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Wednesday, September 21, 2011

World Bank calls for improved health care in Nigeria

The World Bank has called for an improved health care system to help reduce the high rate of maternal mortality witnessed in Nigeria.

Mr Sudhir Shetty, co- director, World Bank 2012 World Development Report (WDR) on Gender and Equality at a video conference on Sunday to launch the report observed that Nigeria still had high rate of maternal death.

He said: “In the case of Nigeria, what is observed is that the maternal mortality is still quite high, which is also a big issue in almost all parts of Africa.

“There is a need for necessary improvement in health care delivery.

“The second issue is that female farmers have lower yield than their male counterparts and this calls for discussion on the need to improve women’s access to resources through window mechanisms, window access to productive resources, improved technology and education.”

Explaining the report, he said it was the first time that the bank devoted its WDR to gender equality.

Shetty said that the outlook observed that in the past decades, women’s and girls’ education and health level had improved greatly.He added that two-third of all countries had reached gender parity in primary education, while more than one-third of girls significantly outnumbered boys in secondary education.

According to him, there are more women than men in universities across the globe, with women tertiary enrolment rising more than sevenfold since 1970.

“Female life expectancy has increased by 20 years to 25 years in most regions in the past 50 years to reach 71 years globally in 2007 compared with 67 years for men,” Shetty declared.

http://tribune.com.ng/index.php/news/28385-world-bank-calls-for-improved-health-care-in-nigeria

Nigeria has second highest maternal mortality rate

From Osaigbovo Iguobaro, Benin



With an estimated maternal mortality rate of 608 per 100, 000 deliveries each year, Nigeria has been rated the second after India in terms of maternal death by the Women Health and Action Research Centre (WHARC).







The organisation, whose aim is to promote the reproductive health and social well-being of women also said Nigeria accounts for 50 percent of the global number of maternal deaths.

Chief Executive officer of the Centre, Prof. Friday Okonofua disclosed this at a workshop on assessment of infection control practices in delivery care units in Edo state.

The workshop which was attended by officials from the state ministry of health, women affairs as well as health workers from public and private health institutions and representatives of non-governmental organisations identified the three primary causes of maternal mortality in Nigeria to include; bleeding after birth, pregnancy hypertension and post-delivery infections.

"Studies, including data from Edo state have shown that up to four out of 10 women who experience puerperal infections die from the complication. Besides, maternal mortality in Edo state reflects the national average. Maternal health is presently not prioritized by the state government," he stated.

Prof. Okonofua declared that 70 percent of pregnant women attend ante-natal care, 60 percent are delivered by doctors and nurses, while less than 10 percent of deliveries are conducted by traditional births attendants.

"The results of the study demonstrate the lack of appropriate policies and practices relating to infection control in maternal units in Edo state, given that puerperal sepsis is the third leading cause of maternal mortality in the country," Prof. Okonofua added.

Worried by the lack of data of maternity care and puerperal sepsis at the health facilities visited, the centre recommended that accurate record keeping should be prioritised as an important strategy to monitor the outcome of infection control measures.

http://www.peoplesdaily-online.com/news/national-news/20629-nigeria-has-second-highest-maternal-mortality-rate

Maternal Mortality - the Plight of Local Women

Nigeria as a nation is blessed with both human and natural resources, yet women die everyday from the scourge of maternal mortality. Research has shown that, Nigeria has the second highest rate of maternal death in the world, one in every eight women die while giving birth, most of these death are avoidable as compared to the united state were only one in 4,800 maternal mortality is recorded.

However, one of the millennium development goals is to improve maternal health care which was adopted by the international community at the united nations millennium summit in the year 2000, by achieving 75% drop from the level of maternal mortality in the year 2015. But come to think of it, would this really be possible in this country, where women die from wide range of complications in pregnancy, child birth or postpartum period which in most cases are caused by poor health at conception and lack of adequate care needed for the healthy outcome of the pregnancy for themselves and their babies.

Nigeria as sovereign state is still gasping for a regular power supply in the 21st century a time where virtually every activity of man have gone digital and most hospitals are not excluded from this darkness age being experienced in the country. Some women are operated upon using candles in the theatre or kerosene lamps.

Pregnancy which should be a thing of joy where women experience changes in their body is now seen as a death warrant for most women due to the weak and poor primary health care system and less qualified staff in most rural communities. In the urban areas where some good health services are available they are too expensive or reaching them is too costly.

Every year, more than 133million babies are born, 90% in low and middle income countries, when their mother die, the chance of their survival is meagre. Lack of maternal care is posing a large burden on babies' death and disability among infants. Every year, 3million babies are stillborn. Almost one quarter of these babies die during birth. The causes of these deaths are similar to the cause of maternal death; obstructed or prolonged labour, eclampsia and infection such as syphilis. Poor maternal health and disease that have not been adequately treated before or during pregnancy contribute to intrapartum death but also contribute to many babies born preterm and with low birth weight. Among the 133million babies who are born alive each year, 2.8 million die in the first week of life and slightly less than 1million in the following three weeks.

Therefore for Nigeria to achieve an accelerating success in improving maternal health, quality health system and barriers to access health services must be identified and tackled at all levels, even down to the grassroots. Proper education should be adequately given to pregnant women on how to take care of themselves during pregnancy. Adequate enlightenment campaign should be carried out in the rural areas using the local chiefs and clergies in collaboration with the local media on the importance of Ante-natal care during pregnancy just the way the campaign against polio is being done. During Ante-natal care women are examined in case of complications and also drugs are administered to cater for the health of the mother as well as the foetus in her womb.

In the northern part of the country VVF is very common mostly due to lack of the care needed during pregnancy. And when this occurs their system becomes damaged, carrying out their daily activities becomes difficult, the worst of all is that most husbands leave their wives to suffer the pain alone without providing the care they need.

Pregnancy and Childbirth
Most maternal death are avoidable, as the health care solutions to prevent or managed the complications are well known. Since complications are not predictable, all women need care from skilled health professionals especially at birth, when rapid treatment can make a difference between life and death.

Nigerian government should try and put smiles on the faces of women especially the rural dwellers by putting different measures in place to cater for their health, money should not be a deterrent in procuring a good health in Nigeria.

Hawwa Baba Muhammad,

400 Level Mass Com,

Bayero University, Kano.

http://allafrica.com/stories/201109160681.html

Okonofua laments high rate of maternal mortality

BY SIMON EBEGBULEM

BENIN CITY-Project Director of Women’s Health and Action Research Centre, WHARC, Professor Friday Okonofua, Tuesday, expressed concern over the high rate of death during delivery in the country.

The former Presidential aide, who described the high rate of death as alarming, added that the two teaching hospitals in the state, University of Benin Teaching Hospital, UBTH, and Irrua Teaching Hospital, Irrua, were being overworked due to alleged failure of the government to prioritise maternal health.

Prof. Okonofua who spoke at a workshop on Infection Control Practices in Delivery Care Facility in Edo State, organised by WHARC, noted that the nation may not be able to achieve the Millennium Development Goals, MDG-5, aimed at reducing maternal mortality by 75 per cent by 2015.

He said: “Globally, Nigeria currently has the second worst case of women who die during pregnancy each year. With an estimated maternal mortality rate of 608 per 100,000 deliveries and 50,000 women dying each year, Nigeria is second only to India in terms of maternal mortality and this number is high.”

“This country was also recently reported to be one of the six countries that account for up to 50 per cent of the global maternal deaths. At this rate, many are worried that Nigeria may not achieve the MDG-5, which is aimed at reducing maternal mortality by 75 per cent by the year 2015.”

He stressed the need for the Edo State Government to establish infection control committees in delivery units in the state, adding “a procedure for regular auditing cases of maternal deaths and near miss cases of puerperal sepsis should be instituted. This will ensure the identification of measures to prevent puerperal infections in the state”.

http://www.vanguardngr.com/2011/09/okonofua-laments-high-rate-of-maternal-mortality/

Indians pledge to build world-class hospitals in Nigeria

By AZOMA CHIKWE

Nigerians seeking Medicare abroad would spend 80 per cent less for better treatment in India compared to Europe. This was disclosed recently by an Indian cardiologist, Dr. Naresh Trehan, during a media chat at the West African Health Sixth International Medical Exhibition and Conference at the Eko Hotels and Suites in Lagos.

Trehan, chairman and chief executive of the multi-specialty Medanta Hospital- Medicity in New Delhi, India, said India offered more medicare advantage to Nigerians, a situation which explains the increasing number of patients from Nigeria seeking medical attention in that country.

“The advantage we provide from the healthcare that has been developed through us is that we can provide treatment for ailments like heart, kidney, liver and cancer at a much higher level of success and the cost is very affordable. People do not have to spend large sum of money, going to other countries. We can do a much better job at a much less price - one fifth of the cost,” he said.

According to him, the monthly health distribution of patients that visit Medanta Hospital from different parts of the world shows that between 40 and 50 are from Nigeria.

Dr. Trehan spoke of plans to have bilateral exchanges with Nigerian hospitals and medical institutions on various areas as a first step to building a multi-specialty hospital in Nigeria in the next two years.
“What we would like to do is to develop some combined programme where we can have bilateral exchange of doctors, scientists and if there are gaps, we try to develop those specialties in Nigeria so that the people of Nigeria can progressively access the best care in Nigeria.

“We have some expertise in public-private partnership (PPP) dormain and we are now talking about sharing some experiences of PPP and doing things together. So, hopefully, in the next two to five years, we will have a hospital present here and we are talking to the government for the PPP model,” he said.

Trehan, while decrying the high rate of child and maternal mortality due to basic lack of knowledge, ideas and facilities at the level where they are needed, hinted that Medanta was willing to provide education and training in medicare.
Medanta is a conglomeration of multi-super specialty institutes, led by exceptional medical practitioners from all over the world, who are leaders in their respective fields. Medanta, also called Medicity, is spread across 43 acres. It has 45 operating theatres, 1,250 beds, and over 350 critical care beds. It offers widest spectrum of clinical care, education and research.
The hospital also has nine specialist medical institutes, covering heart, neurosciences, bone and joint, kidney & urology, cancer, critical care and anaesthesiology, digestive & hepatobiliary services, minimally invasive surgery as well as transplant and regenerative medicine.

The hospital seeks to participate in the public private partnership in healthcare articulated as the theme of the conference, Trehan stated. It already has a training programme in conjunction with the government of Kenya.

http://www.sunnewsonline.com/webpages/features/goodhealth/2011/sept/13/goodhealth-09-13-2011-01.html

Government to evaluate impact of Midwives Service Scheme

By Ngozi Oboh


The federal government is worried that despite the introduction of the Midwives Service Scheme (MSS) in 2009, maternal and neo-natal deaths are still on the increase in Nigeria.

This has informed the need for an impact evaluation of the scheme to ascertain its relevance or otherwise in the Nigerian health sector, said Emmanuel Abanida, the acting Executive Director of the National Primary Health Care Development Agency (NPHCDA).

Mr Abanida who disclosed this on Thursday in Abuja at the MSS impact evaluation meeting stated that it is worrisome that Nigeria has one of the highest child mortality rates in the world and the worst maternal mortality rate in Africa.

"Five hundred women die out of every 100,000 as a result of giving birth to children," he said. "Averagely close to about 200 infants out of 10,000 given birth to die within the first five years. The impact evaluation is done to ensure that what MSS is designed to achieve, it is achieving it."

He added that the proposed MSS impact evaluation will examine the impact the scheme has on antenatal clinic utilisation, access to skilled attendance at birth and, quality of maternal and child health services.

"At the end we are going to find out if it is really giving us reduction in death of women that are giving birth. Are we really having reduction in death of infants? Are we really having reduction in number of children that are being maimed as a result of things that can be prevented? Are the health facilities doing more than what they are supposed to do before the MSS programme was introduced? It is like assessing for meaningful results," he said.

The survey according to Mr Abanida commenced yesterday with the meeting of the stakeholders and will be concluded in two years.

The evaluation is expected to provide evidence on effectiveness, distributional effect and quality of care. This will not only help to understand the impact of the interventions through providing population-wide estimates and distributional outcomes but will inform on distributional impact on the community.


Mobilising experience

The Midwives Service Scheme was established to mobilise unemployed and retired midwives for deployment to selected primary health care facilities in rural communities in order to facilitate an increase in skilled attendance at birth and, consequently, a reduction in maternal, newborn and child mortality in Nigeria.

The MSS programme aims at recruiting, deploying and retaining midwives in primary health centres located in regions of high martenal mortality in order to guarantee the availability of 24-hour service.

Benjamin Uzochukwu, a Consultant Physician at the University of Nigeria Teaching Hospital, Enugu who leads the team of the evaluators said the outcome of the evaluation will be useful for policy decisions of the government.

"The obvious need for the impact evaluation is to help policy makers decide whether the programmes are generating intended effects; and to fill the gaps in understanding what works, what does not, and how measured changes in well-being are attributable to a particular project or policy intervention," Mr Uzochukwu said. "The benefits of impact evaluation are therefore long term and can have substantial spill over effects."

Their study area will include all the local government areas in the 36 states and FCT while the study population will include women of child bearing age in selected households; health workers in MSS and non-MSS primary health care centres and interviews with ante-natal care and family planning users in the primary health care centres.


http://234next.com/csp/cms/sites/Next/Home/5742119-146/story.csp

US-based medics offer free treatment for Ibadan flood victims

Three United States- based Nigerian medical doctors stormed Ibadan, the Oyo State capital on Thursday to offer free treatment to victims of the August 26 flood in the ancient city.
The medics, who visited under the aegis of the Maternal Cord Association, said 500 people would benefit from the treatment while drugs worth N2 million would be donated to the victims.
The treatment is, however, for the aged, children and other less privileged Nigerians.
Having been trained free in Nigeria, the leader of the team, Dr. Tolu Aduroja, said members of the group believe that the time is appropriate for them to identify with their people and help them in tackling the health problems that might have arisen from the flood.
According to Aduroja, other members of the team are- Dr. Ayo Obush of the U.S of Air force and Dr. Louis Ujibo, an Orthopedic Surgeon in Atlanta Georgia.
The project is in partnership with Jesus House, Bahama, Albama and Naomi Medical Centre, Nigeria.
Aduroja declared that they were all trained at the University College Hospital (UCH), Ibadan some years ago.
“I attended free education .I was trained at UCH here in Ibadan some years back and everything was free. So why shouldn't I give out to the less privileged what God and the society had given on to me?,” he asked.

http://www.thenationonlineng.net/2011/index.php/news-update/19682-us-based-medics-offer-free-treatment-for-ibadan-flood-victims.html

US-based medics offer free treatment for Ibadan flood victims

Three United States- based Nigerian medical doctors stormed Ibadan, the Oyo State capital on Thursday to offer free treatment to victims of the August 26 flood in the ancient city.
The medics, who visited under the aegis of the Maternal Cord Association, said 500 people would benefit from the treatment while drugs worth N2 million would be donated to the victims.
The treatment is, however, for the aged, children and other less privileged Nigerians.
Having been trained free in Nigeria, the leader of the team, Dr. Tolu Aduroja, said members of the group believe that the time is appropriate for them to identify with their people and help them in tackling the health problems that might have arisen from the flood.
According to Aduroja, other members of the team are- Dr. Ayo Obush of the U.S of Air force and Dr. Louis Ujibo, an Orthopedic Surgeon in Atlanta Georgia.
The project is in partnership with Jesus House, Bahama, Albama and Naomi Medical Centre, Nigeria.
Aduroja declared that they were all trained at the University College Hospital (UCH), Ibadan some years ago.
“I attended free education .I was trained at UCH here in Ibadan some years back and everything was free. So why shouldn't I give out to the less privileged what God and the society had given on to me?,” he asked.

http://www.thenationonlineng.net/2011/index.php/news-update/19682-us-based-medics-offer-free-treatment-for-ibadan-flood-victims.html

Monday, September 19, 2011

Confidential Inquiry Into Maternal Deaths in Nigeria: A Call to Hold our Health System Accountable

By Bridget Nwagbara

This month, while world leaders gather at the United Nations General Assembly, WRA has called on our members to submit stories and photographs that illustrate progess that is being made to maternal and newborn health, as well as the efforts of advocates to hold governments accountable to commitments that have been made to Every Woman, Every Child. This posting comes from Bridget Nwagbara, WRA Member, Nigeria.

“Under the right to health, those with responsibilities should be held to account so that misjudgments can be identified and corrected. Accountability can be used to expose problems and identify reforms that will enhance health systems for all.” -A UN Special Rapporteur on the Right to Health

As the deadline to reduce the maternal mortality ratio from 1999 by three-quarters approaches, Nigeria is yet to make progress in this direction with a maternal mortality ratio of 1100 per 100,000 live births. The undeniable major contributor to our dallying advance towards this goal is the ailing state of health care facilities and health care delivery system in the country. Consequently, vast investments have been made recently by the United Nations and the donor community to strengthen health systems capacity in Nigeria. In some parts of the country, health facilities are being renovated and furnished with supplies to meet the demand of mothers and their newborn children and health workers are being trained to be better health facility managers as well as health care givers who can empathize and are open to communication.

However, among these uplifting efforts, a centrally germane issue in health systems capacity building yet to be addressed in Nigeria is a framework for accountability. As the preceding quote affirms, communities and individuals have a right to know why and how maternal deaths occur and health care providers and administrators are under obligation to provide reports and explanations for these deaths. This mandate if properly implemented and disseminated has an inimitable role in establishing an inclusive and coherent approach that will bring individuals, communities, advocates and policy makers together to tackle identified causes of maternal deaths. Nevertheless, rising up to this challenge demands a concrete, systematic and bias free monitoring and evaluating mechanisms that will provide a critical analysis of maternal care delivery.

A confidential enquiry into maternal deaths is one of such vital system that entails active scrutiny of pregnancy related and maternal deaths in health facilities, thus aiding in evaluating the levels, causes of and contributors to maternal mortality and to use lessons learned in preventing future deaths. A key feature of a confidential enquiry into maternal deaths is confidentiality and anonymity granted to the women, health providers and health facilities. It involves documenting all maternal deaths which occur in health facilities across the country, providing records on the primary and final cause of deaths as well as detailing avoidable factors, missed opportunities and substandard care. This system necessitates transparency and criticism by health care workers and health facilities involved in the process, a centralized information management system and must be backed by an enforcing legislature.

The United Kingdom as a forerunner has been implementing this system for more than half a century ago and countries like South Africa and Malaysia have adapted their methodology. Implementing countries make reports with recommendations and design realistic indicators for measuring progress in maternal health delivery. Notably, South Africa produces a triennial report with 10 recommendations which usually border on improving health care delivery systems. These recommendations include making health systems more accessible with good transport and referral services, improved antenatal care, abortion care and contraceptive services and increasing maternal health workers and health care equipment among others. Such recommendations mirror the usefulness of confidential enquiries into maternal deaths for x-raying existing health services and identifying gaps in maternal health delivery.

With only four years left to achieve MDG 5, adopting this system in Nigeria is critical at this time. Although various hospital across the federation have an auditing system through maternal mortality reviews and initiatives like the IMPACT implemented by Partnership for Reviving Routine Immunisation in Northern Nigeria; Maternal, Newborn and Child Health Initiative (PRRIN-MNCH) are working to improve maternal health care in Nigeria through quality assessment and recognition, we need a sound mechanism like confidential enquiries into maternal deaths to document and account for maternal deaths.

While donors are investing into maternal health, they should work with advocacy groups to make the federal and state ministry of health as well as private health organizations establish a central health information system and network to account for maternal deaths. Nigerian health workers should be able to own up confidentially and anonymously to what they are not doing right to curb maternal deaths. Policy makers should rise up to create a favorable legislative ambience for this mode of accountability.

Taking these steps will help us explain why our mothers die needlessly during childbirth, avoid future deaths and put Nigeria in the right direction towards 2015 and beyond.

http://www.whiteribbonalliance.org/blog/post.cfm/confidential-inquiry-into-maternal-deaths-in-nigeria-a-call-to-hold-our-health-system-accountable

Special report:Where and why children face the greatest danger of dying in Afrika

By Edward Qorro
Tanzania is among countries where children aged under-five face the greatest risk of death despite ongoing efforts to improve child welfare. Most of those countries are located in sub-Saharan Africa, according to a report released recently by an international NGO Save the Children, titled the State of World’s Mothers 2011.

Others facing the same situation are located in conflict and post-conflict zones, such as Afghanistan and Somalia.

The risk factor is based on under-five mortality estimates calculated by the United Nations Children’s Fund (Unesco) in collaboration with other development agencies.

Mortality rankings show that in 2009, an average of 108 under-five deaths for every 1000 live births were reported in Tanzania, as compared to 118 deaths in 2006 and 116 deaths in 2007.

And according to the United Nations Development Programme (Undp) office in Tanzania, most child deaths in the country are due to malaria, pneumonia, diarrhoea, malnutrition and complications of low birth weight as well as HIV and Aids.

Some studies also associate short birth intervals, teenage pregnancies and previous child deaths with increased risk of child and mother’s death.

“Malnutrition is the underlying factor in more than 50 per cent of child deaths. So is neonatal deaths accounting for 50 per cent of infant mortality. Census data and those from surveillance sites suggest a decline in both infant and under-five mortality rate. Under-five mortality decreased from 191 per thousand live births in 1990 to 133 in 2005 and further to 81 in 2010 in the Mainland and from 202 in 1990 to 101 in 2005 in Zanzibar,” Undp says on its official website.

Although the figures represent some improvement in child welfare, the country still ranks among those where the prospect for life among small children is still uncertain.

In comparison, the industrialised Western countries have the lowest under-five mortality rates, with Nordic states led by Sweden at the bottom of the risk ladder.

Only three deaths for every 1000 live births were reported in Sweden in 2009, as compared to the average of 129 deaths in sub-Saharan Africa. The figures as the most recent estimates by Unesco.

Under-five mortality is used as a principle indicator of human and economic development of a country. In East Africa, Kenya ranked favourably in 2009 at 39 with 84 deaths per 1000 live births, followed by Tanzania (ranked 27) and Rwanda at number 25 with 111 deaths per 1000 live births.

According to Unicef, globally there has been a significant long-term decline in under- five deaths. In 1970, for example, 16.3 million people were dying every year, as compared to 8.1 million reported in 2009.

“In the last 20 years, the number of children under five dying every day from preventable causes has been cut by one third, from 34,000 in 1990 to around 22,000 in 2009,” noted Unicef in the State of World’s Children 2011.


For its part, Save the Children has called for more investments in maternal and health care in the developing countries, noting: “Millions of children are alive today because of past investments in lifesaving programmes.
But our work is not done. Each day, 22,000
children still perish, mostly from preventable
or treatable causes.”

The causes include malnutrition and hunger, which continue to affect millions of children in the developing countries, especially sub-Saharan Africa.

Currently about 11 million people are facing starvation in the famine-stricken Horn of Africa and some parts of East Africa, most of them women and children.

Save the Children is urging developed countries, led by the United States to increase support on programmes for improving maternal and child welfare in the developing nations.

“The United States spent about $667 billion
on defence last year, but only $17 billion on
humanitarian and poverty-focused development assistance. How much more could we have accomplished if we had invested a lot more – and much earlier – in things like hospitals and schools and midwives and medicine
for the women and children of Afghanistan

and other developing countries?” writes in the report Colonel (rt) John Agoglia, who served as Director of the Counterinsurgency Training
Center-Afghanistan in Kabul.

He argues that human suffering caused by hunger and malnutrition leads to conditions of despair and political instability, which in turn are a threat to global peace. “When communities have little hope for the future, they have little hope for peace.”

The report notes that the gap in availability of maternal and child health services is “dramatic” between countries at the top and those at the bottom of the ranking, such as Afghanistan and Norway.

“Skilled health personnel are present at virtually
every birth in Norway, while only 14 percent
of births are attended in Afghanistan,” it notes. “A typical Norwegian woman has 18 years of formal
education and will live to be 83 years old; 82
percent are using some modern method of
contraception, and only 1 in 175 will lose a
child before his or her fifth birthday.

“At the opposite end of the spectrum, in Afghanistan, a typical woman has fewer than five years of education and will not live to be 45. Less than 16 percent of women are using modern contraception, and 1 child in 5 dies before reaching age 5. At this rate, every mother in Afghanistan is likely to suffer the loss of a child.”

Comparing the situation in Sweden and Somalia, the report reads: “While nearly every Swedish child – girl and boy alike– enjoys good health and education, children in Somalia face a more than 1 in 6 risk of dying before age 5. Thirty-six percent of Somali children are malnourished and 70 percent lack access to safe water. One in 3 primary-school aged children in Somalia is enrolled in school, and within that meagre enrolment, boys outnumber girls almost 2 to 1.”

Although the situation in Tanzania is comparatively better than Somalia, the country still suffers from high under-five mortality rates, and is in league with some post-conflict states.

Every year, about 154,000 children die in Tanzania from preventable and treatable illnesses before reaching their fifth birthday and more than a quarter of these children are reported as dying within the first 28 days.


It is feared that “the high presence of anaemia among pregnant women would lead to low birth weight and stillbirths and a significant 20 per cent of new HIV infections which are due to mother to child transmission.”

However, Tanzania has made some strides in child health care, as a half of the births are said to be delivered by a health professional, half of them done in a health facility.

Dr Joy Lawn, the Director Global Evidence and Policy for Save the Children's Saving Newborn Lives program, says that the increasing coverage and quality of care at birth would accelerate Tanzania’s progress to MDG5 and also MDG 4 (newborn deaths account for over 30% of deaths in children under five) and also stillbirth reduction.

The MDG 4 targets reducing by two-thirds the mortality death of children under five by 2015, while MDG5 aims to reduce by three quarters the maternal mortality ratios.

Globally, however, there is some progress towards health-related MDGs. The World Health Organisation (WHO) says fewer children are dying, and the annual global deaths of children under five years of age fell to 8.1 million in 2009 from 12.4 million in 1990.

According to WHO, there is also indication that fewer children are underweight, with the percentage of underweight children under five years old estimated to have dropped from 25% in 1990 to 16% in 2010.

“More women get skilled help during childbirth. The proportion of births attended by a skilled health worker has increased globally, however, in the WHO Africa and South-East Asia regions fewer than 50% of all births were attended,” is stated.

A further decline in under-five mortality is expected as “fewer people are contracting HIV. New HIV infections have declined by 17% globally from 2001–2009,” says WHO, noting also that, among other things, “more people have safe drinking-water, but not enough have toilets. The world is on track to achieve the MDG target on access to safe drinking-water but more needs to be done to achieve the sanitation target.”

Nevertheless, Save the Children points out that the situation in Tanzania and other sub-Saharan African countries still requires move investment in child welfare programmes in order to achieve the MDG targets.


“Investment is needed in more midwives, improving facilities and considering novel approaches like maternity waiting homes, voucher schemes, emergency transport schemes and partnering with Traditional Birth Attendants to bring women to hospitals for birth,” says Dr Lawn, noting adding that such investments would bring a triple return by saving the lives of mothers, newborns and stillbirths.

And according to a situation analysis recommendations, the government and decision makers are required to ensure that every district hospital in the country has the necessary equipment for childbirth and a neonatal unit to care for small and sick babies.

A recommendation has also been made for “integrating services such as emergency obstetric care services with newborn care, especially resuscitation as well as improving supervision, pay, and mentorship and career opportunities for health workers.”

The government is in addition advised to consider offering incentives to families to encourage earlier care seeking during pregnancy, and to introduce flexible clinic hours and facilitate referral services, in addition to ensuring that every birth and death is well recorded.


According to Save the Children, working on children’s and maternal wellbeing and allocation of maximum available resources to achieve it, is a legal obligation which requires the state’s adequate response and action.

Earlier this year, the government pledged its commitment to reducing deaths of children under the age of five, focusing on improving maternal healthcare.

The minister of Health and Social Welfare, Dr Haji Mponda, says the move is necessary for Tanzania to realise targets four and five of the Millennium Development Goals (MDGs) by 2015.

“Our focus will be on reducing maternal and child deaths, by ensuring that we improve the health sector,” he said.
The minister also stressed the importance of ensuring that health services reach the grassroots where adequate health services are unheard of.

For her part, Ms Tonny Ndunguru, the executive director of Chemichemi, a non -governmental organisation based in Mwanza advocating for reduction of maternal deaths, has urged the government to extend it health services to places where maternal deaths are more rampant, particularly in rural areas.

“Maternity health services are lacking in most rural areas in the country; the government has to ensure that such areas are also catered for,” she said.

She cited transport bottlenecks, few skilled midwives and poor infrastructure as among the setbacks in extending health services towards the realisation of the MDGs targets by 2015.

“Most women walk long distances to get maternal healthcare, at some point they deliver on their way to the hospital…such setbacks cause more deaths of women and their children,” she observed.

http://thecitizen.co.tz/sunday-citizen/40-sunday-citizen-news/14626-special-reportwhere-and-why-children-face-the-greatest-danger-of-dying-in-afrika.html

The future of healthcare delivery

By Gbenro Adeoye

Health experts and government officials have stressed the need for improved private sector participation in bolstering healthcare delivery in Africa. Nigeria’s Health Minister, Onyebuchi Chukwu and the Ghanaian Deputy Health Minister, Joseph Mettle-Nunoo, were among government officials at the sixth West African Health Exhibition and Conference held in Lagos, from September 7-9, where Public Private Partnership was held up as integral to achieving effective healthcare delivery.

Themed ‘Public Private Partnership in Healthcare’, the three-day event attracted governments, public and private organisations and institutions, who turned up to share ideas and examine various models of public private partnership in healthcare. Government officials from Nigeria, Ghana, and India gave insights into their respective healthcare challenges, their course of action for actively engaging improved public private partnership in healthcare delivery, and success rates recorded thus far.

A viable partnership

Though the presentation by Mr Chukwu, who was represented by Tolu Fakeye, was not as elaborate as those of his colleagues from Ghana and India, all three presentations agreed on the need for improved private sector involvement in a country’s healthcare system. According to Mr Chukwu, the country’s health profile remains deplorable as the burden of HIV/AIDS, malaria and non-communicable diseases, along with infant and maternal mortality rates are still high. He noted that one of the major reasons responsible for the country’s current poor health indices lies in the system’s inability to harness “all human and material resources in both the public and private sectors for the benefit of the population.

”It is for this reason that fostering effective collaboration and partnership with all health actors is one of the seven strategic objectives of the National Strategic Health Development plan,” he said. Highlighting the essence of partnering with the private sector, Mr Chukwu said such partnership would expand the scope and quality of healthcare delivery. Mr Chukwu further explained that over 60 percent of the country’s health service delivery comes from the private sector, with “close to 70 percent of the cost borne by families, individuals, and so on, hence the need for a successful public private partnership.”

Also speaking at the event, Naresh Trehan, the president of India Healthcare Federation, said his country has made significant progress in healthcare delivery through government partnership with private actors, in spite of her 1.2 billion population. Hence, Mr Trehan expressed confidence in Nigeria’s capacity to also attain a more acceptable standard in healthcare delivery, with her estimated population of 150 million. He however stressed the need for countries to understand their peculiarities, to create a model that suits their individual needs.

In his presentation, Mr Mettle-Nunoo said his country was moving to improve public private partnership in healthcare. According to him, “A Private Health Sector Alliance that seeks to create a collective voice for the private health sector to dialogue government is also in its formative stage in Ghana.” Mr Mettle-Nunoo also said that private health sector caters for more than 50 percent of health services and provides about 30 percent of all facilities in orthodox hospitals and clinics in the country.

According to the Chair of the Local Organising Committee of the event, Wale Alabi, who is the Chief Executive Officer of Global Resources and Project, a Nigeria-based capacity building and medical consultancy firm, one of the organisers of the event, the subject of discourse at the conference had been carefully selected to serve as “a reminder that the development and future of the health sector in Nigeria and similar settings lies in the hands of the private sector and all for that matter.”

Medicine on display

The event also witnessed the exhibition of medical equipment, supplies and services. As in previous years, majority of the exhibitors were from India and China. Various medical material on display ranged from scientific gadgets, laboratory instruments, and hospital furniture to pharmaceutical products and other related services expected to encourage effective healthcare delivery in Africa, with particular emphasis on West Africa. But some of the participants at the event had mixed reactions over the non-availability of locally made medicals at the exhibition. Some participants blamed the high cost of healthcare on the failure of the country’s National Health Insurance Scheme as well as over-reliance on imported medical equipment. For instance, Mr Trehan, who is also the medical director at Medanta, a world-class medical institute in India, had earlier stated that the hospital receives about 50 Nigerian patients monthly. Calling for “a holistic approach” to solving healthcare challenges, Adekunle Oshinubi, a medical doctor, advocated for more funding for some vital sectors of the economy, like education, health and science and technology, to tackle some of the healthcare challenges. According to him, “Most private hospitals cannot afford most of the equipment at the exhibition since they are not produced locally. Because of this, many people pay a lot or travel abroad for simple treatments. So it is glaring that government alone cannot take care of our health system.”

Another participant, Biodun Atunrase, who also asserted that “Nigerians are one of the most medically travelled people in world,” called for private participation in healthcare. “By encouraging the private businesses, both local and foreign to invest heavily in healthcare, it would allow for competition and beat down the cost of healthcare for Nigerians,” he said.


http://234next.com/csp/cms/sites/Next/News/Metro/5741456-147/the_future_of_healthcare_delivery_.csp

Health care in Nigeria



Health care provision in Nigeria is a concurrent responsibility of the three tiers of government in the country. However, because Nigeria operates a mixed economy, private providers of health care have a visible role to play in health care delivery. The federal government’s role is mostly limited to coordinating the affairs of the university teaching hospitals, Federal Medical Centers (tertiary health care); while the state government manages the various general hospitals (secondary health care); and the local government focus on dispensaries (primary health care) which are regulated by the federal government through NPHCDA.

The total expenditure on health care as a percentage of GDP is 4.6%, while the percentage of federal government expenditure on health care is about 1.5%. A long run indicator of the ability of the country to provide food sustenance and avoid malnutrition is the rate of growth of per capita food production. From 1970–1990, the rate for Nigeria was 0.25%. Though small, the positive rate of per capita may be due to Nigeria's importation of food products.

Health Insurance

Historically, health insurance in Nigeria can be applied to a few instances: free health care provided and financed for all citizens; health care provided by government through a special health insurance scheme for government employees; and private firms entering contracts with private health care providers. However, there are few people who fall within the three instances.

In May 1999, the government created the National Health Insurance Scheme. The scheme encompasses government employees, the organized private sector and the informal sector. Legislative wise, the scheme also covers children under five, permanently disabled persons and prison inmates. In 2004, the administration of Obasanjo further gave more legislative powers to the scheme with positive amendments to the original 1999 legislative act.

Mental health

The majority of mental health services are provided by 8 regional psychiatric centers and psychiatric departments and medical schools of 12 major universities. A few General Hospitals also provide mental health services. The formal centers often face competition from native herbalists and faith healing centers.

The ratio of psychologists and social workers is 0.02 to 100,000.

Issues

Regulation of pharmaceuticals

In 1989 legislation made effective a list of essential drugs. The regulation was also meant to limit the manufacture and import of fake or sub-standard drugs and to curtail false advertising. However, the section on essential drugs was later amended.

Drug quality is primarily controlled by the National Agency for Food and Drug Administration and Control (NAFDAC).

Spatial inequality

Health care in Nigeria is influenced by different local and regional factors that impact the quality or quantity present in one location. Due to the aforementioned, the health care system in Nigeria has shown spatial variation in terms of availability and quality of facilities in relation to need. However, this is largely as a result of the level of state and local government involvement and investment in health care programs and education. Also, the Nigerian Ministry of Health usually spends about 70% of its budget in urban areas where 30% of the population resides. It is assumed by some scholars that the health care service is inversely related to the need of patients.

Emigration

Retaining health care professionals is an important objective

Migration of health care personnel to other countries is a taxing and relevant issue in the health care system of the country. From a supply push factor, a resulting rise in exodus of health care nurses may be due to dramatic factors that make the work unbearable; knowing and implementing changes to arrest the factors may stem a tide. However, because a large number of nurses and doctors migrating abroad benefited from government funds for education, it poses a challenge to the patriotic identity of citizens and also the rate of return of federal funding of health care education. The state of health care in Nigeria has been worsened by a physician shortage as a consequence of severe 'brain drain'. Many Nigerian doctors have emigrated to North America and Europe. In 2005, 2,392 Nigeria doctors were practicing in the US alone; in UK the number was 1529. Retaining these expensively-trained professionals has been identified as an urgent goal.

Commercialisation of Public Health Service delivery

Empirical evidences reveal the negative impact of commercialisation of public health service delivery on attainment of the MDGs in Nigeria.

Criticism

The World Health Organization's definition of health is not merely the absence of disease but the attainment of a state of physical, mental, emotional and social well-being.

· In 1993, adulterated paracetamol syrup entered into the health care system in Oyo and Benue States. The end result was the death of 100 children. A year after the disaster, batches of fake ethylene glycol, the major cause of the death, could still be purchased.

· In 1996, about 11 children died of contamination from an experimental trial drug: trovafloxacin. Nevertheless, the government delayed the prosecution of the perpetrators—another tragedy.

· The life expectancy of the country is low and about 20% of children die before the age of 5.

· The 2000 WHO report on the performance of health care systems rank the country 187 out of 191.

· Traffic congestion in Lagos, environmental pollution, and noise pollution are major issues that the government is faced with.

· In 1985, an incident of yellow fever devastated a town in Nigeria, leading to the death of 1000 people. In a span of 5 years, the epidemic grew, with a resulting rise in mortality. The vaccine for yellow fever has been in existence since the 1930s.

· In 2008-2009, at least 84 children died from a brand of contaminated infant teething medication.

Maternal and Child Healthcare

In June 2011, the United Nations Population Fund released a report titled The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Nigeria is 840. This is compared with 608.3 in 2008 and 473.4 in 1990. The less than 5 mortality rate, per 1,000 births is 143 and the neonatal mortality as a percentage of under 5's mortality is 28. The aim of this article/report is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4: Reduce child mortality and Goal 5: improve maternal death. In Nigeria the number of midwives per 1,000 live births is unavailable and 1 in 23 shows us the lifetime risk of death for pregnant women.

Reviewed by ERU KOBE GODWIN
http://www.connectnigeria.com/articles/health-care-in-nigeria/557

Dons Unveil Book On Infant Mortality

As part of their contributions towards checking the alarming rate of infant mortality, which is posing serious challenge to African countries, including Nigeria, two lecturers of the University of Port Harcourt have launched a new book on the issue.

The book, titled, “Reducing Infant Mortality Rate Through Attitudinal Change And Preventive Behaviours”, authored by Dr. Glory Amadi and Dr. (Mrs) Chinelo Joy Ugwu, both of the Department of Educational Psychology, Guidance and Counselling in Uniport Focuses on behavioural perspective.

It emphasised that despite the enormous effort of government and other international organisations to curb the problem, of infant mortality it has persisted and blamed the ugly trend partly on negative attitude of the people towards health care.

The 76 – page book written in simple language with rich pictorials for clear illustrations makes understanding easy and it would complement efforts of medical experts, educators, and government on the prevention of the causes of infant mortality.

The book is dedicated to the wife of the Governor of Rivers State, Dame Judith Amaechi, Mrs Josephine Elechi, wife of Ebonyi State Governor and former Chairman, Senate Committee on Health, Dr. (Mrs) Iyabo Obasanjo-Bello for their determined efforts towards children’s welfare, safe motherhood and the reduction of the alarming rate of infant and maternal mortality in Nigeria.

It is a must read for health institutions, parents and organisations with interest in the safety of infants and mothers who have become most vulnerable.

Chris Oluoh

http://www.thetidenewsonline.com/?p=28706

Nigeria Votes $4M For Contraceptives


The federal government has set aside $4 million to procure contraceptives and other facilities necessary to ensure that maternal health is given adequate attention.
Making this known during the United Nations Summit on Maternal Health in New York on Wednesday, wife of the Senate President, Mrs Helen Mark, who represented Nigeria’s first lady at the event, said that the money would be used to procure contraceptives that will boost the reproductive health programme.



Mrs Mark noted that the fund would take care of the urgent need for an effective supply of contraceptives, medicines and equipment, which is of critical importance to reproductive health in Nigeria, and said that there was still much to do for 35 million women of reproductive age in Nigeria where the rate of fertility, maternal and infant deaths were high, while the use of modern contraceptive methods was low.

“Nigeria has some of the worst maternal and child mortality records in the world and also one of the highest fertility rates and one of the lowest contraceptive use - presently at only 10 per cent - as well as the unmet contraceptive need of over 20 per cent.

“With these abysmal figures, we could not achieve the Millennium Development Goals (MDGs), let alone the ambitious developmental targets we have set for ourselves for the near future,” she said.



In his speech, the executive director of the United Nations Fund for Population Activities (UNFPA), Dr. Osotimehin, called on the 12 countries to put resources in their budget to meet the needs of their women and girls.

“UNFPA will work with you to provide them with education, opportunities and access to information and services, including reproductive health commodities, so that each young girl will be a multiplier, and will add value to the world in which she belongs,” he said.
“As of October 31, the world will have seven billion people, out of which 1.8 billion are young people, and 90 per cent of them live in developing countries. That implies that one billion young women are actively seeking the information and services we are talking about here,” Osotimehin added.
The 12 ‘Stream One’ countries in the Global Programme are Burkina Faso, Haiti, Ethiopia, Laos, Mali, Madagascar, Mongolia, Mozambique, Nicaragua, Niger, Nigeria and Sierra Leone.



Dramatic increases in the use of modern methods of contraception are widely reported by participating countries. In Niger, the contraceptive rate increased from five per cent in 2006 to 21 per cent in 2010.

Access to appropriate methods is improving. In Nicaragua, the percentage of service delivery points offering at least three modern methods of contraception increased from 66.6 per cent in 2008 to 99.5 per cent in 2010. In Ethiopia, the increase was from 60 per cent in 2006 to 98 per cent last year.
Country-driven initiatives include training and supply of computers for stronger supply delivery in the national health system, awareness campaigns and advocacy for national policies, strategies and dedicated lines in national budgets for contraceptives.




The First Lady of Sierra Leone, Sia Nyama Koroma, noted that support through the programme had increased the uptake of family planning and other reproductive health programmes, such as fistula activities and the screening of patients for breast cancer.
“Collectively, we are changing the face of maternal and child mortality in Sierra Leone,” she said.

http://leadership.ng/nga/articles/4911/2011/09/09/nigeria_votes_4m_contraceptives.html

117,000 Community Health Practitioners Registered

Makurdi — The Registrar and Chief Executive Officer of Community Health Practitioners Registration Board of Nigeria (CHPRBN) Mr. Shiono Bennibor has said that about 117,000 community health practitioners have been registered across the country.

Speaking at the mandatory continuing education workshop for community health officers in the North-central, North-east and North-west zones holding in Makurdi, Mr. Bennibor said apart from issues of emerging and re-emerging diseases, high maternal and infant mortality rates, CHPRBN is also saddled with the issues of integrating new intervention programs into primary health care.

According to him, the present trend where community health practitioners reject postings to rural communities whereas members of other health professions crave for rural postings is a serious contradiction to the original concept of the programme. He added that the craze by community health practitioners with higher academic qualifications as against those with professional training is not good enough.

"We must grow and maintain our professional integrity. There must be a balance between the attainment of academic and professional excellence. The board is currently working with the West African Health Organization (WAHO) on the harmonization of the training curricula for community health workers in the West African sub-region", he said.

Also speaking, the chairman, CHPRBN, Alhaji M.I Yahya said the once neglected rural health care services have suddenly become the toast of all health professionals, pointing out that except community health practitioners embrace the various training and re-training programs and remain committed to living and working in the community, they would loss grip of a service that was entrusted to them.

He pointed out that the Millennium Development Goals target of year 2015 is already around the corner, and that for maternal and infant mortality to reduce, community health practitioners must bring their wealth of experience to bear in the course of their job. Declaring the workshop open, the Benue State Commissioner for Health and Human Services, Dr. Orduen Abunku said the state has offered employment to medical students of Benue origin on salary Grade level 07 and that it has developed a health plan for 2011-2012 to be introduced at the local government councils. He added that a bill for the upgrade of the primary health care system in the state is before the state Assembly.
http://allafrica.com/stories/201109080940.html

Group wants government to invest in health workers



BY NGOZI OBOH
September 9, 2011 01:01PM
Save the Children, a non-governmental organisation that works to save children’s lives and fight for their rights, has called on the federal government to step up its investment on ensuring that adequate manpower is provided in the health sector.

Hadiza Aminu, the campaign coordinator for Save the Children in Nigeria, told journalists on Wednesday in Abuja that it might be impossible to achieve some portions of the Millennium Development Goals (MDGs) if there are inadequate health workers to implement policies of government.

“The issue of health workers came about when we realised that no matter what we do to achieve MDGs 4 and 5, reduction of maternal and child mortality will be vain because the people at the core to provide these services are health workers especially frontline ones at the rural communities,” she said.

According to Ms Amina, “Nigeria has a lopsided distribution of health workers. There are a few of them in rural areas but in some urban facilities they do not have so much to do. There is need for even distribution so that all citizens will have equal rights to having health workers. That will be a major achievement for Nigeria.”


Nigeria at the bottom


Saying there is a need to train and retrain because new innovations keep coming up everyday, she said government should prioritise the recruitment, training, deployment retention of more health workers within the reach of every woman and every child. Most of them apart from not having the proper skill do not have the facilities to give adequate health care to people at the community level.

Susan Grant, the country director of Save the Children in Nigeria, acknowledged the current efforts of government, especially with the midwives service scheme, but noted that “Nigeria must be creative to get more health workers into poor and rural communities where there are acute shortages of trained health workers. Failing to invest in health workers will cost lives.”

The group said it was disturbed that despite its massive oil wealth, Nigeria ranks bottom in the global health workers index.


http://234next.com/csp/cms/sites/Next/Home/5741242-146/group_wants_government_to_invest_in.csp

Counting Down the MDGS: What Do Continued High Neonatal Mortality Rates Mean for Africa?

07/09/2011 - According to a new study conducted in part by the UN, newborn survival rates in Africa lag behind the rest of the world's. With few countries "on track," Africa may not meet the MDGs by the 2015 deadline.

A new study by the United Nations (UN) and its partners has shown that, though global neonatal deaths are down overall, African countries still have yet to record fast enough progress in bringing down their own high rate of death among neonates. While the first few weeks of a child's life are both critical and risky, many countries have only just begun to reach new mothers and their newborns with special programmes.

The study under discussion, published in PloS Medicine journal, is acknowledged to have used the most extensive collection of data to date, following trends in 193 countries over 20 years. The study was undertaken by Save the Children, the London School of Hygiene and Tropical Medicine and the World Health Organization. The neonatal death rate refers to deaths among children who are less than four weeks old. Ultimately, the research showed that the number of worldwide newborn deaths decreased from 4.6 million to 3.3 million between 1990 and 2009. The rate of decline was slightly quicker after 2000, after countries began working towards the Millennium Development Goals (MDGs).

The fourth MDG aims to reduce child mortality (the under-five death rate) by two-thirds of the 1990 level by the year 2015. At present, more than 8 million children die before reaching their fifth birthdays. Children above this age are more likely to live into adulthood, but children in their first few weeks of life are more vulnerable. As more children are surviving past the age of five, a greater proportion of child deaths are among neonates (41 per cent). Given these consideration, failure to improve death rates among babies could jeopardize the achievement of the fourth MDG.

One of the key contributing factors to neonatal deaths are premature delivery, which is estimated to account for 29 per cent of neonatal deaths. Other factors include asphyxia during birth and infection. Sadly, many at-risk newborns would have survived if their births had been attended by a midwife. Too many of the 79 million babies who have lost their lives during the neonatal window since 1990 had zero or little access to medical services.

African countries in particular have not shared highly in the overall gains. Africa has reduced its neonatal mortality rate only 1 per cent per year, according to the WHO. The fact that deaths among neonates dropped 17.6 per cent on the African continent but dropped 50 per cent in the rest of the world is indicative of the unevenness of global trends.

While 27.8 per cent of neonatal deaths were in India, 7.2 per cent were in Nigeria. Nigeria has slipped three spaces since 1990 when it was ranked fifth in neonatal mortality. An increase in the total number of births in combination with only a slight decrease in the risk of newborn deaths has meant that Nigeria now ranks second in the world when it comes to the infant mortality rate (defined as neonatal deaths per 1,000 live births). Nigeria is currently "off-track" to meet the fourth MDG and a WHO official recently expressed concern that Africa will not meet the MDGs by the 2015 deadline.

India, Nigeria, Pakistan, the Democratic Republic of the Congo and China account for roughly half of all newborn deaths in the world.

At the present rate of progress, African countries could only expect to attain the survival rates of some Western countries in about a century and a half. Yet, many neonatal deaths are preventable with "well-documented, cost-effective solutions to prevent these deaths," said Dr. Flavia Bustreo, who is the WHO Assistant Director-General for Family, Women's and Children's Health. She added that with less than four years to go before the deadline for the MDGs, newborns need to receive much more attention and action.

In Nigeria, the Minister of State for Health, Professor Muhammed Ali Pate, told the Daily Trust (local paper) that 3,000 midwives had been dispatched to rural communities that were in desperate need of their life-saving services. Additional communities have had their primary health care facilities renovated in order to improve the quality of care. Another Ministry official confirmed that there are also plans in the works to help traditional birth attendants to meet standards of care.

http://www.soschildrensvillages.ca/News/News/child-charity-news/Pages/MDGS-Neonatal-Mortality-Rates-Africa-696.aspx

Big drop in children under five dying, says UN report



The number of children under five who die each year has plummeted from 12 million in 1990, to 7.6 million last year, the UN says.

The reasons for the change include better access to health care and immunisation, says a report by Unicef and the World Health Organization.

But they warn that more needs to be done to reach UN development goals on reducing child mortality.

About 21,000 children are still dying every day from preventable causes.

But even the poorest regions have made progress. Child mortality in sub-Saharan Africa is declining twice as fast as it was a decade ago.

"Focusing greater investment on the most disadvantaged communities will help us save more lives, more quickly and more cost effectively," said Anthony Lake, the executive director of Unicef.

Many factors are contributing to reductions in child mortality, including better healthcare for newborns, prevention and treatment of childhood diseases, clean water and better nutrition.

Most improved

Sierra Leone in West Africa - one of the world's poorest nations - ranks among the top five countries seeing improvements in child mortality in the past decade. The others were Niger, Malawi and Liberia - also in Africa - and East Timor in South East Asia.

One of the reasons for Sierra Leone's success is that the government scrapped all fees for child and maternal health, said Ian Pett, the chief of health systems at Unicef.

About half of all deaths among under fives in the world took place in just five countries in 2010 - India, China, Pakistan, Nigeria and Democratic Republic of Congo.

Babies are particularly vulnerable. According to the report, more than 40% of deaths in children under the age of five occur within the first month of life and more than 70% in the first year of life.

In sub-Saharan Africa, one in eight children die before reaching the age of five. That compares with one in 143 children dying before five years old in developed countries.
http://www.bbc.co.uk/news/world-14930778

Why Citizens Go Abroad for Medical Treatment - Minister

Nigerians go abroad for medical treatment because they have lost confidence in their nation's health sector, Minister of Health Professor Onyebuchi Chukwu has said.

The minister, who said this yesterday in Abuja during a briefing to commemorate the 100 days in office of President Goodluck Jonathan, however maintained that most of those seeking medical services abroad had often returned with tales of woes.

He identified incessant industrial action by health workers as a factor mitigating the nation's health sector.

He, however, said progress had been made in the sector with the establishment of cancer screening centres, the distribution of over four million insecticides, treated nets and the establishment of the Nigerian Centre for Disease Control.

He added that about 17.5 million free contraceptive commodities distributed by his ministry for the reduction of maternal and infant mortality could help check population explosion being experienced in the country.

http://allafrica.com/stories/201109150873.html

Why Citizens Go Abroad for Medical Treatment - Minister

Nigerians go abroad for medical treatment because they have lost confidence in their nation's health sector, Minister of Health Professor Onyebuchi Chukwu has said.

The minister, who said this yesterday in Abuja during a briefing to commemorate the 100 days in office of President Goodluck Jonathan, however maintained that most of those seeking medical services abroad had often returned with tales of woes.

He identified incessant industrial action by health workers as a factor mitigating the nation's health sector.

He, however, said progress had been made in the sector with the establishment of cancer screening centres, the distribution of over four million insecticides, treated nets and the establishment of the Nigerian Centre for Disease Control.

He added that about 17.5 million free contraceptive commodities distributed by his ministry for the reduction of maternal and infant mortality could help check population explosion being experienced in the country.

http://allafrica.com/stories/201109150873.html

Gynaecologists commend Ondo’s safe motherhood model



The leadership of the Society of Gynaecologists and Obstetricians of Nigeria on Tuesday praised the Ondo State governor, Olusegun Mimiko, for what it said were his contributions towards reducing child and maternal mortality in the country.

A delegation of the society led by Oladapo Ladipo said in Akure on Tuesday during a courtesy call on Mimiko that the association is to confer on him its Distinguished Fellow award later this year.

Mr Ladipo, who commended the state government’s Abiye (Safe Motherhood) programme that gives equal access to children and wives of both the rich and poor at no cost, said such an initiative should be emulated by other states in the country.

According to him, most of the maternal death globally was occasioned by discrepancies in the geographical, economic and political settings, which he said must be critically addressed.

“No other governor in this country has done so much as you have done,” Mr Ladipo said. “You have gone a step forward. Indeed, you are a visionary leader. That you associated with key factors to save humanity shows that you are a visionary governor. You established mother and child hospital, your Abiye motherhood programme has been recognised globally. What you have put in place to ensure that mothers do not die, this reflects your kind of leadership even at the political level. People are happy when their efforts are appreciated. For this reason, the society is not in doubt at all that you are a great leader.”

Impacting on lives

Mr Mimiko thanked the society for appreciating his government’s efforts at transforming the lives of the people and vowed to continue to impact more on the lives of the people in different areas.

He also assured that his administration would leverage on their experience to improve the health sector in the state.

“That this recognition is coming from you, I must tell you, for me it is even bigger than the endorsement of Abiye by the World Bank as a template for Africa, coming from professionals like you, I must thank you,” Mr Mimiko said. “I can assure you that this will be a further challenge for us to do more. I want to thank you on behalf of the people of this state. I assure you that we will continue to do more. By the time you visit this state next year, we will have surpassed what you have seen in terms of what we will keep doing. Not only for the mother and child hospital, but for the future of our children”.


http://234next.com/csp/cms/sites/Next/News/National/5741903-147/story.csp

Okonofua laments high rate of maternal mortality

BY SIMON EBEGBULEM BENIN CITY-Project Director of Women’s Health and Action Research Centre, WHARC, Professor Friday Okonofua, Tuesday, expressed concern over the high rate of death during delivery in the country. The former Presidential aide, who described the high rate of death as alarming, added that the two teaching hospitals in the state, University of Benin Teaching Hospital, UBTH, and Irrua Teaching Hospital, Irrua, were being overworked due to alleged failure of the government to prioritise maternal health. Prof. Okonofua who spoke at a workshop on Infection Control Practices in Delivery Care Facility in Edo State, organised by WHARC, noted that the nation may not be able to achieve the Millennium Development Goals, MDG-5, aimed at reducing maternal mortality by 75 per cent by 2015. He said: “Globally, Nigeria currently has the second worst case of women who die during pregnancy each year. With an estimated maternal mortality rate of 608 per 100,000 deliveries and 50,000 women dying each year, Nigeria is second only to India in terms of maternal mortality and this number is high.” “This country was also recently reported to be one of the six countries that account for up to 50 per cent of the global maternal deaths. At this rate, many are worried that Nigeria may not achieve the MDG-5, which is aimed at reducing maternal mortality by 75 per cent by the year 2015.” He stressed the need for the Edo State Government to establish infection control committees in delivery units in the state, adding “a procedure for regular auditing cases of maternal deaths and near miss cases of puerperal sepsis should be instituted. This will ensure the identification of measures to prevent puerperal infections in the state”. http://www.vanguardngr.com/2011/09/okonofua-laments-high-rate-of-maternal-mortality/

Wednesday, September 7, 2011

NAFDAC And Adequate Breastmilk For Babies

By MARTINS F.O. IKHILAE


Indisputably, appropriate childhood growth and development is often to a very Large extent facilitated by adequate and ideal nutrition as inadequate knowledge of what constitutes genuine nutrition on the part of parents could result into malnutrition and other diseases for infants.


This perharps explains the rationale behind the commitment of Nigeria’s Advocate of ideal health for all, the National Agency for Food, Drug Administration and Control (NAFDAC)towards a befitting feeding partern for Nigerian babies by confronting infants developmental challenges through relentless emphasis on the imperativeness of an adequately sustained and standardized nutrition for Nigerian infants.


Armed with the belief that only healthy, quality and ideal nutrition for infants at birth could guarantee appreciable and dynamic developmental growth for them ,it has consequently implored all nursing and intending mothers nationwide to urgently, embrace the internationally acceptable “six months mandatory, exclusive and intensive breastfeeding for the newborn, with subsequent complimentary nutrition from both local foods and natural milk substitutes with continuous breast milk application for a period of two years or more.


Remarkably, the current mode of infants nutrition being canvassed by the Dr Paul Orhii led NAFDAC management team ,is absolutely in line with globally recommended health practices as supported by numerous international health organizations among which are-the World Health Organisation (WHO),United Nation Children Fund (UNICEF) as well as the World Alliance for Breast Feeding Action(WABA)which coordinates the annual World breastfeeding week, to mention just a few.


Undoubtedly, inspite of the various internationally acclaimed sophistications that seems to have characterized human mode of existence over the years, human female breast milk have remained the most unique ,nutritious, dependable and highly inegligible commodity certified globally as suitable for feeding newly born babies in view of its very rich nutritional contents such as adequate protein, fats, carbohydrate, salt, minerals, vitamins, water, sugar, anti-bodies, ideal temperature, bacterial free status etc.


Unfortunately, the comprehensive adoption of this internationally adjudged highly nutritious and pro-infant development ingredients laden substance for infant nutrition by Nigerian nursing mothers appears to have suffered severe setback in recent times due to the emergence of numerous varieties of breast milk substitutes which ardorns the nation’s markets.


While some mothers hinge their preference for these artificial alternative nutrition on the need to adequately and urgently meet work demand at offices as co-bread winners for their families in line with modern economic demand, some consider it as a strain free and stress free alternative while simultaneously helping them to maintain and retain very enviable and attractive shapes for the admiration of both the general public, their spouses or husbands.


From whichever perspective these arguments are being critically examined, natural human female breast milk remains the most highly nutritious and therefore more advantageous than its numerous man made substitutes which abounds in all nooks and crannies of Nigeria.


Conscious of the numerous negative implications of current maternal practices whereby breast milk substitutes appears to have taken over the place of natural milk as ideal nutrition for babies, various countries of the World have painstakingly evolved various strategies and techniques meant to encourage nursing and expectant mothers to resort to the use of natural milk as a most ideal means of nutrient for their babies.


Interestingly, Nigeria, an internationally revered and acclaimed Giant of Africa, is however not left out in the current global health boosting practices as her unique and vibrant healthy Nigeria guaranteeing machinery tagged-the National Agency For Food, Drug Administration and Control ,acronym NAFDAC, has since swung into full action in this regard impressing on mothers nationwide, the need to ensure that their infants are fed exclusively, intensively and adequately with natural breast milk minimally for six months from date of birth before ideal breast milk substitutes and locally available foods could be adopted as complimentary nutrients while still continuing with breast feeding for over two years.


Being an agency of the Nigerian Government saddled with the scientific cum medical responsibility to guarantee a healthy population in accordance with its enabling Act tagged:decree number 15 of 1993,amended by decree 19 of 1999 and now known as Act Cap N1,Laws of the Federation of Nigeria (LFN) 2004 and mandated to regulate as well as control the manufacture, importation, exportation, distribution, advertisement,


sale and use of Foods, Drugs, Cosmetics, Medical Devices, Packaged Water, Chemicals and Detergents collectively regarded by the agency as “regulated products, ’NAFDAC has left no one in doubt particularly since the advent of the agency’s current management team as to its total determination to ensure and achieve a sustainable, durable, dependable health for both old and young Nigerians including infants.


This laurel winning agency, is absolutely mindful of the fact that Nigerian infants which will in turn metamorphose into ‘the youth ’often regarded as the nation’s leaders of tomorrow, absolutely deserves the best of both care and nutrition to be medically fit so as to ideally confront the perceived socio-economic and political challenges of the future.


It is also aware that the economic, political and social success of any nation ,is largely dependent on the availability of adequate and highly dependable human resource potentials and thus its current insistence on a very good, amiable, reliable and virile developmental background for the nation’s infants who incidentally are our tomorrow’s adults thereby alluding to the popular saying that ‘it is an egg that becomes a Hen’.


Expectedly, NAFDAC has severally, made series of very frantic and highly positive result oriented efforts aimed at enlightening and educating Nigerian mothers in this regard.


Among such infants life saving efforts include, placement of pro-exclusive natural breast milk/breast feeding messages on radio, television, daily newspapers, weekly tabloid and magazines, erection and display of bill boards at strategic locations nationwide, printing and free distribution of public enlightenment booklets (eg NAFDAC campaigns-which comprises varieties of educative messages in this regard) etc.


Interestingly, the benefits derivable from ideally complying with this regulatory agency’s directives on infants feeding pattern and techniques are indeed numerous and as such only few of such advantages are highlighted bellow.


Apart from fostering a very strong mother –baby relationship via the promotion of a psychological bond between babies and their mothers, utilizing human female breast milk for feeding infants out rightly reduces the risk of mothers developing breast cancer, cervical or ovarian cancers.


It helps to prevent obesity, complications at child birth, maternal mortality as well as check social ills.
Breast feeding accords babies the opportunity and ability to grow faster, stronger, healthier, happier, garner the needed weight, reduces risk of infections, allergy potentials, convenience, enable’s mothers to speedily return to pre-pregnancy weight as well as encourages child spacing.


Conclusively therefore, the promotion, protection as well as outright support for exclusive, intensive and durable breast feeding as a more ideal nutrition for new born babies should be compulsorily embraced by all and sundry in the interest of our infants, nation and posterity more so that breast milk has been proven by experts as incontestably advantageous, particularly due to its vantage status as the milk that nature has already provided for babies and has the ability to adjust itself during feeding so that infants first gets ‘foremilk’ which they gulp easily to quench their thirst and desire to suck the eventual richer ’hind milk’ which satisfies babies appetite.



We must all heed the music of reasoning as being played by NAFDAC since to be forewarned they say is to be forearmed.


http://nigerianobservernews.com/05092011/features/features3.html

Still far away

IN the year 2000, the UN, moved by the decrepit situation of the world’s poor nations and their downtrodden peoples, decided to do something definitive about the receding basic living conditions of man. In concert with her 193-country strong membership and about two dozen world bodies, she devised eight goals - the most basic of human needs, to be achieved by her mendicant member countries in 15 years.

Christened Millennium Development Goals (MDGs), they are: the need to eradicate extreme poverty and hunger; to achieve universal primary education; promote gender equality and empower women and reduce child mortality.

Others are: to improve maternal health; to combat HIV/AIDS, malaria and other diseases; to ensure environmental sustainability and to develop a global partnership for development.

After over 10 years of implementing the MDGs initiatives world-wide, reports out of Africa indicate that the goals are far from being achieved, with Nigeria’s performance reportedly abysmal. In fact, a recent review of the MDGs implementation milestones shows that Nigeria has been most lackadaisical towards the initiative, making her one of the worst examples in Africa.

Speaking recently in Kaduna, a director in the MDGs office, which is under the Presidency, Mr. Oluwole Edun, noted that about N120 billion has been spent by the Federal Government on the MDGs in the last three years. This comes to an average of roughly N3 billion per state over this period. Considering the size and population of Nigeria, this is paltry.

With barely four years to the target date of 2015, one needs no elaborate statistics to prove that the level of poverty in Nigeria today is not markedly different from what it was 10 years ago. Child and maternal mortality is anything but in recession, while free primary education is still largely in the realms of political campaign promises; common diseases like malaria and cholera have not stopped ravaging parts of Nigeria.

One reason why the MDGs seem to have fallen far short of expectations is that Nigeria’s governments at all levels have shown little commitment towards giving Nigerians the very basics of social amenities and economic leverages. For instance, the most visible organ of the MDGs is a unit in the Presidency headed by a special assistant. For such an important and fundamental programme that affects the lives of the majority of the population, a stronger implementation organ ought to have been put in place over the years.

At the state level, most governors have been remiss in keying into the initiative while it is almost non-existent at the local government level where it ought to be rooted. Where the MDGs are implemented in some states, it is signposted by misappropriation of funds, substandard and non-functional projects, especially in water and health care projects. As a proof of the lack of seriousness in the MDGs initiatives, a team from UNESCO’s Institute of Statistics (UIS) which visited Nigeria recently lamented its frustration at accessing up-to-date data, especially as regards the MDGs. How could a project of this magnitude which is fundamental to the people’s existence achieve its objectives without quality data?

Little wonder that Nigeria perpetually ranks low in world’s human development index? Particularly intriguing is why the Federal Government has, in the last few years, embarked on another initiative to make Nigeria to rank among the 20 largest economies in the world in the year 2020. How can a country still grappling with poverty and common diseases grow to a high-end world economy?

With only about four years left to pursue the MDGs, we urge Nigeria’s governments at all levels to redouble efforts to achieve some, if not all the laudable goals of the MDGs.

http://www.thenationonlineng.net/2011/index.php/editorial/18382-still-far-away.html

The “Stupid Strategist”: Satire On Retrogressive Traditions

By FRANCIS U. ODUPUTE

INTRODUCTION:



The family unit is the nucleus of the society and a primary agent of socialization and development. If this is true, it therefore goes without argument that a well-planned family is the base for a well-planned development, sustainable growth and moral capital/richness of any society.

This is why family planning has been globally accepted and promoted as an indispensable way to check rapid population momentum in order to sustain human lives and the environment, now and for the future.

Family planning entails all the necessary pre-marital and marital knowledge and responsibilities needed to achieve well-planned individual families with limited members whose maintenance and upkeep is possible with limited available resources and tools.
Africa’s Cultural Dilemma:

Apart from the governments and policy makers coming up with better workable policies that will educate, motivate and promote behavioural changes needed to mitigate unplanned births, there is a dire need for socio-cultural re-orientation across the continent, as this editorial cartoon tries to argue.

Banking on personal experiences, empirical/participant observations and available records/data, this cartoon journalist laments through the above editorial cartoon that very many socio-cultural and religious forces abound in traditional African societies that reinforce and promote large families and make family planning or population control efforts complex and very difficult.

Until recently, very few governments in Africa had population control policies and or family planning programs to address population issues in their polities. This was not unconnected with cultural beliefs and misconceptions about reproductive health programs, chiefly viewed as Western intrigues to limit African population on selfish grounds. This wrong mindset is omnipresent across Sub-Saharan African cultures.

In Nigeria, for example, there is an unmet need for socio-cultural re-orientation about fecundity and family size. It is still a celebrated custom in many cultures here to have large families. In most parts of Igbo land (eastern Nigeria) from where this cartoon journalist hails, despite the well-articulated “National Policy on Population for sustainable Development (January, 2004)”, the on-the-ground realities faced by family planning advocates is that many people reject it is a foreign idea by western nations to limit the growth of Nigerian families.


The 2008 Demographic and Health Survey reveals that the fertility rate in Igbo land (southeast) is 4.8% while the percentage of married women who use modern family planning methods is 12% against that of the southwest that is 21%.

A man’s greatness is apparently measured by how many children he has. A woman’s status and relevance in the family and in the community improves with the more children she birthed who are alive.

The traditional “Ibu Eze” festival in parts of Igbo land, for example, is dedicated to honouring and celebrating our women who have given birth to nine or more children. She is showered with lots of gifts and respect. Other ignarant women craving for relevance and social security strive for the same recognition and honour of a lifetime. These are common population problems in Africa generally.

In Malawi, the high rate of illiteracy (about 67% of the country’s 9.8 million people) as well as cultural and religious beliefs regarding reproductive health has cost the country severe socio-economic stagnation. Now, family planning advocates like the Banja La Mtsogolo are increasingly pushing for the government to urgently step up reproductive health education.

In the early 1960s, the country abolished family planning on the grounds of widespread cultural misconception that reproductive health messages and programs were counter-culture to their belief that having many children amounts to more riches. In 1982, however, through persuasions, the government began to allow family planning services, but only under the guise of child spacing later renamed

Maternal Child Health. Since 1994, NGOs have made a lot of impact through awareness creation and cultural re-orientation: about 90% of the targeted group became aware of the contraceptive methods, though only 14% use them and about 36% were willing to delay pregnancies by 2 to 3 years but not by family planning methods.

In Tanzania, the government implemented a comprehensive family planning strategy in 1992 to reduce the country’s population growth rate to less than 2% per year by the year 2010. The government provided free contraceptive services through its Ministry of Health clinics. Yet, there were rumours that family planning pills made women infertile, caused deformed babies, cancer, itching private parts, and hampered conjugal sexual satisfaction and communication between married couples.

There were also myths that men had no role whatsoever to play in reproduction and fertility control. Commonly held cultural and religious beliefs and misconceptions about oral contraceptives, etc, held sway across the country, filliping the intervention by PSI-Tanzania - a local affiliate, of Population Services International - to introduce a consumer brochure as a creative education strategy to counter all the claims and beliefs.

In Cote D’Ivoire, alarmed by the 3.3% annual growth rate, a former Minister of Planning, Programming and Development conceded that only by educating women and young girls on the importance of family planning, how rapid population in the country be reduced, especially in rural areas where poverty forces parents to give away their teenage daughters into forced early marriages for material gains.

This list is endless but for space. As an informed pan-African, I can confidently say that experiences have shown that major hindrances to societal development and progress in sub-Saharan Africa today are traceable to retrogressive “cultural traditions” and needless norms.

In the context of population challenges, it is no more news that in Nigeria, for example, government policies as well as concerted efforts and contributions by non-governmental organisations and development advocates across the world aimed at controlling rapid population growth to achieve sustainable balance with available natural resources and healthy environment, continue to be frustrated and stagnated by the deep-seated and settled wrong cultural mindsets, attitudes and values of many “traditionists” who see the whole population agenda as nothing but western propaganda. Yet the truth remains that there are population changes the country cannot just ignore.

Last year, on September 1, 2010, to be precise, a report released in Abuja by the Next Generation Nigeria, captured trends in Nigeria’s population growth and economic performance, and projected into the future with a warning on an impending, “demographic disaster” looming over the most populous black nation in the world, expected to become the world’s 6th largest country by the year 2050, by the predictions of the Population Reference Bureau (PRB).

Despite the alarming population emergency in the country, many Nigerian men, out of a lack of spiritual culture and self-discipline, ignorance and or culture/tradition-driven rebellion, wild libido and clandestine sexual behavioural attitudes, continue to produce children they have no plans for their growth, welfare and general development.

“Why single out the men…?” you may ask. Because in Africa, we men call the shots in the acts that lead up to the human population in the first place, and, unfortunately,no adequate efforts have been directly focused on making men voluntarily commit to planned parenthood/family planning, especially at the grassroots, their traditions and cultural norms notwithstanding.

A lot of international investments and assistance have been pouring into Sub-Saharan Africa targeting women - who are at the receiving end – with the realization that the more African women are educated and empowered, the easier it becomes for them to negotiate sex, abstain, delay or prevent pregnancy with more education and access to contraception and family planning methods, etc.

But I see that something is left on the sidelines which ought not to be, and that is the reality that until boys and men in our society, particularly, are encouraged to voluntarily accept and make wise and responsible decisions about their libidos, sexual behaviours and family planning, as well as actively participate in its promotions, etc, we should expect a time bomb of more homeless and unemployable young people on our streets, causing havocs, constituting nuisance, creating insecurity, violence and all forms of criminality to destabilise the society – the latest of which is terrorism and suicide bombing.

Men in our society, especially within the marriage union, need a lot of cultural re-orientation, sexual discipline and respect for womanhood, especially within the context of their sexual rights and reproductive health, for family planning – and ultimately a sustainable environment – to work in Africa.

Rather than stereotyping to culturally destabilize the environment societies fighting to reclaim their cultural identities from western cultural imperialism” should employ cultural innovations that help young people go back to their roots without making culture to hurt and dehumanize or cause more hardships, especially in the context of sexual behaviours and beliefs.

The role of men in population control must become a central issue in the global demographic debates and investments. This is essentially important considering the fact that in Nigeria, for example, “men are generally regarded as the heads of households and they dominate sexual and reproductive health decision-making”, records the 2004 ‘National Police on Population for Sustainable Development”.

It continues, “Men often have greater say in sexual relations, use of family planning methods, access to productive resources and property inheritance….. Men who deny their sexual partners the use of contraception to space children or to prevent high-risk pregnancies also contribute to poor reproductive health among women.

To date, male participation and involvement in reproductive health issues have been low. Reproductive health programmes have focused mostly on women and children, and have failed to adequately target and provide men with appropriate information and services. Culture, religion, and socially sanctioned gender roles pose additional challenges.”

Analytical Description of the cartoon:

A critical study of the cartoon, the “Stupid Strategist”, is all revealing of a satire. A young, modern man had a vision to become greater in life than his father was (which in itself is a laudable aspiration). Alas! His definition of “greatness” leaves much to be desired. His main strategy to be taken to the appellation of a great son-of-the-soil in his family was to have a ‘football team’ or more children to add to his late peasant father’s 22 children (including himself).
http://nigerianobservernews.com/02092011/features/features1.html

This did not go down well with his more-informed wife who, after having six children already in their marriage union, saw the need for the couple to introduce family planning- both for her own health and for her husband’s economic benefit and those of the entire family in midst of worsening inflation, austerity and global economic recession among other vital reasons.


But her suggestion met stiff opposition and disapproval from ‘the man of the house’, a custom and tradition freak and a chip of the old block who felt insulted by his wife’s stance.



She must continue to prove her fecundity and give birth to as many children he so desires, no matter how she felt on the errorneous cultural grounds that “it is God who gives children and He knows how to provide for the welfare of the children;” moreover, “it is a taboo in Africa, for a woman to renege in producing all the “eggs of offsprings” in her belly, for the more children a man has determines how much respect he gets from his competitors, friends and foes.


This is modern times, for crying out loud, and such silly and myopic beliefs should be jettisoned for progress sake. Culture is dynamic and traditions that negate human dignity and healthy living, social justice and peaceful co-existence, should be done away with. We live in a global community, nowadays, and one man’s recklessness here in one little corner of the earth has a far-reaching consequence on other’ lives round the globe – on a long term!


A man should have the wisdom, knowledge, understanding and moral capital to willingly obey the ‘clarion calls’ for voluntary family planning in an apparently over populated society, and be disciplined and committed to having just as much children as he can adequately cater for and nurture.



Making a “bloated family unit” is old fashion, barbaric and retrogressive in today’s society, and since men (and boys) are the ones with the greater stake here, Nigeria, and of course, all of Sub-Saharan African nations, will be the better for it if more finances, enlightenments and energies are channeled towards polices and programmes that will make African male citizens to be more responsible and responsive to changing religious and socio-cultural beliefs and practices that inhibit reproductive health and sexuality issues.


These are the encapsulated messages in the cartoon “Stupid Strategist,” a visual satire intended to offer an enhanced perspective on the subject of population control to the African public, in the context of achieving a global population in balance with a healthy, secure and sustainable global environment.



The editorial cartoon has been repeatedly published in The NIGERAN OBSERVER since 2010, including one on Wednesday, May 4, 2011, possibly to drum the message deep down the hearts of our people. Our mumudon do