‘Funding of family planning, pivotal to maternal mortality reduction’

Written by Sade Oguntola



NIGERIA is one of the countries with the highest maternal mortality and to achieve its reduction, ensuring Family Planning (FP)availability through its adequate funding and reorientation of policy makers is pivotal, a survey has indicated.

The study conducted by Nigerian Urban Reproductive Health Initiative (NURHI) on resources for family planning commodity at the federal and four NURHI-supported sites, indicated that the absence of a budget line for FP activities was a major challenge to family planning commodity security.

Dr Farouk Jega, a public health expert made the findings of the assessment known at a 1-day NURHI de-briefing meeting for policy makers in Ibadan.

Dr Jega remarking that family planning commodity security exists when people are able to choose, obtain and use the contraceptive they want whenever they need them, declared that the absence of a dedicated budget line for FP at the Federal government level was not in conformity with its determination to address the maternal and child health challenges facing Nigeria.

However, he pointed out that despite states like Oyo state having a budget for FP, “the monies appropriated do not always get released for family planning activities.”

Dr Jega declared that the assessment found that frequent stock out of contraceptive methods such as injectable methods and intrauterine devices was also a challenge to Nigeria’s attainment of contraceptive security.

In order to address these challenges, he suggested tapping fund from other sources to ensure a broader funding base for family planning; high level advocacy to support evidence based forecast and procurement of family planning commodities; and reorientation of all stakeholders to give FP issues the attention it deserves.

Earlier at the meeting, Oyo state team leader for NURHI, Mrs Stella Akinso, said that Nigeria need to take up the responsibility of ensuring that FP is funded.

According to her, “Nigeria for many years depended on donor funding of family planning services, thus accounting for 22 per cent of unmet contraceptive needs.

NURHI is trying to sensitise and stimulate the government to drive the process of increasing family planning services while we provide the technical support.”

http://tribune.com.ng/index.php/health-news/17648-funding-of-family-planning-pivotal-to-maternal-mortality-reduction

Shining a light on maternal mortality

Photo: Laura Stachel, at right, at a clinic in northern Nigeria the day they received a solar suitcase.

An obstetrician-gynecologist by training, Laura Stachel became interested in maternal mortality when she began attending the School of Public Health at the University of California, Berkeley. Through a school project, Stachel ventured to northern Nigeria in 2008 to learn why so many women there were dying during childbirth.

What she found were substantial infrastructure problems, including a lack of supplies, equipment, training and supervision. “And there was another factor that seemed huge to me,” Stachel recalled. “They didn’t have reliable electricity.”

Even at large state hospitals, electricity was rationed. Doctors were lucky to get 12 hours of electricity in a day. Without electricity, hospitals couldn’t power refrigerators to store blood for transfusions or ensure that cell phones could be charged. And there was no guarantee that doctors would have light to deliver babies and perform Cesarean sections.

The Nigerian hospital performed about 150 deliveries each month and could see as many as seven or eight deaths in the same time frame, Stachel said. “Electricity was playing a pretty big role in some of the delays that were affecting maternal health outcomes,” she said. “It felt like there was very little I would be able to offer clinically if we didn’t take care of some basics first. We really needed to be able to ensure that there was a reliable electricity system.”

Determined to find a solution, Stachel launched WE CARE Solar. Here’s more of our recent conversation:

How did you start WE CARE Solar?

My husband, Hal Aronson, is a solar educator. When I was writing to him from Africa, he said, Maybe we can get a solar electric system for the hospital. When I came back to Berkeley, there was a competition to provide a technology for a social good. My husband and I pulled together a team to see if we could get some money for this solar electric system. We didn’t win the top prize, but we got enough attention to secure funds for this project. Our initial project was to help one hospital and provide a fairly hefty amount of solar power. We also brought in a walkie-talkie system that was charged by the solar power. We named our group WE CARE, which stands for Women’s Emergency Communication and Reliable Electricity.

Before that installation happened, I wanted to show my Nigerian colleagues what we’d been working on. I asked my husband to put together a small unit — small enough to fit in my suitcase — to show what solar electricity was all about. I showed them this demonstration kit — and they loved it. It was enough to power walkie-talkies and power batteries for headlamps. They wanted to keep it. I left it there while we were getting ready for the larger installation. They used it for six months. When we came back to do the big installation, people in the hospital had already talked to their colleagues at other clinics in Nigeria about the solar suitcase. [The other clinics had] the same problems. It occurred to me that we could have enough power in that little suitcase to provide quite a bit of good for these clinics. We ended up creating more suitcase-sized systems. We literally adapted a carry-on piece of luggage to have all the equipment it needed.

Do you primarily do the suitcases now, or are you doing more big installations at hospitals?

We’re not primarily doing big hospitals anymore. We decided to focus on smaller systems because it didn’t seem like there were other groups working on that. The solar suitcase can be expanded. It started with a fairly limited amount of electricity, using either a 40-watt panel or an 80-watt panel. But it has the capacity to be expanded to accommodate a 300-watt panel. My guess is that over time we’ll have different sized solar suitcase-like systems. We started getting requests for these suitcases from all over the world, so we feel like there’s a need for these. We’ve tried to have a focus on the solar suitcases and other types of accessories. The solar suitcases come with solar-powered flashlights, solar-powered lanterns, headlamps.

We’re going to do a study with the World Health Organization starting in Liberia. We’ll be equipping 18 clinics with these systems and we’ll be comparing clinical outcomes to 18 clinics that don’t have solar suitcases. What we found in that first hospital [in Nigeria] was that the maternal mortality rate in the hospital decreased substantially and the capacity to admit more patient increased. The hospital that had as many as seven or eight deaths a month now only has one or zero. They’re also seeing more patients every month. It seemed like that larger installation made a big difference. What we want to see now is if a solar suitcase can also have an impact on lowering maternal and neonatal deaths.

How many suitcases have gone out so far?

Around 50 [suitcases] in about 11 different countries.

What’s been the biggest challenge so far?

We started as a cottage industry and as we’ve had increasing demand, we’ve needed to develop an organizational structure. There’s a lot that needs to be done to build the capacity of an organization. We need to formalize processes that were, up until now, very informal. Most of the people in the organization have been volunteering. But as we grow and become sustainable, we need to create a budget and hire people. To me, what’s been challenging is growing an organization and learning how to scale something up so it can work in different countries and develop supply chains. As we want to supply larger organizations with these, we need to come up with other mechanisms for transport. All of these things become more complicated as we grow.

Other than the WHO study, what else is planned for the organization?


We were funded by the Blum Center for Developing Economies to create a second iteration of the solar suitcase. We’ve tried to get feedback from people who have been using the solar suitcase around the world and pull that together to try to make a better piece of equipment — something we think will be more robust, more cost effective and suit the needs of clinicians better than the original. We’ll be doing field trials in Nigeria in the coming year.

By Christina Hernandez
http://www.smartplanet.com/people/blog/pure-genius/shining-a-light-on-maternal-mortality/5547/

Is Nigeria on track in achieving MDG 4?

The recent document ‘Saving New born Lives in Nigeria; NEWBORN HEALTH in the context of the Integrated Maternal, Newborn and Child Health Strategy; Revised 2nd edition, 2011’ has come at a significant time, as the world over, every country is taking stock of how far it has gone in accelerating effort to achieving the health related Millennium Development Goals (MDGs)

The forward signed by the Professor C.O. Onyebuchi Chukwu, Nigeria’s Minister of Health Federal Ministry of Health, has emphasized that “the first 28 days of life – the neonatal period – is a critical time for the survival of the child. Every day in Nigeria, about 700 babies die (around 30 every hour). This is the highest number of newborn deaths in Africa, and the second highest in the world.”

The report owned up to the fact that care of the newborn is an aspect of child survival that has received limited attention. The situation is tragic, especially as most of these babies are dying due to preventable causes such as intrapartum-related injury, infections, and prematurity.

In 2007, the Federal Ministry of Health (FMOH) put together the Integrated Maternal, Newborn, and Child Health (IMNCH) strategy to help revitalize maternal, newborn, and child health in Nigeria. This strategy is being implemented within the framework of the National Strategic Health Development Plan (NSDHP). In line with that, Nigeria has began the ‘Countdown to 2015 for Maternal, Newborn and Child Health (MNCH)’ which is a global movement of governments, academics, agencies, non-governmental associations and healthcare professionals, with The Lancet as a key partner. Countdown was established in 2005 to improve the use of country-specific data to stimulate and support action and accountability by tracking coverage for priority MNCH interventions to accelerate progress towards most especially MDGs 4 and 5 that aim towards reduction of Child and Maternal Mortality.

The report reiterate that “Nigeria, as the largest country in Africa holds the key to Africa’s progress towards the MDGs. Recent progress for MDGs 4 and 5 is more encouraging but much remains to be done with 33,000 maternal deaths and almost 1 million under-five deaths. Time is short and focused action is critical. Priority actions based on the Nigerian data are clear:

Focus on coverage gaps for high-impact interventions, particularly family planning services, and antenatal, childbirth, and postnatal care, and case management of childhood illnesses is essential.

Prioritize within the continuum of care, especially around the time of birth, and from pre-pregnancy through 24 months. This will save mothers, babies and also the many stillbirths in Nigeria each year, and improve child health and survival.

Implement equitable healthcare. Programmatic implementation is critical to address inequities by geographic region, by urban/rural and by socioeconomic status, supported by monitoring data.

Emphasize maternal and child nutrition. Nutrition is central to both national and sub-national development strategies and requires a multi-sectoral approach.

Ensure predictable, long-term funding for MNCH in all states, and invest in the highest impact care for the poorest families.

Monitor progress and evaluate outcomes. Conduct locally driven implementation research and act on the results.

The report has informed the readers some home truth that recent progress has been made towards reducing child mortality but Nigeria is currently off track for Millennium Development Goal (MDG) 4 – a two-thirds reduction in child mortality (on 1990 levels) by 2015. According to UN mortality estimates, Nigeria has achieved only an average of 1.2% reduction in under-five mortality per year since 1990; it needs to achieve an annual reduction rate of 10% from now until 2015 to meet MDG 4

“While some progress has been made to reduce deaths after the first month of life (the post-neonatal period), there has been no measurable progress in reducing neonatal deaths over the past decade. About 5.9 million babies are born in Nigeria every year, and nearly one million children die before the age of five years. One quarter of all under five deaths are newborns – 241,000 babies each year. Many deaths occur at home and are therefore unseen and uncounted in official statistics….. Nigeria’s failure to make inroads regarding the MDGs significantly influences Sub-Saharan Africa’s achievement of these goals as a whole and contributes disproportionately to global childhood mortality.”

The report pushed some specific recommendations that could ensure progress, such as;

Up to 70% of these newborn deaths could be prevented if essential interventions in existing health packages reached all Nigerian women and newborns.

The leading causes of death are intrapartum-related, or ‘birth asphyxia’ (28%), complications of preterm birth (30%), and severe infections (22%). Healthy home practices and community-based care – which are possible to improve even in hard to- reach areas – could save over 90,000 babies a year.

Greater priority on tackling malnutrition is vital to attain Millennium Development Goals on eradicating poverty, reducing child mortality and improving maternal health.

I will conclude this article by asking to what extend is the Federal Government and its international partners genuinely involving the states and LGAs in designing, planning, implementing evidenced based interventions and monitoring and evaluating initiatives that will improve our not too good health indices. The national figures are aggregates of what happens at the state and LGAs and selecting few of them to intervene may not lead to the changes we desire by 2015.

All comments to Dr Aminu Magashi at healthweekly@yahoo.com
http://dailytrust.dailytrust.com/index.php?option=com_content&view=article&id=12509:is-nigeria-on-track-in-achieving-mdg-4&catid=12:health-reports&Itemid=13

Boosting child and maternal health

It is laudable that the Federal Government recently renewed its resolve to checkmate child and maternal deaths in the country in order to achieve the Millennium Development Goals (MDGs) by the 2015 target date.

Revealing this in Abuja at the National Summit on Maternal and Infant Care (NSOMIC), organised by the Ministry of Health in collaboration with US-based Healthline Foundation, the Minister of State for Health, Suleiman Bello, said that the care programmes will soon commence in seven states of the federation.

The benefiting states are Ebonyi, Taraba, Bayelsa, Kwara, Adamawa, Ogun and Zamfara. According to the minister, the states chosen for the maiden implementation of the maternal and infant care health plan have the poorest maternal and infant health indexes in the country.

Government’s optimism that it can achieve the MDGs by the target date is borne out of the fact that the country made some progress in reducing maternal and child mortality as shown by the 2008 National Demographic and Health Survey (NDHS). But, there is still need for more work to consolidate the gains.

Similarly, Bello elaborated that governments at the federal, state and local government levels are focusing more on the issues of women and children using implementation of the National Health Insurance Scheme (NHIS), revitalization of Primary Health Care, provision of free health care services for pregnant women and children under five years as well as substantial increase in health budget.

Also, the Executive Director of Healthline Foundation, Dr. Uchenna Ibeh, said the NSOMIC was conceived to reinvigorate and assess the progress made to ensure equitable coverage of high impact maternal, newborn and child health interventions, to reduce maternal and infant deaths and focus on attendant challenges.
It is commendable that the Federal Government is leading this special intervention to boost child and maternal health in order to enhance our performance in MDGs. We believe the initiative, if well implemented, will tremendously improve our dismal health outlook. Over time, we have been placed in the league of countries with poor health records by global health organisations.

We urge the three tiers of government to make substantial contributions to ensure success of the initiative. Nigeria has an obligation to be among countries that are doing well in MDGs and other health goals. With our enormous human and material resources, the goals are achievable.
To achieve the maternal and infant health objectives, government should ensure systemic planning, good strategy, follow-ups and evaluations to put the programme firmly on course. To ensure sustainability, the people the programme is meant for must be involved. They must be part of the process.
This project must be given all the support it deserves because maternal and child deaths can cripple a nation. Any nation that cannot check such deaths will have a bleak future.

Government should learn from previous botched health interventions of this nature to avoid repeating past mistakes. For this initiative to succeed, it must also carry the people at the grassroots along.

Let government and the relevant organisations embark on elaborate enlightenment campaigns on both electronic and print media in English, Pidgin and indigenous languages. Also, local medium of information dissemination like town criers should be employed to reach the rural communities. Efforts should be made to ensure that the other remaining states of the federation and the Federal Capital Territory (FCT), Abuja, also benefit from the programme.
Above all, the initiative should be tailored to make it acceptable to the intended beneficiaries concerned.

By Sun News Publishing
http://www.sunnewsonline.com/webpages/opinion/editorial/2011/feb/22/editorial-22-02-2011-001.htm

It takes a Cleric to point the way forward to national development...

The Bishop of Oyo Catholic Diocese, Most Rev. Dr. Emmanuel Adetoyese Badejo, has said that for the re-branding project to be meaningful, government at all levels must first accept that it has become a worrisome phenomenon that needs urgent solution.

Speaking with Newsextra in Oyo town, Bishop Badejo stated that this should not be misconstrued as a damning or pessimistic attack on a hated social formation, but the reality that patriotic Nigerians and friends of the country must first of all accept; that there is a problem with Nigeria, before thinking up ways of solving the situation.

He further pointed out that Nigeria, being so much blessed with abundant human and natural resources should not be under-developed as it currently is; insisting that it is a country of great potential. He regretted that the country is pervaded by numberless problems which, according to him, could have been effectively addressed, if sincere and committed leaders are allowed to govern it.

"It is unfortunate that the country is confronted with vicious networks of criminality and violence. In a period of unprecedented wealth and invention, Nigerians have continued to be locked into lives of misery without a stake in their country, or any certainty or control over their future."

The clergyman lamented that corruption has completely enveloped the country.

"Within the possibilities that liberal democracy has to offer, and based on the principles of "another development," it would be a strong social democratic direction that could introduce capital punishment for corruption, for example, and set about to legislate against the vices that are distorting the country’s development."

On poverty, Bishop Badejo posited that it is the most dreadful single problem confronting the country.

While noting that despite the fact that Nigeria is second largest economy in Africa after South Africa, he stated that 96 million Nigerians live on less than 1.25 U.S dollars a day, while one out of every six children die before the age of five.

He said: "20 per cent of poor people in Africa are Nigerians. Closely related to the issue of poverty are disease and other health challenges. Nigeria has the highest malaria burden in Africa. Water and sanitation underpin all the Millennium Development Goals (MDGS), especially those concerning health, education and economic growth."

On religious violence, Bishop Badejo asserted that the Catholics believe in the dialogue of life, truth, as well as promoting action on justice, equity, and rights which enhance openness and mutual understanding.

"It is against this background that the Diocese organises seminars on ecumenism and inter-religious dialogue annually, in order to provide spiritual framework for the birth and growth of Nigeria in the last 50 years of her existence. If we focus on our vision of God as our Creator, we shall have no difficulty respecting one another that are His creatures. We must take every opportunity possible to reflect together, know one another’s religion better and emphasise more on what unites us and see what we can do to make our environment and country a better place for all to live in."

On the way forward, the Catholic Bishop suggested that for the country to be among the 20 economies in the world, Nigeria must be seen to be making progress towards realising the MDGS as captured in their 2005 report, and as more or less confirmed by recent tracking of MDGs performance in the country.

He said: "It will be better that instead of achieving the 21.4 per cent poverty reduction by 2015; it would be 43 per cent. Within the 15-24 years age bracket, literacy rate would be declining rather than increasing. Gender equality in terms of primary schools enrolment has been consistently higher for boys.

"In fact, mortality rate has been increasing, and there is no indication of significant improvement in the maternal mortality rate. Happily, HIV/AIDS prevalence has been decreasing. Environmental challenges persist, causing social conflicts. There is the need to enhance global partnership."

By: Bode Durojaiye, Oyo 21/02/2011
http://thenationonlineng.net/web3/newsextra/28573.html

World Bank lauds Mimiko over safe motherhood project

Press Release-- The World Bank has examined the founding and operation of the one year old Safe Motherhood Project tagged “ABIYE” initiated by the Olusegun Mimiko administration in Ondo State and gave the State government a pat on the back for using the project to reduce maternal and child deaths in the State.
The World Bank’s Country Director for Nigeria, Mr Onno Rhul gave the commendation while speaking at the commissioning of the project’s four health facilities in Ifedore Local Government area by the State Governor, Dr Olusegun Mimiko saying the project was worthy of emulation not only by other State Governments in the nation but in Africa as a whole.

“It is a great pleasure to see the various programmes of the State government which we believe would have equally great impact on the lives of the people. The main reason for coming here today was not only to say well done, though you have performed well, but to encourage you to improve on the achievements already recorded.

“I also want to commend the efforts of the government aimed at ensuring that the lives of both mother and child survive in Ondo State which is the target of the World Bank. We feel that other States should emulate this project,” Rhul said.

In his address at the occasion, Dr Mimiko who reeled out statistical data showing the successful implementation of the project so far, enthused that the several months of toiling to put the project on sound footing had resulted in the delivery of accessible and quality health care services to the citizenry.

“The Baseline Survey carried out revealed that out of 2,989 that registered for ante-natal care, only 432 actually delivered at the clinics. This represents about 16 per cent of registered patients. However, since the inception of the programme about a year ago, 1,031 deliveries have been recorded out of about 3,000 that registered representing about 35 per cent or double the baseline percentage.

“The Mother and Child Hospital in Akure, a 100-bed facility, in less than 12 months of operation has registered and treated 8,061 pregnant women and 11,737 children with at least 20% being non-residents. In addition, 3,389 safe deliveries including 628 surgeries have been conducted as the hospital now records an average of twenty deliveries daily.

Mimiko announced that construction is on-going at Laje in Ondo West Local Government area of a similar referral centre which is to serve as Mother and Child Hospital.

According to the governor, “The poor health indices of the states in the South West as attested to by the World Bank 2008 Report was a wake-up call for the administration to undertake, as a matter of urgency, the total reform of a dysfunctional health system.

“Our goal was to revitalize integrated service delivery towards a quality, equitable and sustainable health care as encapsulated in the state’s Strategic Health Development Plan and the Caring Heart programme of the state government in order to address the situation” the governor asserted.”

For the people of Igbara Oke and Owena, it was commendation galore for the State government as community leaders, beneficiaries of the ABIYE Project in the last one year lauded the Mimiko led Administration saying that their lives have been greatly improved by the project.
http://www.worldstagegroup.com/worldstage/index.php?&id=1964&active=news

Press release: Nigeria’s newborn death toll highest in Africa

Saving newborn lives key to achieving child survival goal, says new report

12 JANUARY 2011 | ABUJA, NIGERIA – New data shows that as the death toll in Nigeria is falling, the percentage of deaths that happen in the first month of life is increasing. Newborn deaths now make up 28% of all deaths under five years compared to 24% two years ago. Six out of 10 mothers give birth at home without access to skilled care during childbirth and it is in the first few days of life when both women and newborns are most at risk.
Every year 241,000 babies die in the first month of life in Nigeria making it the African country with the highest newborn death toll, a new Ministry of Health report, Saving Newborn Lives in Nigeria, revealed today.
The report calls for an increased focus on reducing newborn deaths, the vast majority of which are avoidable. It says thousands of newborn lives can be saved via simple methods, such as teaching mothers about danger signs, encouraging them to seek help early and making sure there is enough medicine and enough healthcare workers at community health centres. The policies are mostly in place and the cost is affordable so now priority must be given to implementing these policies and making sure all families receive essential care.
“The loss of a baby at birth or soon after is a very traumatic experience, especially when the majority of these deaths can be prevented with well known interventions. Such loss affects the family, and also carries social and economic ramifications for the nation, creating a vicious cycle that keeps families in poverty,” said Save the Children in Nigeria’s Country Director, Susan Grant. “The health and survival of Nigeria’s newborns has gone unnoticed for too long.”
The report reveals that there is wide variation in mortality across Nigeria. Nearly 3,000 mothers, newborns and children die every day but there is a big difference between states, between urban and rural areas and between the poorest and the richest. This is partly due to the fact that, although the Nigerian health system is rich in human resources compared to many other African countries, there is inequitable distribution of maternal, newborn and child health staff across the country. For example, while over 90% of women in two states – Anambra and Imo – give birth with a skilled attendant present, in 6 states - Katsina, Jigawa, Sokoto, Kebbi, Zamfara, and Yobe, fewer than one in ten women have access to skilled care at birth.
The report, which was unveiled on 13 January at the 42nd annual Paediatric Association of Nigeria Conference, includes up-to-date child and maternal health profiles for each of the 36 states in Nigeria, as well as national data in order to make local decision making more effective. Mickey Chopra, UNICEF Chief of Health and the global Countdown to 2015 for Maternal, Newborn and Child Health co-chair says from New York, “We applaud Nigeria for this report focusing on state level data and critical coverage, equity and quality gaps. We call on the technical and political leaders in Nigeria to use this data to set evidence-based priorities, invest in implementation and be accountable for change, especially for the poorest families.”
Every state is different and so the key to success is the use the local data contained in the report so State and Federal Ministries of Health can develop and implement an effective, comprehensive health system that reaches all mothers and their newborns.
Nigeria is one of the first African countries with an integrated plan to look after mothers, newborns and children right through from conception to the child’s fifth birthday. The Federal Ministry of Health’s Integrated Maternal, Newborn and Child Health Strategy, is to be commended but implementation has been slow and coverage remains low and inequitable. “We need more funding for maternal, newborn and child health, and specifically a budget line for newborn health in national and state budgets,” says Dr Nkeiru Oneukwusi, Head of the Child Health Division at the Federal Ministry of Health. “We must re-double our efforts to make progress and save children’s lives in line with the United Nations Secretary General’s Global Strategy for Women’s and Children’s Health.”
Recommendations for the report
The Saving Newborn Lives in Nigeria report calls on healthcare decision makers to:
• Ensure leadership, appropriate funding and accountability by meeting the target set in the Abuja Declaration of 2001 to allocate 15% of the national government’s annual budget to health. The 2007 allocation for health of 6.5% of national government spending is still far below this target.
• Prioritize tackling malnutrition. More than a third of children’s deaths are attributed to maternal and child under nutrition, so it must be addressed to attain the Millennium Development Goals on eradicating poverty, reducing child mortality and improving maternal health.
• Orient policies, guidelines and services to include newborn care including advocacy for the passage of the National Health Bill into federal law and ensure its prompt implementation, while continuing roll-out of the IMNCH strategy in all state and support the development, review, dissemination and implementation of newborn care standards, to be adapted and used at state level. In addition, to review, adapt and disseminate newborn care standards and ensure accelerated implementation at state and LGA levels. Saving more newborn lives requires free and equitable access to a comprehensive package of health services for all mothers, newborns, and children under five years of age.
• Effectively plan for and implement policies related to human resources, equipment and supplies and accelerate implementation of the highest-impact and most feasible interventions using a clear, data-based process. Priorities and phasing of implementation will differ by state and can be linked to the IMNCH strategy planning process in each state in the context of the State Strategic Health Development Plan.
________________________________________
For more information on the Saving Newborn Lives in Nigeria report or to speak with newborn health experts, contact Hadiza Aminu at +234 803 388 1288 or h.aminu@scuknigeria.org.
Notes to Editors
The report is led by the Federal Ministry of Health in partnership with multiple agencies and professional associations. It features letters of commitment from key stakeholders in maternal, newborn and child health in Nigeria including the global Countdown to 2015 for MNCH; UNICEF, WHO, UNFPA; USAID’s Maternal and Child Health Integrated Program (MCHIP) led by Jhpiego, the Partnership for Revising Routine Immunisation in Northern Nigeria / MNCH project; Save the Children, Nigeria’s health professional associations (Pediatric Association of Nigeria, Society of Gynecologists and Obstetricians of Nigeria, Nigerian Society of Neonatal Medicine and the National Association of Nigerian Nurses and Midwives), celebrity ambassadors for children, and the Minister of Health.
http://www.who.int/pmnch/media/membernews/2011/20110112_savingnewbornlives_nigeria/en/index.html


In a similar vein we have the speech of her Excellency: First Lady of Kwara State, posted on the partnership for Maternal, and Newborn Child Health (PMNCH) website (She is known to run an advocacy called wellbeing foundation) where she expressed her views about infant mortality in Nigeria.


First Lady of Kwara State speaks out on infant mortality
All Africa.com



8 January 2008
Posted to the web 9 January 2008
Toyin Saraki
Ilorin
Over the past few years, I have continually ruminated over the incidence of infant mortality in Nigeria and how to put a stop to it.
As a private citizen without any executive power to effect any change, the only way one could make any impact remains in the areas of advocacy and public enlightenment.
The former is geared towards getting the powers that be to improve the health system, and the latter to alert communities towards the situation and various ways in which the ordinary citizens can also facilitate a drastic change in the situation.
I also embarked on research on what other countries of the world have done to change the trend and what Nigeria needs to do right to attain the Millennium Development Goals (MDGs). One of my discoveries is the lack of integration of the well-being of the mother, her newborn and her child up till the age of five.
We often talk about the issues of infant and maternal mortality as if they are totally exclusive of each other. The fate of these group of people are so intertwined that the lack of care for one invariably translates into trouble for the others.
Few families are aware that the quality of a child's nutrition from the age of three could be instrumental to the reproductive capacity of this child when he or she grows up as man or woman. Also, education of women and girls is central to the reduction of deaths from childbirth as it is to so many other things including national development. Nigeria terribly lags behind in this.
According to UNICEF, of the 3.2 million children who are out of school, 2.6 million of them are girls. The point is that to achieve Millennium Development Goal (MDG) 4 which is about saving the millions of children who die before the age of five annually, we must integrate Goal number 5 which aims at reducing maternal mortality by 75% before the target date of 2015! None of these two goals can be achieved with the exclusion of the other.
Only a very healthy woman, who is well informed on the options available to her and with adequate medical attention, would deliver a child with any chance of survival. So till date we suffer from lack of adequate data to even plan for proper and well articulated health delivery.
Hospitals at the primary, secondary and tertiary levels are usually not adequately equipped and managed while we are almost without a well co-coordinated referral system.
Nigeria, which produces one in every five Africans anywhere in the world ranks second
in global under-five mortality. This means that we lose not less that 1,000,000 under-five
children every year. It is estimated that between 100 and 201 infants and under-fives die
out of every 10,000, a frightening ten percent of global deaths. Neonatal mortality rate in
Nigeria is estimated at 48 per 1000 lives.
Maternal mortality rates are as frightening. A woman's chance of dying from pregnancy related complications in Nigeria is 1 in 13. So between 52,900 and 59,000 women are believed to die from pregnancy and child birth related causes in Nigeria annually. And for every woman who dies, between 20 and 30 more are believed to develop short and long term disabilities.
We have a weak health system and low coverage of previous interventions on Maternal,
Newborn and Child Health (MNCH) interventions; while there is a huge problem of lack of education for our women on the need for them to seek medical attention on
reproductive issues and even antenatal care.
There is the problem of the economic capacity of women to even attend these hospitals.
There are several instances of women who would not go to hospitals simply because
they do not have money for transportation, not to talk of money to consult doctors or pay
for drugs.
Nigeria is currently off track as far as MDGs 4 and 5 are concerned. True we have seen
a marginal decrease in the death of under-fives in the last few years; we are no where near achieving the MDGs. It is however not late to move in the right direction so that the giant of Africa is not left behind.
The current administration has put an Integrated Maternal Newborn and Child Health
Strategy (IMNCH) in place as policy guide toward achieving MDGs 4 and 5, which is expected to target focused antenatal care for pregnant women.
This ensures that every pregnant woman sees a doctor at least four times during her pregnancy. IMNCH also plans to strengthen interpartum care, emergency obstetric and
Newborn Care, routine postnatal care, newborn care, Infant Young Child Feeding and prevention of malaria through the use of Insecticide treated nets and IPT.
It will focus on immunisation; prevention of mother to child transmission of H1V/AIDS,
management of common childhood illnesses and care of HIV exposed or infected children as well as water, sanitation and hygiene; all in all, a huge plan to help Nigeria avoid unnecessary maternal and infant death.
With the drive being lead by the Minister of Health, Professor Adenike Grange, I am
confident there will be no problem with the implementation of this plan. The several
partnership initiatives currently and more of such collaborative efforts are needed to
ensure the IMNCH works.
We need to eradicate the inequality of access for women and children to hospitals. So
apart from providing more hospitals, states and local government administrations need
to consider the user fee abolition for pregnant women and children under five announced
by the federal government last year.
If we make the education of our girls' a priority we make the girls knowledgeable family
planners, more competent mothers, more productive and better paid workers, informed
citizens, confident individuals and skillful decision makers.
We must go some steps further towards dealing with all the encumbrances to the
emancipation of women. We must make effort to reduce poverty and income inequalities
among women.
We must also empower families and communities to take necessary MNCH actions at
home and to seek health care at the right time.
Every family must understand how to take the Temperature, Pulse, and Respiratory
Rate (TPR) of children when they present for illness. The issue of the nutrition of our
children is very important as their growth as children and their capability in future
depends on that. Everyone should know where the nearest hospital is and what services
are available there.
We really need to upgrade hospitals at the primary level with medical personnel who are
adequately remunerated and happy to do the job. Laboratory support with a framework
for prompt and accurate diagnostics must be a priority for us at this stage even as we
must ensure that we have a strong policy on the availability and standard of drugs.
I see no way we can have a healthy newborn or child without having a very healthy
mother. It is what we invest in our women that they give society back in the children they
deliver to us. And we can not blame them if they deliver still births or when their children
die even before they start life. A society serious about its future must take the physical,
mental and social well-being of its women seriously.
We all have a role to play in our various homes and places of work to change this sad
tide. We need to think well about how to work together to achieve this and give our
country a future we all can be proud of even when we are no longer here.
Saraki, First Lady of Kwara State, wrote in from Ilorin
http://www.who.int/pmnch/topics/newborn/sarakiletter/en/index.html
http://www.who.int/pmnch/topics/Sarakiletter.pdf

World Cancer Day

World Cancer Day is a global observance that helps raise people’s awareness of cancer and how to prevent, detect or treat it. This event is held on February 4 each year.

Background

Cancer is a leading cause of death around the world, according to WHO, which estimates that 84 million people will die of cancer between 2005 and 2015 without intervention. Low-income and medium-income countries are harder hit by cancer than the high-resource countries. It is essential to address the world's growing cancer burden and to work on effective control measures.

The WHO has also estimated that up to 500,000 new cases of cancer will be diagnosed annually in Nigeria by 2015 if prevention and screening strategies are not robust. As the world marks World Cancer Day again on 4th February, how informed and equipped is Nigeria to fight cancer?

World Cancer Daly. lets all join the group:

http://www.bloggersunite.org/events/search/world+cancer+day



This years theme for the World Cancer day is: "teach children and teenagers to avoid UV exposure by being "sun smart"
Mother's should try and make sure their children and wards are properly clothed in clothes whenever the sun is out. This is usually between the hours of 10.00am and 6.oopm.
This will go a long way in reducing and totally eliminating skin cancer amongst others.
Though emphasis seems to be on skin cancer this year due to the amount of exposure youths especially are being exposed to, market women with little or no stalls also stand a good chance of having cancer of the skin.
Students should be raised with the awareness of staying out of the sun whenever the sun is fully out. This usually occurs in Nigeria between the hours of 12.30pm and 4.30pm.
Fight against cancer has been going on for a while now.
it is one of the highest killers in Nigeria. it kills more people than AIDS!!

The campaign emphasizes that 40% of cancers can be prevented through these healthy behaviors:

Provide a smoke-free environment for children
Be physically active, eat a balanced, healthy diet, and avoid obesity
Learn about vaccines for virus-related liver and cervical cancers
Avoid over-exposure to the sun

So lets go out there with a new outlook on life.
Its a beautiful World....dont lets leave it in a hurry.

One woman dies every hour from cervical cancer

One woman dies every hour from cervical cancer -Statistics .

“A woman dies every hour from cervical cancer in Nigeria, while 10,000 other women succumb to breast cancer in a year,” says Rev. Cannon Kin Egwuonwu of the National Cancer Prevention Programme.

Egwuonwu, who presented the sordid statistics at the 2011 convention of the Nigerian Guild of Editors in Ikeja on Saturday, added that 14 Nigerian men also die from prostate cancer every day.

He noted that though the casualty figure was alarming, “most cancers are either preventable or curable”.

According to Egwuonwu, a third of cancers are curable, another one-third preventable, while victims have to live with the remaining one-third.

He advised that screening and early detection was crucial to controlling or curing cancers.

Egwuonwu explained also that there were anti-cancer vaccines for some form of cancer, and that these were available in Nigeria.

He decried the poor attention that cancer was receiving in the Nigerian media and appealed to practitioners to bring the issue to the front burner.

“Cancer kills more people than HIV/AIDS, malaria and tuberculosis combined,” he stressed.

Egwuonwu said that the World Cancer Day coming up on Feb. 4 would be preceded with awareness campaigns and free cancer screening and advised Nigerians to take advantage of it.

http://www.compassnewspaper.com/NG/index.php?option=com_content&view=article&id=73348:one-woman-dies-every-hour-from-cervical-cancer-statistics&catid=43:news&Itemid=799

All Claimed By Cancer...

Cancer is one of the world's most killer diseases today that has defied total cure. It is one of the major causes of death in Nigeria especially among the women who die from cervical and breast cancer.

The burden of cancer is increasing globally with an expected 20 million new cases in 2020, half of which will be in low and middle income countries.

According to the World Health Organisation Report, Nigeria alone is estimated to have 350,000 new diagnosed cases annually which WHO further stated will increase to about 500,000 by the 2020.

The high prevalence of HIV experts say was largely responsible for the escalating rate of cancerous ailment across the globe particularly in Africa.

The 4 commons cancers found in Nigeria are prostrated and liver cancers in males and breast and cervical cancers in the females.

In recent times breast and cervical cancer is gaining global attention.

In Nigeria, the disease is not only causing anxiety among the old and middle aged women but also in teenagers.

The disease no doubt can be said to be the major cause of death among Nigerian women today irrespective of their social class and age.

Unfortunately,themedical profession is yet to the sudden rapid scourge yet demystify the sudden rapid scourge of the disease which is today spreading in a manner never expected before.
The Vice Chancellor of the University of Ibadan, Prof. Isaac Adewole in an interview with Daily Champion said over 10,000 Nigerian women die of cervical cancer annually in a painful , miserable and undignifying manner.

Prof. Adewole said 80 per cent of cases in Nigeria were presently in advanced state were little and nothing can be done.He also observed that Nigeria generally records 100,000 new cases of cancer annually.

According to the University don, cancer is alarming in Nigeria because we have not put in place measures to detect and treat cancers at pre-cancer and early cancer stages.

He said" We also have in abundance cancer promoting factors like infection, diet and poor life-styles"

Despite the high prevalence of cancer in Africa and Nigeria in particular ,Prof.Adewole insisted that both cervical and breast cancer can be prevented," 40% can be treated successfully" he assured.

He said"There is a prevention vaccine against Human Papilloma Virus-HPV, the virus that is responsible for cervical cancer. The vaccines are available in Nigeria but beyond the reach of the common people who need it, he noted

However, he further revealed that cervical cancer is now on the decline worldwide as many countries have acquired cervical cancer preventing vaccines-Human Papilloma Virus vaccine deployed on nationwide basis for girls who are predominantly at risk and boys who infect the girls.

Asked on the way out,the erudite scholar posited that for Nigeria to witnessed reduction in cancer scourge, the federal government must be able to do what the developed nations are doing to address the health challenge, "hence the right attitude and measures must be in place".

"Developed countries have self breast examination as a routine and offer mammogram to women above the age of 50 years .We are yet to adopt any of these as national priority"

He called on the federal government to adopt the HPV vaccine through the National Programme on Immunization and be given to all Nigerian girls between the ages of 9 and 15 (before they commence sexual activity.

Other measures enumerated by the Premier University Vice-Chancellor included, provision of adequate fund,research, awareness campaign and the education of Nigerians that about 40% of cancers are preventable. Again he said, the government should also declare cancer control a national priority and establish a cancer control department.

Nigerians on their part should also make themselves available for regular check and screening for early detection of the disease irrespective of the economic crunch.

The Director-General of Nigerian institute of Medical Researcher (NIMR) Prof. Innocent Ujah attributed the high prevalence of cancer in Nigeria to traditional faith and belief system of many Nigerians.

To tame the scourge he said, there should be a renewed effort in cancer awareness and improvement in cancer screening method.

He said since some of these cancers are preventable, the scourge can also be address by generating a data from all parts of the country whereby already identifiable risk factors are properly documented, while observing other emerging issues.

The Coordinator of National Cancer Research Network (NCRN) Dr. Nkiru Odunukwe said in places where HIV prevalence is high, the overall incidence of cancer seems to have increased by 15 per cent.

Dr. Odunukwe who is also a Deputy Director Research Head of Clinical Science Division of NIMR said to fight cancer head on in Nigeria, the goal 6 of the Nigeria cancer control plan which is to increase research activities in cancer control must be implemented immediately without further delay.

Again she said, it is necessary to put in place a mechanism to identify epidemiological risk factors for cancer in our environment to save lives.She also called for a commom working document that will serve as a guide among stakeholders and researchers in cancer.This she said will help the government come out with a national cancer policy that wiil help tackle the disease.

While assuring that increase in capacity building will go a long way in addressing the cancer scourge, Dr. Odunukwe also believe that increase in infrastructure, increase cancer research centres establishment of a central Data Bank will help adequately in the management, prevention and treatment of the disease.

When the federal and state governments enthusiastically put the above underscored measures in place, Nigerians would no doubt heave a sigh of relief in this area of health challenge.


http://allafrica.com/stories/201102030361.html

Nigerian women deserve free cervical cancer screening – NYONG

In readiness for the World Cancer Day coming up tomorrow..i was thinking of what to write then i discovered an article, extract below:

Rot. (Dr.) Eyo Nyong is a General Medical Practitioner and Medical Adviser, Motorparts Industry. In this interview with Chioma Obinna, Nyong who is also Coordinator of the annual health programme of the Catholic Chaplaincy Centre, Lagos University Teaching Hospital (LUTH) maintaines that free screening for all Nigerian women will check the spread of cervical cancer.
Excerpts:
Cervical cancer affects that area of women’s anatomy called the cervix which is the mouth of the womb that opens up during child birth for the baby to come out. Cervical cancer is an abnormal growth of the cells of that area of the womb that grows out of proportion and then start spreading to distant areas of the body where they can cause problems. It can also affect the bladder and rectum. The cancer is associated with the human papilloma virus which is transmitted sexually. Any woman who has been previously exposed sexually is at risk of having the virus.
The virus can stay in the body without causing any problem but in concert with other environmental factors it can now become effective and start causing changes in the cervix. Some of these environmental factors that have been identified include early exposure to sexual intercourse, exposure to sex at early stage, in multiple sexual associations, multiple delivery, sometimes oral contraceptives, sometimes vitamin deficiency, etc.

Campaign

The cervical cancer campaign should be in two prone approach, the first one, is to screen all women because a woman who has been sexually exposed may be harbouring the early stages of the disease and show no symptoms. We know that it takes between 10 to 15 years after commencement for the woman to come down with cancer. It gives us a window of opportunity over this long years that if you screen a woman you were likely to pick up this early stages of the disease and at that point when it has not spread it is totally curable. That is the beauty of screening. So we are encouraging people all women should go for screening at least once in three years.

The other side of the campaign isvaccination. Earlier before now, we did not have the vaccine but now the vaccine has been developed against most of the viruses that cause the cancer, the type 16 and type 18 that are implicated. The vaccine has been developed. People that should be targeted during this programme should be girls between the ages of nine and 13, hoping that they are not yet sexually exposed. If we vaccinate them, they are protected for life. Then, any woman who has been screened and found to be negative for early stages of the cancer can also take the vaccine regardless of whether you have been sexually exposed before or not.

This is the campaign Rotary Club of Victoria Island, District 9110 is doing to be able to protect these categories of people as well as our women.

Statistics

In Nigeria we don’t have data but globally there are about 500,000 cases diagnosed every year. If about 5 per cent come from developing countries like Nigeria, then about 300,000 women are dying annually from cervical cancer. Also, 83 per cent of them comes from developing countries. In Nigeria here, the statistics is such that we have per day, about 4 to 10 women dying from this cancer.

Way forward

If the causative factor has been identified and there is a vaccine for it the campaign should be stepped up. Firstly, let us screen all women. Early detection means a better chance of out come, during treatment. The way forward is to advocate for free screening of our women as part of our public health initiative and then vaccination of the young girls people who are yet to be expose sexually.

Prevention

Unlike any other sexually transmitted disease it is not the one you can find out if you have it. But chances are that if you are able to screen all women for cervical cancer most likely you may have eight in 10 who harbour the virus because the virus can lie dormant for so many years without any symptoms.

Surge of cervical cancer

There is an increase in awareness. Many women are now willing to go to hospital for examination. So we are seeing early stages of the cancer joining the statistics but before now women with this problem were dying because they never knew.

Some of them are post menopausal women who have past the age of seeing their menses and then all of a sudden, they started noticing blood or stain and discomfort and then, they go to the hospital and they tell them it is cervical cancer at that stage, it is late. So the surge is one, increase in awareness and secondly, a lot of ignorance are still going on in the past that we couldn’t screen these women before now. We start only seeing them at the late stage because at that stage it is not curable. Unlike in Europe the incidence of cancer in developed economy have dropped because they have incorporated it into their public health system. Every woman does that almost every two years. There, they are vaccinating people there. The incidence has dropped.

Policy

It is desirable, we have to start from somewhere because prevention is better than cure. Once the cancer starts there is very little thing we could do. It is a burden to the patient, family, individual it is so enormous, and the misery. So, would we rather not have these people screened? Which is the cheapest and safest thing to do.

Rotary Campaign

We are rolling out with the vaccination of 50 girl children and free screening of 100 women today. We decided to roll out with the Catholic annual health programme because here, they have resources persons. Just this year the vaccines are available, then it is so expensive, but people cannot afford it, that is why Rotary is coming in.

Vaccination is the main issue. We are rolling out with 50 girls today when we move from here we are going to be going to schools in some areas in Lagos state to have these girls selected and vaccinated.

By Chioma OBINNA

http://www.vanguardngr.com/2010/11/nigerian-women-deserve-free-cervical-cancer-screening-nyong/