on women who come for delivery. If we are to serve effectively for 24 hours in the 23 Local government areas in the state, we require at least 15 midwives, eight community health workers, and we need females in this aspect, because here they don't allow men to conduct delivery for their wives."

The Maternal and Child Health Week was, according to the organizers, about delivering integrated package for intervention to boost the health status of women and children.

In Sokoto, the Week was flagged off at Shagari town with a campaign rally aimed at enlightening people on the importance of safeguarding the health of mothers and children under five years.

Primary and secondary health facilities in the state were assigned for the conduct of the intervention package with services for the children such as routine immunization, polio vaccine, hepatitis, DPT in the health facilities, vitamin A de-worming tablets and birth registration.

Other services showcased include nutrition service provided while intervention for pregnant mothers include health education about ANC and delivery, tetanus vaccine, blood tonics and folic acid to check anaemia responsible for morbidity and mortality in pregnant women.

Executive Secretary, State Primary Heath Care Development Agency, Dr. Abdurrazaq Musa Gandi explained, "This is just an extra effort by the federal, state and local governments and development partners to ensure that intervention which improves the lives of children and pregnant mothers is delivered to them. It started in 2009. At that time it was supposed to be only on child health but later we found that it was important to incorporate mothers. That is why we have maternal/ new born and child health week. It is a week actually set aside to deliver this intervention and it is done twice in a year. We had one recently in June and then Monday the 14th November."

He said things were being done in the state to boost maternal and child health and curb mortalities: "There has been serious social mobilization to ensure people are actually informed. In some situations we have low utilization of these health facilities due to other factors. The state government, he said, is collaborating with development partners such as UNFPA, UNICEF, WHO, and many others to ensure improvement in the wellbeing of this target group.

A mother, Hajiya Hadiza Musa, stated, "We are happy that this exercise is taking place as it would impact positively on the lives of women and children but there is need for more to be done in terms of ensuring adequate supply of drugs, well equipped health facilities, and adequate medical personnel in the rural areas at all times".

Another respondent, Aisha Muhammad, described the Week as apt in the effort towards meeting the 2015 Millennium Development Goals (MDGs) targets on the reduction of maternal and child mortality.

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