The Bridge Clinic wins 2012 best IVF hospital in Nigeria award

THE Bridge Clinic has won the “Best Assisted Conception and In-Vitro Fertilisation (IVF) Hospital 2012.” The Award was presented to the hospital by the Institute for Government Research and Leadership Technology (IGRLT) at its 2012 African Governance and Corporate Leadership Awards event held on August 25, 2012 at Nicon Luxury Abuja. The Managing Director of the Bridge Clinic, Dr. Richard Ajayi, savouring the award, said in a statement: “We have continued to give our best in our path of offering alternative fertility options to couples in Nigeria and we have indeed derived deep fulfillment from our patients’ successes so far, but to be recognised and awarded for doing so by the Institute for Government Research and Leadership Technology, is even more exhilarating…I’m sure that this award will provide the necessary drive for (our medical) team to do more.” According to a letter signed by the Country Director/Chief Executive of IGRLT, Moses Essien, the parameters for the award to The Bridge Clinic were outlined as including expertise in the provision of first rate IVF; outstanding in the provision of first class assisted conception; excellence in brand integrity, reputation and patient service; compliance with professional codes and ethical standards; and compliance with regulatory laws and guidance among others. The Clinic had also been commended by the Lagos State Ministry of Health for the first ICSI babies in Nigeria; won the Guild of Medical Directors Award for excellence in medicine and the SOGON Award in recognition of outstanding contributions in clinical service delivery towards the promotion of maternal healthcare in Nigeria. The Managing Director also recently received the award for Lagos Medical Icon for his contribution to the development of quality-assisted conception and IVF practices in Nigeria. The Bridge Clinic, founded in 1999, provides fertility services in Nigeria. It is reputed to have restored the joys of numerous families with the voices of over 1,400 children born so far in homes all over the nation through its services. It runs clinics in Lagos, Port Harcourt and Kaduna. “As part of its corporate social responsibility initiatives, The Bridge Clinic in collaboration with the Lagos State University Teaching Hospital, provides subsidised IVF services to socio-economically disadvantaged couples in the state thus helping to reduce health inequalities. It implemented its quality management system since 2004, ahead of most clinics globally, and was awarded the ISO9001:2000 certificate by TUV Austria which was upgraded to the ISO9001:2008 certificate in 2010. http://www.ngrguardiannews.com/index.php?option=com_content&view=article&id=97110:the-bridge-clinic-wins-2012-best-ivf-hospital-in-nigeria-award&catid=93:science&Itemid=608

Teamwork lacking in health care’

AUGUST 30, 2012 BY MUDIAGA AFFE, CALABAR LEAVE A COMMENT LACK of team work among different professionals in the medical sector has been identified as being responsible for the problems in the health care delivery system in the country. The National Chairman of Nigeria Association of Hospital and Administrative Pharmacists, an arm of the Pharmaceutical Association of Nigeria, Dr. Nkechi Anyanwu, made this known at the 14th Annual National Scientific Conference of NAHP, in Calabar, Cross River State. Anyanwu said no professional within the sector could singlehandedly deliver quality health care to the masses. She said the government needed to promote teamwork in its bid to achieve the Millennium Development Goals. Chairman of Pharmaceutical Society of Nigeria, Cross River State, Mr. Paul Agulu, said despite that Nigeria had not attained its optimum feat of providing excellent quality health care for her citizens, there were conscious efforts by various state governments to set positive goals to improve health care of her citizens. http://www.punchng.com/news/teamwork-lacking-in-health-care/

Mega hospital project: Concerns mount over accessibility, cost

MIXED reactions have continued to trail government’s plan to set up private sector-managed mega hospitals in Nigeria’s six geo-political zones and the commissioning of experts to draw a road map for the actualisation of the long-term dream. Under the scheme, the government is giving the private sector the nod to mobilise resources to set up and manage the facilities in a selected state in each of the six zones. The committee is headed by former United Bank for Africa (UBA) Chief Executive, Tony Elumelu, representatives of the Nigerian Economic Summit group (NESG), the Association of General and Private Medical Practitioners of Nigeria (AGPMPN) and several other members from the sector in Nigeria. The projects are part of the government’s renewed attempt to bring affordable health services to Nigeria and check the exodus of the citizens abroad for medical tourism. The panel will also draw up an implementable plan for President Goodluck Jonathan’s vision of setting up at least one world-class private hospital in each of the zones before the end of his tenure in 2015. They are also to identify and engage potential investors with a view to guiding them to develop business models and plans for the setting up of world-class hospitals in the country. The team will also look into and propose an accreditation scheme that would ensure full compliance with global best practices in the operations of the proposed facilities. The plan has drawn intense applause from some stakeholders. Some stakeholders are also calling for caution. In separate interviews with The Guardian, they attempted to set agenda for government, insisting that the efforts to attract private sector investment into the healthcare system should primarily focus on affordability. Former Federal Commissioner of the National Human Rights Commission of Nigeria, Emmanuel Onwubiko says that the critical issues of healthcare are not one to be left entirely to the private sector to drive because of the cost implication on the poorest of the poor. He said, “if we allow the private sector to drive process of building, maintaining and running healthcare facilities across the country, this will adversely affect the enjoyment by the citizenry of the fundamental freedom of right to life because basically, the private healthcare providers are interested in maximising profits.” He rather tasked government to strengthen the primary healthcare facilities in the rural areas and put strategies in place on how to make them function optimally to bring succor and healthcare at very affordable rate to the poor rural inhabitants. His words, “government must not hand over the running of hospitals especially in the rural areas to the private sector because that would be suicidal and, in fact, would mean the end of government because the rural poor have no other way of feeling the impact of government other than the healthcare they receive from little healthcare facilities that are at present in those local council areas. “There has to be a clear determination of stakeholders in the political process to ensure that democracy works at the level of the local councils so that the elected officials are compelled to run the rural healthcare facilities efficiently making use of the allocations that they are entitled to from the federation account.” For the city and urban areas, Onwubiko, who is also executive director of Human Rights Writers Association of Nigeria (HURIWA), argues that government could allow the private sector investor to drive investments, noting, however, safeguards should be put in place to ensure that patients are not exploited unduly. “Government can grade the hospitals in such a way that government would have a way of offering incentives to Nigerian patients to enjoy some affordable healthcare. Government must ensure that there is a national health insurance scheme that is workable and not encumbered by bureaucracy but is run efficiently to enable every Nigerian to buy into the scheme. This health insurance scheme should be used to raise some fund that could be used as subsidy for poor patients in the urban areas who may not be able to afford the regular cost of healthcare in the privately run hospitals...” Director, Capacity Building /Programme Manager, Health at ActionAid International Nigeria, Ipoade Omilaju, raised fears that the mega hospital concept could create unnecessary class in the nation’s healthcare system. He commended the optimism displayed by the minister of Health on the workability of this initiative, but raised concerns about affordability. His words, “the minister spoke as if he is not a Nigerian and pretends as if he is not aware of the 70 million Nigerians who go to bed daily without a meal and without hope for the following day. How will they be able to afford this or in whose interest are we creating this? “I see this as another opportunity to transfer government responsibility in protecting and upholding the right to health of the citizens. Agreed, government might not be able to do everything but government should at least make the primary healthcare system work and affordable to all; be committed to providing needed things that make up minimum health package.” According to him, “promoting this kind of initiative is another way to create class in the healthcare system and widening the already existing gaps between the rich and the poor in access to quality healthcare services.” National President, Association of General and Private Medical Practitioners of Nigeria (AGPMPN), Dr. Anthony Omolola, on his part, assured that his association would give the committee all the support it requires to succeed. Founder of Community Health Information Education Forum (CHIEF), Remi Akinmade prefers that the project be run as private-public partnership, instead of leaving it entirely in the hands of private investors. http://www.ngrguardiannews.com/index.php?option=com_content&view=article&id=97103:mega-hospital-project-concerns-mount-over-accessibility-cost&catid=93:science&Itemid=608

Nigerians in Diaspora volunteer to boost tertiary healthcare

NAMFI opens office in Lagos A GROUP of Nigerian medical specialists in the United States (U.S.) is embarking on voluntary medical services to address gaps in tertiary care services in the country. Efforts by the group, under the aegis of Nigeria American Medical Foundation International (NAMFI), will address overseas medical trips and reverse brain drain “through the immense human capital and brainpower of Nigerian super-specialists in the American Diaspora.” Secretary to NAMFI Board of Trustees in Lagos, Dr. Adeyinka Shoroye said that the initiative was born out of the discovery that the biggest challenge to tertiary care in Nigeria was more of the dearth of medical experts than infrastructure. Meanwhile, there are currently about 4,000 Nigerian specialists in the U.S., about a third of whom are sub-specialty trained in about 80 sub-specialties from American Medical Association (AMA) database. “But with deficiencies in key sub-specialties in Nigeria, sick Nigerians now travel daily to the Apollo and Care Hospitals in India seeking second-opinions, highly specialised care,” Shoroye said. He said that it is worrisome that an Indian private diagnostic facility in Lagos alone weekly refers 20 patients to India for oncology diagnosis and treatment. And on daily flights from Lagos, about 40 patients are said to be India-bound patients for cardiac and renal conditions. While the rich and top government officials travel on medical tourism to Europe, North America, Dubai and South Africa, the middle class Nigerians travel to India, the poor and government-sponsored go to Egypt. “Data from the Central Bank reveals that $2.5 billion is spent by rich Nigerians on medical treatment abroad annually. It is also estimated that about the same figure is remitted home yearly from Nigerians in Diaspora for the cost of treatment of relatives! “Is this 21st century trade by barter? This is a big capital flight our human capital abroad can reverse. This cannot continue. Import our ‘finished products,” he said. To bridge the gap, NAMFI recently set up an office in Ikoyi, Lagos, with the mission “to fill the present huge gap in tertiary care in Nigeria with the immense human capital and brainpower of Nigerian super-specialists in the American Diaspora.” Shoroye, who is an attending physician at Oasis American Hospital, Abu Dhabi, said Nigeria’s luxury of expertise and experienced medical hands in America would be rotating voluntarily, year-round (by appointments only) to give tertiary care services in Nigeria. “We should remember that this is the generation that first put Nigeria on the global stage of excellence in medicine. We have a huge opportunity of human capital in history now to make a difference. They are bringing the flavour of experience with huge talent of those rotating from the U.S.” NAMFI is incorporated as a non-profit organisation in California and later in Nigeria, with Lagos office at Mulliner Towers, No. 39, Kingsway Road, Suite 113, Ikoyi. Their web address is www.namfi.org and has 01-215-0000 as phone number. Shoroye said further that the group had already partnered with about two well-equipped hospitals within 15 minutes distance to the office suites for admitting privileges/procedures. “We have office practices akin to faculty practice offices across America in tertiary care centres. We also have in our Ikoyi office suite telemedicine’s latest technology with Nigeria’s new satellite-NIGCOMSAT and also broadband. “Telemedicine facilities will be available for tele-consultation, tele-education and distance learning, as we develop a ‘central clearing house’ for Nigeria tertiary care consultative service for diagnostic challenges with Cleveland e-clinic for Nigerian patients. “We have made some strides in transferring large bandwidth of digital radiologic and pathologic images between Lagos/Abuja and North America overseas experts. This is our modest beginning. We have few highly experienced physicians living in Nigeria who will serve as ‘in-house’ experts and add value,” he said. The effort has been made possible with support of some donors in U.S. and also in Nigeria (all for non-profit status), coupled with transparency policy of trustees’ board management. http://www.ngrguardiannews.com/index.php?option=com_content&view=article&id=97109:nigerians-in-diaspora-volunteer-to-boost-tertiary-healthcare&catid=93:science&Itemid=608

Why is it important to prevent anaemia in pregnancy?

Anaemia in pregnancy is still a major health problem in Nigeria, especially among new mothers. Besides, experts warn that it is important that women prevent anaemia in pregnancy because it affects both the growth of their babies before they are born and afterwards, reports Sade Oguntola.

Many pregnant women feel reluctant taking folic acid and iron tablets, a common prescription by doctors. The usual excuse is that they are not sick and it is not important that these drugs be taken every day. But the worsening economic situation of many families and lack of consumption of leafy vegetables and a balanced diet, can all combine to make women give birth to low birth weight infants due to anaemia. Anaemia is a major hazard during pregnancy, especially in the last trimester of pregnancy. This is a condition in which you don’t have enough red cells in your blood. Red blood cells contain haemoglobin, which carries oxygen from the lungs to the rest of the body. If a person’s haemoglobin level is very low, the body tissues will not be getting enough oxygen. About 40 per cent of pregnant women worldwide are estimated to be anaemic, and iron and folic acid supplementation during pregnancy is commonly prescribed to prevent anaemia in pregnancy, which is often caused by iron deficiency. During pregnancy, there is high iron requirement, almost three times required for non-pregnant women of childbearing age, which is difficult to meet from dietary sources. Also, anaemia, caused by iron deficiency alone or in combination with other factors such as folic acid or vitamin A deficiency and malaria, has several negative effects on the pregnant woman and her unborn child. The benefits of iron and folic acid supplementation surpass what was previously perceived by many people. According to a new study that analysed the long-term effects of iron and folic acid supplementation in pregnancy on childhood survival, the use of these supplements during pregnancy ensures that babies are healthy and better protected from diseases during childhood. The researchers from Johns Hopkins Bloomberg School of Public Health suggested that taking folic acid and iron supplements in pregnancy might reduce infant mortality by 31 per cent in children less than age seven. What is more, intakes of these medicines reduced the occurrence of low birth weight by 16 per cent and anaemia in a pregnant woman and after the birth period by 50 per cent. This was a study that recruited almost 5,000 pregnant women in rural Nepal to take part in the randomised, double-blind, controlled trial. The women were divided into five groups: one group received folic acid only; the second group received folic acid plus iron; the third received folic acid plus iron plus zinc; the fourth received multiple micronutrients and the final group received vitamin A and acted as the control group. It was a follow-up to a 1999 to 2001 trial of the administration of micronutrients to women during pregnancy. Out of the 4,130 babies born alive, 209 died in the first three months and eight were lost to follow-up. Of the 3,761 remaining, the researchers report in the American Journal of Epidemiology that 150 died between the ages of three months and seven years, while 152 were lost to follow-up. Given a 31 per cent increase in childhood survival, due to intakes of iron and folic acid tablets, both during and after pregnancy, they declared that this should provide additional motivation to increase global programmes for antenatal iron and folic acid supplementation. Dr Kayode Afolabi, a consultant obstetrician and gynaecologist, explained that anaemia was a serious hazard both to the pregnant woman and her unborn baby because of its complications. “If you look at the mother who is anaemic during pregnancy, such a woman is bound to have repeated infections, including malaria, because her body immunity is lowered. Due to the fact that they tolerate many undercurrent diseases much more easily, they stand a higher risk of experiencing more ill healths and even deaths than the average pregnant woman that is not anaemic,” he stated. Dr Afolabi pointed out that low blood level in a pregnant woman is not good for the unborn baby either. According to him, “anaemia in pregnancy is a known cause of abortion, restricted growth of the baby in the womb; low birth weight and even the death of the baby that is still in the womb. If there is restriction in the growth of the organs of the body, including the brain, when such a baby is eventually born, such may not grow to their full mental potential.” What accounts for anaemia in pregnancy? According to the expert, “in this environment, we have malaria in pregnancy as a major problem. It causes the breakdown of red blood cells in the body. Also, it depresses the bone marrow from producing more red blood cells to meet the demand of pregnancy, hence leading to an anaemic state.” In addition, he mentioned other causes of anaemia in pregnancy as urinary tract infection and chest infection as well as poor diet (what is termed nutritional anaemia). What is, however, worrisome according to Dr Afolabi is that “most of our women, in fact, start pregnancy with less than optimal nutritional status and their condition is made worse by the demands of the unborn baby, the placenta cord attaching the baby to the mother and even the body’s preparation for breast milk production.” While this could contribute to such women becoming anaemic in pregnancy, he pointed out that many dietary practices in Nigeria further accentuated the problem. “Things like overcooking of vegetables lead to loss of folic acid,” he declared. Meanwhile, Dr Afolabi declared that the routine prescription of iron and folic acid tablets to pregnant women after 12 weeks of pregnancy was aimed at providing extra supply of these essential ingredients for blood formation, as well as meeting the demands of the baby, placenta and even prepare the woman for breast milk production afterwards. He said that the use of iron and folic acid tablets in pregnancy could help to improve child survival, considering that the baby would have access to adequate micronutrients in the womb and the baby would develop sufficiently to meet the challenges of early life. He declared: “Such a baby would have good body immunity, have good body weight and the vital organs in the body would also develop optimally, thus ensuring that during childhood, such a baby would be able to cope better with the challenges of health. Since, the mother is adequately prepared for breast milk production, the baby’s intake of breast milk would boost the body immunity and reduce risk of diarrheal disease, a major killer of children.” Given that many pregnant women do not conform to their doctors’ instructions to take iron and folic acid tablets, he emphasised the need for educating women on the importance of taking these medicines. “It could be a bit difficult if a woman does not understand why she must take these medicines three times in a day, throughout the period of pregnancy, when she is not sick,” he declared. For a healthy pregnancy, he advised that pregnant women should book for antenatal care early, rest, eat a balanced diet, maintain good personal hygiene and stick to other advice they are given by their doctors. http://www.tribune.com.ng/index.php/your-health/46746-why-is-it-important-to-prevent-anaemia-in-pregnancy-

Nigeria’s 2015 MDG targets won’t be achieved unless… – Don

By DAUD OLATUNJI, OLADEPO MICHAEL & EMMANUEL IBUWARISO ABEOKUTA— Professor Opeyemi Ajewole of University of Ibadan, Wednesday, predicted that Nigeria’s 2015 Millenium Development Goal targets will not be achieved unless state and local governments take their responsibilities proactively. The University Don however tasked the Chairmen of the 20 local government areas of Ogun State to strive in achieving the Millennium Development Goals, MDGs. Speaking as a resource person at the 3-day leadership workshop titled, “Enhancing Local Government Leadership in Ogun State,” jointly organised by the MDG office, Ken Nnamadi Centre for Leadership and Ogun State government in Abeokuta, Ajewole said local governments are closer to the grass roots in providing basic services which impact directly upon the MDGs. “The more local governments are able to target and develop the right interventions, the better will be the results on poverty reduction, health, sustainable development and education.” The role of local councils is very crucial to the attainment of the goals under Millennium Declaration”,he said.. The Special Adviser to the Ogun State governor on Millennium Development Goal, Mrs. Hafsat Abiola-Costello in her remarks advised the chairmen to be ready to take tough decisions that would engender development within the 20 council areas of the state. According to her , though, local government is facing some financial challenges but the current poor performance can be improved upon if the new leadership are ready to initiate developmental programmes. Meantime, the Chairman of Isagamu Local Government in Ogun state, Mrs Funmilayo Efuwape, has promised to curb down cultism both in Isagamu and Ogijo communities of Ogun state, noting that Isagamu is going back to full peace. Speaking with Vanguard in Ogun, the newly elected Chairlady of the Isagamu Local Government said during her tenure there will not be insecurity in the area, stressing that by providing good jobs, passing good orientation programs and engaging youths in physical and urban developmental projects, issues of security would have been well handled. http://www.vanguardngr.com/2012/08/nigerias-2015-mdg-targets-wont-be-achieved-unless-don/

Nigeria: Okigbo Takes Free Medical Health to Anambra

A TEAM of doctors and medical assistants from the Nnamdi Azikiwe University Medical School in Nnewi, Anambra State, was recently in the Ojoto Community of the State. to provide free medical services to the residents. Led by Dr. Chinelo Okigbo, a health practitioner at the University of North Carolina, Chapel Hill, USA, the team conducted tests and treatment for prevalent yet silent killer diseases such as hypertension, diabetes and obesity. There was also counselling on malaria prevention, hygiene and healthy living. Over 1,000 persons benefitted from the free medical programme that was facilitated by Mr. Patrick Okigbo III, Principal Partner of Nextier Advisory and brother to Dr. Chinelo Okigbo. The programme is part of the outfit's commitment to community development, Okigbo noted. Nextier Advisory, a leading public sector advisory and investment firm based in Abuja with specific focus on agriculture, power and petroleum industries, is committed to funding grassroots humanitarian efforts in healthcare, education, and enterprise. In a chat, Okigbo said free medical programmes have become a critical effort by his firm. The current one, was the second in series in Ojoto after the debut in 2008. The firm collaborates with committed individuals and groups in a community to identify the best form of intervention that will yield the most impact. Once decided, Nextier Advisory contributes a percentage of the programme cost while their community partners contribute the balance. Ojoto Akanasato Union under the leadership of its president, Prince Amobi Adirika (former Managing Director of Anambra Broadcasting Service), took care of the logistics for the visiting medical team. Essence of the programme is to foster a sense of community ownership. One of the beneficiaries, Madam Gladys Okeke, prayed for commitment and resources to sustain the programme while another, Mrs. Ego Nnoluka, who was diagnosed with high blood pressure, said she had learned how to manage her condition. Ms. Vivian Egbuna, Matron of the community health centre however expressed need for a resident doctor at the health center noting that "Even a Youth Corper doctor would be a great help to this community." In her view, Dr. Chinelo Okigbo, a specialist in maternal and child healthcare, confirmed that most of the deaths in the local communities were from preventable ailments that, if detected early, could have been prevented with lifestyle changes. She promised to analyse the data collated from this and other Nextier-funded medical efforts to develop a policy paper on new approaches to medical intervention in local communities. The Nextier Advisory CEO acknowledged that the free medical programmes are not the sustainable solution to healthcare delivery in Nigeria, but adduced for sustained intersection of good public policy and concerted action from the private and the public sector. Hence, Nextier Advisory has committed to continuing their interventions in the local communities. He acknowledged that the bulk of the solution is with the public sector and its policy choices; however, he affirmed that there is a lot that can be done by individuals. "When a small group of thoughtful, committed people apply themselves to a problem, miracles begin to happen. I believe there are enough of us to change Nigeria." http://allafrica.com/stories/201208280429.html

Nigeria: FG Scales Up Special Sickle Cell Centres Nationwide

SICKLE cell centres in the six geo-political zones of the country are to be scaled up following plans by the Federal Government to step up sickle management and care in the country. Minister of Health, Professor Onyebuchi Chukwu who disclosed this in Lagos at a book presentation entitled "Sickle Cell Disorder:Early Warning Signals" by Dabma Sickle Cell Foundation in collaboration with Genotype Foundation and the Health Writers Association of Nigeria, HEWAN, said the scale up was part of strategies to holistically tackle the burden of Sickle Cell Disorder, SCD, in Nigeria. Chukwu who was represented by a Desk Officer for Sickle Cell Disorder in the Federal Ministry of Health, Dr. Alayo Shopekun, explained that the centres would be dedicated to the management, control and prevention of SCD. Lamenting the plight of people living with the disorder, Chukwu said SCD is associated with poverty, maternal mortality, newborn and child mortality and HIV& AIDS particularly in those with history of frequent blood transfusion, stigmatisation, and bias in terms of job selection amongst others. "The foregoing picture for this hereditary disorder therefore calls for urgent attention,"he added He announced that a national guideline on the control and management of the disease was in advanced stage to ensure that care provided at the health facilities are informed and conform with international best practice.s The special centres for SCD have been provided with variant machines to ensure that diagnosis of the disorder is accurate and that suspected newborns are screened for the disorder and interventions and follow up could be instituted to ensure survival and improved quality of life for such children. Also, a database on the disorder is expected to be set up to provide information for effective planning and policy decision on the disorder. Earlier, writer of the book and Chairman, Dabma Sickle Cell Foundation, Pastor Emmanuel Ibekwe said Nigeria accounts three quarters of live births into the disorder in Sub_Saharan Africa, which is equivalent of 150,000 out of every 200,000 births in the region shows the stark reality of the disorder and the need to urgently address it to save lives as well as reduce related ailments. Ibekwe opined that his practical ordeal of victims of SCD influences his emotional connection to his writings to fight against the disorder. "We are here to launch a book that reveals why victims of the disorder keep wiping tear drenched faces daily not knowing where and when the pain shall come to an end due to the complications. "Many go into crisis and all of a sudden their health takes a drastic turn around for the worst." "We are appealing to stakeholders to support education through adoption of schools and libraries, providing books on our experiences as instructional materials for public enlightenment and awareness among other things," he added He called on the federal government to develop and encourage the non-for-profit social sector with a view to reducing the burden of the disorder. In his presentation, President, HEWAN, Mr. Azoma Chikwe, said the Association's participation is to "re-dedicate commitment to addressing sickle cell anaemia. As health writers, our impact must be felt in the environment we live." According to him, HEWAN's partnership with Dabma would go a long way in disseminating needed information on how to prevent or manage the disease to a large, scattered and heterogeneous population of the Nigerian community. http://allafrica.com/stories/201208280423.html

Time is ripe for breakthrough on child mortality, says senior Unicef official

Unicef doctor says investment now could help meet millennium development goals on tackling child and maternal mortality • Explore our interactive on tackling child mortality

A mother and her children collect water in the Lira district of northern Uganda. Photograph: Jonathan Porter/Alamy. An intense focus on countries with the highest levels of child mortality combined with the availability of cheaper vaccines and medicines can lead to a development breakthrough, according to a senior UN health expert. Dr Mickey Chopra, chief health officer at Unicef, the UN children's agency, said investment now would lead to massive strides in meeting the millennium development goals of reducing maternal deaths by three-quarters (MDG4) and the deaths of children under five by two-thirds (MDG5), both by 2015. "If we make the kind of investment we need now, which is not huge, we could achieve a 'man on the moon' moment," Chopra told the Guardian. "We have a clearer idea why and where children are dying. Twenty-four countries account for 80% of the deaths. We know where they are dying within those countries. Combined with effective interventions such as vaccines and breastfeeding, we have the potential to reach kids in the most cost-effective manner." Since 1990, annual maternal deaths have declined by almost half and the deaths of young children have fallen from 12 million to 7.6 million in 2010. Some of the world's poorest countries have achieved impressive progress in reducing child deaths. Rates of child mortality in many African countries have been dropping twice as fast in recent years as during the 1990s. In Botswana, Egypt, Liberia, Madagascar, Malawi, Rwanda and Tanzania, the rate of decline was on average more than 5% a year between 2000 and 2010. Similar progress has been made in reducing maternal deaths, although in fewer developing countries: Equatorial Guinea, Nepal and Vietnam have each cut maternal deaths by 75%. However, many countries – especially in Africa and south Asia – are not making progress. According to Countdown 2015, an umbrella group of academics, donors and NGOs that tracks progress in maternal and child survival, only nine of 74 Countdown countries with available data are on track to achieve MDG5. Eight of them (Bangladesh, Cambodia, China, Egypt, Eritrea, Laos, Nepal and Vietnam) are also on track to achieve MDG4. Chopra said countries such as Niger and Nepal had made significant progress on child mortality even without fast economic growth or significant poverty reduction. "In Niger, child mortality dropped by 47% in 10 years," he said. "It went from 227 down to 125 per 1,000 births. Niger concentrated on getting health workers into rural areas with simple interventions. The exciting thing is that with the money we have now, we can buy more medicines and save far more lives." Countdown said analysis for 2010 showed that 64% of child deaths were attributable to infectious disease and 40% occurred during the neo-natal period. The leading causes of death among older children remain pneumonia, diarrhoea and malaria. Chopra said new, more effective and cheap anti-malaria drugs that can be delivered by community workers to people's homes held out great potential. "The new drugs are much more effective and can be delivered quickly to kids who need it most," he said. Over the course of the decade, global malaria deaths have dropped by an estimated 38%, with 43 countries (11 of them in Africa) cutting cases or deaths by 50% or more. This is down to more effective drugs (artemisin combination therapies) – although there are reports of growing resistance to the new drugs, rapid diagnostic tests, long-lasting insecticidal nets (developed since 2000), better policies, and increased resources (human and financial), including distribution of enough bednets to cover nearly 80% of the population at risk in sub-Saharan Africa. Other means of reducing child mortality, such as handwashing and breastfeeding, come down to education rather than money. Modifying behaviour can be difficult, but not impossible. Chopra pointed to Uganda, where education has led to a significant increase in breastfeeding. "It is possible to change behaviour and it is being done and can be done in a short period of time," he said. The promotion of handwashing in schools in China, Colombia and Egypt has led to a drop in primary school absenteeism due to diarrhoea or respiratory infections of between 20% and 50%. Still, money will be needed to help achieve MDGs on child and maternal mortality, but official development assistance for maternal and child health appears to have plateaued in 2009 after increasingly steadily over the past decade, according to Countdown. In 2009, total official development assistance for maternal, infant and child health increased by 14.1% to $4.5bn from 2008. This compared with increases of 17.1% from 2006 to 2007 and 21.2% from 2007 to 2008. http://www.guardian.co.uk/global-development/2012/aug/28/breakthrough-child-mortality-unicef-official?newsfeed=true

Bassir-Thomas presents book on health research funding

THE Bassir-Thomas Biomedical Foundation (BTBF) will next week present a new book titled: Masks and Pandemic: Who Should Fund Health Research in Nigeria? The book is made up of contributions from some of Nigeria’s eminent medical scientists who advocated that health research initiative and its funding in Nigeria should not be abandoned to foreign donors. Chairman BTBF, Prof. David Okpako, noted that the book underscores the legacy of the founder, the late Prof. Horatio Oritsejolomi-Thomas who led the way in advocating that Nigerian government and people must empower indigenous scientists. This is to encourage the scientists to take initiatives at identifying priorities in health research into human and animal diseases that are of particular interest to the Nigerian people. The new book notes the danger of abandoning health research and funding to agencies like the World Health Organisation (WHO) and foreign donors in the long-term. Okpako, who also edited the work, added that while the work appealed to governments to budget specifically for health research in Nigeria, it also drew the attention of wealthy Nigerians to the importance of supporting health research for the long-term benefit of the Nigerian people. The book will be presented at the 14th Horatio Oritsejolomi-Thomas lecture on Friday, September 7, 2012 at the Drapers’ Hall, Institute of Africa, University of Ibadan. Theme of the lecture is “Countdown to 2015: Community engagement for improved maternal health and newborn health,” to be delivered by Country Director, Jhpiego (Nigeria), Prof. Emmanuel ’Dipo Otolorin. President, Nigeria-America Chamber of Commerce, Mazi Sam Ohanbunwa and Group Chairman, Bond Industries, Asiwaju Debo Omotosho will present the book, while Vice Chancellor, University of Ibadan, Prof. Isaac Adewole chairs the event. http://www.ngrguardiannews.com/index.php?option=com_content&view=article&id=97108:bassir-thomas-presents-book-on-health-research-funding&catid=93:science&Itemid=608

WIN US A TRUCK AND HELP OUR CAUSE!

My name is Tolu Omooba Akinboye. I am an Animal farmer with a farm in Ogun/Osun State where I breed organic pigs, and poultry.

Although a very busy farmer, I make out time to give back to my community by volunteering with various charities involved in improving healthcare results and statistics in Nigeria. In 2009, I volunteered with a Non-governmental Organisation (NGO) focused on reducing Maternal and Infant death in Nigeria and my work with this NGO was a great eye opener for me.

Maternal mortality rate (MMR) is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes). The MMR includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year

Maternal health is a critical topic in global development. Maternal ill health and death impacts families, communities, and societies and has far reaching effects across socio-economic strata. Despite recent data showing a positive turning point in the battle to keep mothers alive through pregnancy and childbirth, 342,900 women die each year from causes related to pregnancy and childbirth.
Every year, more than 133 million babies are born, 90 per cent in low and middle income countries.
Every year, three million 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.
Among the 133 million babies who are born alive each year, 2.8 million die in the first week of life and slightly less than one million in the following three weeks.

Nigeria
Maternal mortality rate: 840 deaths/100,000 live births (2008)
Nigeria’s maternal mortality rate is at an unacceptably high level. It is estimated that one in eight women die yearly of pregnancy-related complications.
Nigeria has the second highest rate of maternal death in the world: In Nigeria, approximately one plane load of pregnant women die every day!; with an estimated 608 deaths per 100,000 deliveries, Nigeria ranks second only to India in the list of nations with the worst child mortality.
Every Nigerian is only four (4) persons away from knowing someone that died from child birth alone!!
Women in Nigeria still have an average of six children each, and, according to the 2008 edition of the Nigerian Demographic and Health Survey, 20 per cent of married women of reproductive age want to space or limit births, but are not using any method of family planning.
The low usage of family planning services calls for greater private health sector involvement to complement the Nigerian government’s effort in providing family planning and reproductive health services to its citizens.
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. Worst of all is that most husbands leave their wives to suffer the pain alone without providing the care they need.
Nigeria is still battling to achieve regular power supply in the 21st century, a time where virtually every activity of man has gone digital and most hospitals are not excluded from this reign of darkness. Some women are operated upon using candles or kerosene lamps in the theatre.
Most maternal deaths are avoidable, as the health care solutions to prevent or manage the complications are well known.
Therefore, for Nigeria to achieve an accelerated 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.

I also realized in the course of my work that a sizeable percentage of maternal and infant death could be averted if pregnant women and mothers were empowered with information. Yet in Nigeria there remains a low level of information dissemination to pregnant women and nursing mothers especially in rural areas; healthcare information that could assist these women in improving their health, the health of their children and subsequently their survival rates.
On this basis, I and a group of like minded young Nigerians created the Advocacy for Maternal and Infant Health in Nigeria (AMIHIN). AMIHIN is a non-profit making NGO created with the objective of reducing maternal and infant mortality in poor communities in Nigeria by providing relevant healthcare information and best practice updates to pregnant women and mothers in these communities.
The AMIHIN team comprises of medical and healthcare professionals, lawyers and other career professionals who are intent on contributing to the improvement of Nigerian maternal and infant mortality statistics.
AMIHIN projects currently include:
1. Collation of maternal and infant mortality causal data across the various states in Nigeria.
2. Provision of up-to-date maternal and child care information to pregnant women and mothers using traditional storytelling and cultural dance troupes in communities all over Nigeria. The tour will also include medical professionals who will be on hand to answer questions and provide practical advice
One of the main concerns we have had so far in the course of these projects has been transportation.
I have entered the Ford Ranger Challenge in the hope of winning a Ford Ranger truck which will serve not just as a means of transport on my farm but also a tool for transporting AMIHIN materials and personnel across the country in the course of our various projects.

AMIHIN is my passion and the project I now devote a lot of my time to. The Ford Ranger truck is more than a truck for a simple farmer; it is to us at AMIHIN a truck to facilitate the reduction of maternal and infant mortality in Nigeria.
Help our cause!!
Please Vote Tolu Omooba as Ford Challenge Winner. Go to the link:http://www.fordrangerchallengessa.com/contests/showentry/1011431

Follow us on twitter @amihn2000
For more details or to discuss our work, send a message to us at: amihn2000@gmail.com

Greece 53.5% Debt Write-down: Nigeria and Africa can do better

Nigeria received 18 percent write-down on her 2006 debt payment, Greece received 53.5 percent



History was made when the highly indebted Greece received 53.5 percent write down restructuring on her initial debt deal from its sovereign bondholders. The struggling southern European nation "Greece implemented the biggest debt write-down in history ... swapping the bulk of its privately-held bonds with new ones worth less than half their original value. Although the exchange will keep Greece solvent and at the receiving end of billions in international rescue loans, markets were underwhelmed amid fears that the country's debt load still remains far too heavy,” Associated Press reported.

To enforce the debt swap the application of collective action clauses was utilized to approach the rate of 95.7 percent as was confirmed by Greece finance department. The Greece bond holders will be losing 53.5 percent of the face value of the original bonds. As this deal went through it will lower Greece debt by $190 and prepare the country for the second round European bail-out.

Bloomberg stated that "Holders of at least 60 percent of the Greek bonds eligible for the deal, including Greece’s largest banks, most of the country’s pension funds and more than 30 European banks and insurers including BNP Paribas SA and Commerzbank AG (CBK), have agreed to the offer. That brings the total to at least 125 billion euros ($166 billion), based on data compiled by Bloomberg from company reports and government statements."

Associated Press further reported that the scope and dimension of the deal was made known by statement issued by Greece Finance Ministry that the “bonds issued under Greek law with a total face value of €177.2 billion ($232.5 billion) were exchanged. A smaller batch worth €28.5 billion, issued under foreign law or by state enterprises, will be swapped in coming weeks."

Nigeria during her exit from 2006 Paris Club of Creditors was granted a merely 18 percent write down for her $36 billion she owned to mostly European creditors. At the end of deal Nigeria paid almost $(15-20) billion to pay off the debt. The international media made sure that every person and hamlet heard about the 'wonderful and generous’ news on how Nigeria has been offered a great helping hand from the Paris club of Creditors. The only one thing that was missing on the news report was the original principal amount Nigeria owned and the subsequent higher interest rates and arrears that made it possible to transfer such an enormous wealth to the foreign syndicates.

Greece is not by any means a third world nation, it has modern infrastructures and her people are relatively secured. Greece has 24 hours electricity, clean and treated drinking water gushing out from the water pumps, paved roads together with well paid, trained and equipped police force that maintained peace and order. Greece has political stability and security that made it possible to attract investors. All things being equal, why was Greece given this enormous write down and Nigeria a relatively poor and third world country was not given a quantifiable break that will make a difference in the lives of average Nigerians?

At the time Nigeria was convinced to transfer almost $20 billion to first world and developed nations mostly in the continental Europe, seventy percent of Nigerians were living in penury poverty and depravity surviving with less than $1 per day. The ugly head of AIDS/HIV virus was enveloping the nation and the healthcare facility was in dire straits. Nigeria's high infant mortality rate was among the highest in the world averaging 200-300 per 1000 live births. Nigerian educational system was in shambles and teachers' salaries in most cases were insufficient and were rarely paid on time. There was and still poor security, the protection of lives and property were minimal. Yet with all these wellbeing abysmal indices Nigeria received only 18 percent write-down even with the ever and continuous servicing of the debt from time immemorial.

Many of these nations in southern hemisphere especially in Africa have to qualify as a Heavily Poor indebted countries (HPIC) before they can receive debt relief and write down. Many African nations that were struggling to pay their debts were saddle with austerity measures before they qualifying for HPIC and these stringent conditions and criteria are back breaking. The prescriptions have more deadly than the disease - those conditional ties leave them poorer with infant industries porous to protection, less productive, weaken currencies and in financial shambles. But Greece has not even implement its own austerity measures before she received almost 53.5 percent write down on its first debt deal.

To further compensate Greece for mustering the courage to make debt deal, IMF just approved euro28 billion ($36.56 billion) for Greece. The European Investment Bank (EIB) will soon be putting a finishing touch to disburse $1.31 billion to Greece.

The goodies are still flowing into Greece, Reuters reported, “Greece averted the immediate threat of an uncontrolled default on Friday, winning strong acceptance from its private creditors for a bond swap deal which will eat into its mountainous public debt and clear the way for a new bailout” and now "With euro zone ministers set to approve the 130 billion euro ($172 billion) rescue."

International Monetary Fund (IMF) was quite impressed with the just concluded deal made by Greece that was why it approved euro28 billion ($36.56 billion) in the absence of austerity measures that suppose to come when Greece will make its second debt deal. IMF is now logical even patient and benevolent to Greece. But IMF did not have any qualms counseling Nigeria to remove fuel subsidy for a nation that barely provide any social program to its masses. IMF did not see anything wrong for a poor country with over 170 million population to make a payment that was too perplexing for a nation struggling on how to feed its bulging poor population.

There was a back drop that probably made it possible for Greece to successfully complete the debt deal. Last December the energetic and trail blazer Mario Draghi, the head of Europen Central Bank (ECB) lower the interest rate to 1 percent and pumped in 500 billion euros into the euro zone monetary base. At the interest rate of 1 percent ECB has just started to play a vital role in eurozone's monetary policy and this is a gutsy role for once a low key and timid ECB. With problem of liquidity solved, the solvent banks and private financial institutions were ebullient and energetic to participate in adjusting the economic wellbeing of eurozone.

This is how Reuters put it: "Mario Draghi, 64, has taken the helm of the euro zone's most important institution in the midst of Europe's deepest financial crisis since World War Two. He faces a seemingly impossible mission: satisfying German demands to focus on the ECB's main mandate of ensuring price stability, while at the same time dealing with market and political pressure from other countries to steer Europe out of a debt crisis that has engulfed Greece, Portugal, Ireland, Spain and even his native Italy. The back-to-back rate cuts took the euro zone's interest rate to a record low of 1.0 percent. But they also sent a clear message that Draghi's ECB would be decisive, pragmatic and prepared to ignore its powerful German contingent."

The point must be succinctly made that no one is suggesting that Nigeria and African nations not to deleverage their debts and fulfill their financial obligations. Greece has shown that the private sector and international financial institutions could be logical when they deem it necessary. Africa also deserves same treatment.

Emeka Chiakwelu is the Principal Policy Strategist at Afripol Organization. Africa Political and Economic Strategic Center (Afripol) is foremost a public policy center whose fundamental objective is to broaden the parameters of public policy debates in Africa. To advocate, promote and encourage free enterprise, democracy, sustainable green environment, human rights, conflict resolutions, transparency and probity in Africa. http://afripol.org. strategist@afripol.org


http://www.groundreport.com/Business/Greece-53-5-Debt-Write-down-Nigeria-and-Africa-can/2945065

Mobile Maternal Health Programme: Global One 2015 in Nigeria

Global One 2015's mobile maternal health programme, which serves pregnant women, mothers, children under five and the gynaecological problems of women between pregnancies and older women, is currently operating in Delta state, in southern Nigeria. The programme is being delivered locally by the Red Cross. The focus of the programme is on at-risk rural women with significant obstacles that prevent them receiving maternal healthcare for antenatal, child birth and post-child birth (puerperium) stages, as well as between pregnancy gynaecology care. By at-risk is meant women with symptoms and/or other features that make it likely for them to die in pregnancy, child birth, or after child birth, or to have severe ill health (severe morbidity), and to equally risk the death of the unborn child or predispose the child to ill health and/or death after birth. The programme will identify these women and get them the specialised healthcare they require. The programme is a pilot, which will be scaled up depending on the willingness of new donors to come on board for an extended programme.


http://go2015.blogspot.com/2012/03/mobile-maternal-health-programme-global.html

How the developing world is using cellphone technology to change lives

Many places are jumping straight from paper records to mobile information because they are getting cellphone towers before Internet connections or even traditional phone lines. A man makes a phone call at a calling centre on top of the Bisie mine in North Kivu, Democratic Republic of Congo.

LUCAS OLENIUK/TORONTO STAR
Tim Alamenciak


In Nigeria, a young girl can ask questions about sex discretely through SMS and get accurate information.

After the earthquake in Haiti, survivors in remote towns could receive money for food straight to their cellphone.

In Senegal, election monitors sent updates on polling stations through their mobile phones, revising an online map in real time with details about late openings or worse.

Projects like Learning about Living in Nigeria, MercyCorps in Haiti and Senevote2012 in Senegal are just a few examples of how the rapid spread of mobile technology has changed life in the global south.

Many places are jumping straight from paper records to mobile information because they are getting cellphone towers before Internet connections or even traditional phone lines. This means that for the first time it’s possible for a doctor in Guatemala City to monitor a newborn baby in a rural part of the country.

“People who never had access to information can get to a telecentre or a computer at their church or they have a mobile phone even if they share that mobile phone with their whole family and everyone just has their own SIM card,” said Revi Sterling, director of Information and Communication Technologies and Development (ICTD) graduate studies at the University of Colorado at Boulder.

“If that’s your data collection tool instead of papers that get blown away and eaten by goats, that’s valuable,” said Sterling.

Sterling founded the master’s program in 2010 to help produce students who could capitalize on the boom of connectivity in the developing world. It focuses on building connections between the world of technology and the world of development — something many see as a lucrative opportunity.

In 2001, just eight out of 100 people in the developing world had a mobile phone subscription. Now, nearly 80 out of 100 do.

In India, more people have access to cellphones than toilets, according to a 2010 report from the United Nations University.

“I have lots of students who come from an engineering and science background who say, ‘But you can’t eat (network) cable and you can’t drink YouTube,’” said Sterling. “The idea that you could ride the development wave on an emerging trend like technology certainly makes the technology a really indispensable tool.”

AID

FrontlineSMS

This software allows anyone to set up their own communications hub to send mass messages, manage automated SMS systems and collect data from the field. FrontlineSMS allows users to connect their mobile phone to a computer, transforming communication into something more powerful and manageable.

“If you go to the developing world and you look at how cellphones are being used you can really see that people are already doing this kind of organizational management, communicating with stakeholders, communicating with people they’re working with and for,” said spokesperson Laura Hudson.

The system enables easier management of SMS messages and also allows users to set up mailing lists, collect data and code automated reply systems. Traditional procedures involved checking in over the phone with remotely dispersed members of, for example, an aid team.

“Instead of that they can send an SMS. It’s cheaper for them, it saves time and the data can go straight into their report,” said Hudson.

FrontlineSMS was used to coordinate aid response after the 2011 floods in Pakistan and to manage reconstruction in Haiti. It has also been used to remind HIV patients of best practices and nutritional information.

Ushahidi

This project came as a result of post-election violence in Kenya in 2008, when high mobile penetration met a need to know where trouble spots were located. The original idea was to produce a map of violent areas based on reports sent in by citizens via SMS or email. The system has evolved into an open-source platform to be deployed anywhere. Ushahidi has been used to map everything from earthquake damage in Haiti to blizzards in New York. A site called Crowdmap runs the Ushahidi software and allows anyone to sign up and create their own crowd-sourced map without the hassle of using their own server.

Refugees United

This project is designed to help refugees reunite with their friends and family. It replaces traditional forms of reconnection, allowing anyone to create a free profile with as much or as little information as they’re comfortable releasing. The profiles allow friends and family members to search under certain criteria, including given name, nickname, village or city of origin. The software works from both computers and internet-enabled phones.

NextDrop

One of the challenges with water delivery is predicting when the pipes are going to be opened. In many places this means lineups at the wells, often lasting hours or even days. Being tested in rural India, NextDrop alerts people via SMS 30-60 minutes before the water is turned on.

FINANCE

MercyCorps

In Haiti, where 85 per cent of the population has a cellphone but only half has a bank account, MercyCorps deployed a new way to stimulate the economy after the earthquake: mobile payments. MercyCorps has dispensed more than $1 million (U.S.) to 6,000 people in rural Haiti — all using their cellphones.

“We pretty early on recognized that mobile was a great tool for (reaching more people) and also a direct channel into the communities where we work,” said Cameron Peake of MercyCorps.

Peake’s team is now working on a mobile savings system in the Philippines.

“The financial services area is really a promising and strong area to see financial sustainability,” said Peake.

M-Pesa

This system allows Kenyans to use their cellphones to send and receive money. It is designed for people who don’t have bank accounts, enabling them to receive money domestically or from abroad and to pay bills. At its most basic, M-Pesa allows one user to send money to another as simply as sending a text message. The service is wildly popular in Kenya — it processes more transactions domestically than Western Union does globally, according to the International Monetary Fund. Founded by Safaricom and Vodafone, M-Pesa recently introduced M-KESHO, a savings account to complement the service.

Boom

This software does one thing — allows for easy money transfer between countries using mobile phones. It costs less than typical wire transfer services. Once the link is established and software registered on both ends, someone in the United States could send money to someone in Mexico with a simple text message. Currently the service works in Mexico and the U.S., with Haiti planned for future rollout.

AGRICULTURE

iCow

Using SMS, the app tracks a cow’s gestation cycle and gives farmers notifications at key moments in a cow’s life. iCow allows farmers to optimize milk production and better monitor calving periods.

“It’s a little more unique in that there are lots of price apps but iCow gets down to the nitty-gritty, like the gestation period of a cow,” said Sterling.

Based out of Kenya, the app also helps farmers keep accurate and permanent records of milk production and breeding. It offers tips on farming dairy cows.

In a June 2011 pilot, farmers using the iCow app reported a 42 per cent increase in income on average.

The app also features a directory of veterinarians and a call centre that allows farmers to get advice. A recently released feature called iCow Soko allows farmers to trade livestock directly with one another.

CocoaLink

Cocoa farmers in Ghana can get a helping hand through CocoaLink, a mobile app that delivers advice and allows rural farmers to have their questions answered without leaving the field. It is a partnership between Hershey’s, the World Cocoa Foundation and Ghana’s Cocoa Board.In Ghana, two out of three cocoa farmers have access to a mobile phone. The program is in its pilot phase, but there are already plans to extend the service to the Ivory Coast.

mFarm

mFarm helps farmers in Kenya by relaying market prices through SMS. The software is designed for small-scale farmers who can’t make it to the major marketplace and risk being lied to by middlemen. The app retrieves prices from five major markets, allowing farmers to determine the best prices for their goods.

NAFIS

National Farmers Information Services is a service provided by the Kenyan government that gives farmers tips and advice on anything from ostrich farming to beekeeping. The service provides information in both English and Kiswahili through an automated telephone line. NAFIS also maintains a website containing this information as well as commodity price information.

GOVERNANCE

Senevote2012

The 2012 Senegal election saw a new kind of monitoring develop — independent, observant and connected through mobile technology. A group of people in Senegal have been monitoring elections since 2000, but this year they were dispatched with a mandate to report their findings immediately.

“It’s a very slow process traditionally. What we did was we took their process, we didn’t change it at all and we just said what we can do here is put a very simple coding system in,” said Jeffrey Allen, program coordinator with Mobile4good.

Since the monitors all had cellphones, it was just a matter of training them to use the system and send updates to the data collection and mapping software.

The map highlights both successes and failures, indicating where polling stations opened early or late, and other violations. It has the benefit of providing immediate accountability, but the data is also more easily assessed than if it were recorded on hundreds of sheets of paper.

“On the one hand, (the observers are) an alert for immediate issues. On the other hand, they’re data collection for the bigger picture so that at the end of the day, the civil society team can look at the data in total, look at everything that happened in the election, and make a pronouncement whether everything was free and fair or not,” said Allen.

The group is planning on employing the same technology in the upcoming runoff elections March 25.

Samadhan

A system is being piloted in India that allows people to file complaints about their government using SMS. The complaints are logged and filed according to their location and type. Once the complaints are registered, the person receives a tracking number and the local government deals with the complaint. The system is currently being tested in the Sehore district of Madhya Pradesh, outside of Bhopal, and Koraput district in Orissa.

uReport

uReport is a polling and citizen journalism organization that runs on SMS. Ugandans can respond to polls or text their stories to uReport. The group gathers this information and passes it along to radio and television stations, also publishing polls on its website. The poll results are available on a map. For example, a Jan. 31 poll asked uReport members if they knew female circumcision was illegal. About 76 per cent responded “yes.”

HEALTH

Learning about Living

Youth in Nigeria face strong opposition when it comes to learning about their own sexual health. Mobile4good, the company behind Learning about Living, allows them to discretely seek advice through SMS messaging. The service launched in 2007 and has received more than 400,000 messages.

“We realized there’s a serious problem with HIV/AIDS and with adolescent pregnancies and abortions — sort of clandestine abortions. A lot of this came from a lack of awareness among young people of how to protect themselves as they were reaching puberty and coming of age in that way,” said Mobile4good’s Allen.

Live operators trained in sexual health education answer the text messages.

“It’s not that they didn’t want to know how to protect themselves, it’s that they didn’t have any access to information,” said Allen.

The project has since been expanded to Senegal and the team is working on deploying it in Morocco.

TulaSalud

This project in Guatemala uses technology to help better equip nurses in remote areas in an effort to reduce the infant mortality rate. Its software products allow nurses to track patient data over long periods of time, replacing the need for stacks of charts and forms. The service also offers free phone numbers that practitioners and patients can call to get answers about their health. The project is supported by the Canadian Tula Foundation.

Childcount+

This software allows medical professionals to use their mobile phone to monitor the health of young children and babies. It allows each child to be registered and their data to be tracked electronically, providing valuable insight into their health. The system uses SMS messaging to track specific data about the children and monitor for malnutrition, malaria and other diseases. The software is used at Millennium Villages projects across sub-Saharan Africa.

Txtalert

This simple app can make a profound difference in someone’s life, providing reminders when treatment is needed. Anti-retroviral therapy was the original purpose, though the software can be customized to work with any regular treatment or to remind patients of scheduled appointments. The software is free and open source, allowing any medical clinic to use it.

http://www.thestar.com/news/world/article/1150416--how-the-developing-world-is-using-cellphone-technology-to-change-lives

Countdown update fosters country accountability, supports Global Strategy

As follow-up to the Global Strategy for Women’s and Children’s Health, Countdown to 2015 released Accountability for Maternal, Newborn & Child Survival: An update on progress in priority countries, with updated profiles on high-burden priority countries that account for over 95% of maternal and child deaths. The report will be launched at the 126th Assembly of the Inter-Parliamentary Union, which takes place in Kampala, Uganda from 31 March through 5 April 2012.

The profiles in this publication highlight how well each country is doing in increasing coverage of high-impact interventions that can save the lives of millions of women and children. The core indicators included in these updated profiles, selected in 2011 by the Commission on Information and Accountability for Women’s and Children’s Health, encompass key elements of the reproductive, maternal, newborn, and child health (RMNCH) continuum of care. The report also includes a brief report providing a snapshot of progress on these core indicators across the priority countries, revealing promising news as well as challenges that still remain to be addressed.

Countdown to 2015 is contributing significantly to the global accountability agenda around the Global Strategy for Women’s and Children’s Health, an unprecedented plan to save the lives of 16 million women and children by 2015, which was launched by UN Secretary-General Ban Ki-moon in September 2010. Countdown’s key role in fostering accountability consists of:

Preparing Countdown profiles focused on the Commission’s indicators—the profiles published in this report will be updated every year with new data and results
Producing global-level analyses, reports, and cross-cutting research on coverage and its determinants
Conducting special analyses to address accountability questions—Countdown research will inform the work of the independent Expert Review Group (iERG), appointed by the Secretary-General to report annually on progress in implementing the Commission’s recommendations regarding reporting, oversight, and accountability
Supporting country-level Countdown processes that include national consultations, workshops, or publications utilizing Countdown data and methodological approaches—Countdown will publish a toolkit to assist countries in implementing their own Countdown processes later in 2012
The country profiles in this publication, customized to showcase the Commission indicators, are adapted from the full, two-page Countdown country profile, which Countdown produces on a roughly two-year cycle. Full country profiles will be included in Countdown’s 2012 Report, which will be published in June 2012.

http://countdown2015mnch.org/media-centre/2012/accountability-update

Nigeria: Bauchi Employs All FG Midwives

By Ruby Leo

The Bauchi State government has employed the 144 midwives posted to the state under the Midwives Service Scheme programme (MSS) initiated by Federal Government to reduce maternal and child death in Nigeria.

The minister of state for Health Dr. Muhammad Ali Pate disclosed this over the weekend while commissioning a completed General Hospital in Bayara, Bauchi State.

Pate commended Bauchi State for its progress in the health sector acknowledging it as one of the few state's that have employed all Midwives posted to them.

He said: "Bauchi State is a very committed partner and I want to commend the State Government for all the good work they have been doing in various area of development more particularly in the area of health. There is progress in infrastructure, vehicles, welfare of staff in the health sector with the implementation of the CONHESS and recruitment of the 144 midwife posted to the State Government."

"Bauchi State is one of the few state that recruit all the 144 midwives that were posted to them this is very commendable". He stressed

Governor Isa Yuguda, represented by the Deputy Governor Alh. Sagir Aminu Sale, said that the hospital was constructed based on the request made by people in the community.

According to him, efforts to improve the health sector include, de-centralization of the Ministry of Health for greater efficiency and effectiveness in the healthcare delivery,

He said that four Agencies were created namely Hospital Management Board, Primary HealthCare Development Agency, Bauchi State Agency for the control of AIDS/TB and Malaria, and State National Health Insurance Scheme (SHIS).

Earlier the state's commissioner for health, Dr. Sani Abubakar Malami said that the State Government has sponsored 364 health professionals to study all over the country adding that they are already employed.

He said: "The Government of Bauchi State, under a special arrangement has sponsored a total of 38 students and 6 others to study medicine in Egypt."

http://allafrica.com/stories/201203200516.html

Polio Eradication Initiative

interview

India has been polio free for a year and Nigeria hopes to follow suite, marking out high risk areas where more effort is needed. But the first round of immunisation this year has seen persistent challenges; caregivers refusing the vaccine, children still being missed, and health worker commitment in need of improvement. Pharmacist Inuwa Ya'u, programme officer for Polio Eradication Initiative at the National Primary Health Care Development Agency, monitors implementation of immunisation across states. He spoke to Daily Trust's Ruby Leo and Judd- Leonard Okafor.


What is the difference between the National macro plans for polio eradication and the way the micro plans are implemented at the local government levels?

Microplans are developed at lower levels. By implication, what it simply means is that they are plans that are developed to enable the team cover the four-day period within available resources, which means the vaccines, target population, resources. Why we do that is to ensure every child in every ward and settlement is covered. Planning is the foundation of every programme.

What I see here is that Jigawa has been using the microplan, but just like in any other state the microplan sometimes does not take us to where we want to go, meaning that some settlements are still being missed.

And at this age, when we are pushing very hard to ensure that we get polio out of Nigeria, teams still do develop their own microplans and they are expected to work with these microplans for any visitor that comes in to know the exact location and to really understand the plans they have for that day.

Unfortunately, some of them don't go with those plans even though they have them. We have had to make some corrections today, but some wards still go along with their microplans.

Does the general implementation on the ground give you hope, as someone involved in the running of the polio eradication programme? Are we getting close?

We have strong hope that we can eradicate polio out of Nigeria. But then there are three basic problems we must overcome. One is the quality of our implementation, that is the way we deliver these vaccines. There are gaps in the human resources, there are gaps in the pluses, there are gaps in even the commitment of some health workers. And to address this, the National Primary Health Care Development Agency, in collaboration with development partners, developed the Accountability Framework, where every person from the highest level to the lowest person giving the vaccines to the children is accountable for his or her own actions.

And we are now changing the training and selection process. The selection used to be between the ward focal person and just the village head. Now we have ward selection committee, comprising five distinguished members of the community that involve the traditional leader, the religious leader, any civil society organisation--to give balance and fairness--and then the ward focal person and also any partner (WHO, UNICEF) that is there in that community. This is the starting point. If we are able to get the right mix of personnel to do the house-to-house team, if we are able to acquire quality practical knowledge of how to do it, and if we are able to improve on our microplan, then the delivery component, which the is supply side of this programme, will improve.

The second component is the demand side. Are we really getting to the communities in the right way? Yes, but there is room for improvement. And unless we are able to do that improvement, we will not be able to reach there. This has to do with the issues on ground. Are we really using the media, especially the local radio stations, to really impact? Is our majigi system really working? Are we really expanding or we are just doing pockets of majigi film shows here and there that will only give us little impact? Are we identifying community champions? It isn't only the structural chairman, governor, commissioner. There are individuals that are highly respected and adored by the community people. They could be politicians, footballers, traders. The programme must identify them. These people must identify with the programme for the people to have confidence, because up till now noncompliance is still an issue.

The third component is underlying health system issues that are beyond the polio programme. When you visit a mother, her major reason why she is not allowing her child to be vaccinated is that if she goes to the nearby health facility for her malaria [stricken] child, she doesn't get attention...so why then would you be coming to her house to give medication? These are broader health system factors that we have to improve along the line for us to really get to the Promised Land.

How would you practically deal with these issues while the round is ongoing?

We need to develop a very robust health system. Government at all levels, the partners that are supporting health systems in Nigeria must come on board to improve the system. If this health system is not improved, it would create a barrier to our house to house strategy to immunising children. It is a broader context, but it is a very important factor that we have to bear in mind. But that should not stop us. If we are able to address the delivery and demand issues, which are programme oriented, I think we will able to reach the Promised Land.

There are other issues, beyond immunisation, that primary health care deals with. How do all those issues come together? People you deal just identify you with polio and that's it?

NPHCDA is a government institution constitutionally empowered to develop policies, direction and resource mobilisation for primary healthcare in Nigeria. Immunisation is one of seven key components of primary health care. We deal with maternal and child health, resource mobilisation, essential medicines, all the broader aspects of primary health care.

Why immunisation? Immunisation has been proven still to be the most cost effective intervention, and everywhere in the world it is the cornerstone of the primary health care. If every PHC facility has a functional immunisation system, I tell you all the remaining components--nutrition, food, hygiene, water--will automatically come to bear under the single platform of primary healthcare.

Secondly, Nigeria is still the only remaining African country where polio is endemic--meaning that all other countries at one point or the other have eliminated poliovirus. We have reached a very good level, and we have made progress. We should also bear in mind that for the past three years, 22 states in the southern part of this country have been polio free. We need to really put in much energy.

Fortunately for us, we have international support, and that support is gingering us. But we cannot do it unless the local government areas and states buy in as much as possible. The level of buy-in is growing.

There are a lot of fantastic components we use to support the LGAs. We have been constructing primary health care centres all over the country; it is one aspect of improving access. We have been mobilising resources to ensure that maternal health is improved. We are now doing this Midwives Service Scheme, which has even gotten an international award.

India has been polio free for a year. Nigeria is getting close but for a handful of states. By analogy, say, nine-tenths of the work is done. Isn't there a risk of complacence with just the final one-tenth?

Complacency, yes. We recorded very huge success in 2010 and the whole world celebrated us, and in 2011 we had some challenges. We were a bit complacent and went down a bit, but now we are coming up. The good thing is that at the highest level, Mr President has made an unequivocal pronouncement to the whole world and demonstrated that with commitment and action.

He has improved resource mobilisation toward polio eradication, and has constituted a presidential task force. This is leadership by example. Mr President sleeps with polio; Mr President wants polio to be eradicated. And good enough through the structure of the Nigerian Governors Forum, headed by the governor of Rivers state, Mr President, the health ministers and the agency are really working very closely with the governors at the second layer.

http://allafrica.com/stories/201203200654.html

Nigeria: Local Scientists Develop Vitamin Enriched Cassava

By Chioma Obinna

Nigerian scientists at the National Roots Crops Research Institute, NCRI, in collaboration with the International Institute of Tropical Agriculture, IITA, have developed and released the first ever African set of pro-vitamin A-enriched yellow cassava as part of strategies to curb the prevalence of malnutrition in the country.

The three varieties which include UMUCASS 36, UMUCASS 37 and 38 will provide more vitamin A in the diets of more than 70 million Nigerians who eat the root crop every day.

Launching the varieties at the NCRI, Umudike, Abia State weekend, the Minister of Agriculture, Dr. Akinwumi Adesina, in his paper entitled; "Pro Vitamin A Cassava: A Revolution for Nutrition and Health in Nigeria" explained that the successes achieved in Nigeria with the control of the cassava mealy bug and cassava mosaic virus came from improved application of science, especially plant genetics and integrated pest management practices.

Describing it as a giant stride in the pursuit of better nutrition for vulnerable Nigerian groups, Adesina noted the success was part of the drive to transform agriculture through the Federal government Agricultural Transformation Action Plan, ATA, to ensure additional 20 million metric tonnes of food to the domestic supply and to focus on agriculture as a business.

"Cassava is one of the major crops under this Transformation Agenda. Our focus is to create new markets for cassava: these include high quality cassava flour, to be used in replacing some of the wheat flour being imported to produce bread, high fructose cassava syrup to replace the 200,000 metric tonnes of sugar currently being used in the juice manufacturing industry, dried cassava chips, and the production of ethanol. Our goal is to add an additional 17 million metric tonnes of cassava to our domestic food supply.

Maintaining that producing more food is not enough, he stressed the need to ensure that there are enhanced food nutrition and health.

His words: "UNICEF reports show that 43 per cent of under-five children in Nigeria are stunted. This is high when compared to 39 per cent for all developing countries; 26 per cent in Ghana; 25 per cent in Benin; 29 per cent in Botswana, Burkina Faso and Cameroon; and 33 per cent in Kenya.

Nigeria's ranks 158th out of 182 countries in the Human Development Index (HDI), with life expectancy of 48 years; risk of maternal death of 1 in 18; and under_five mortality rate of 186 per 1,000 live births. Nigeria's stunting prevalence puts it as the 32nd highest out of 136 countries.

"Nigeria has the third highest absolute number of children, who are stunted, with 41 per cent of children under the age of five stunted, 23 per cent underweight, and 14 per cent wasted. Moreover, 14 per cent of infants are born with a low birth weight.

Adesina stressed the need to accelerate efforts and policy measures on improving health and nutrition of vulnerable groups, especially women, infants and children.

"Scaling up core micronutrients interventions would cost less than US$188 million per year. This can be achieved through nutritional supplementation, diversity of diets and bio-fortification. Although the overall prevalence of stunting and underweight has been decreasing over the past two decades, progress in Nigeria may not be sufficient to meet MDG's goal of halving 1990 rates of child underweight by 2015."

He noted that annually, Nigeria loses over US$1.5 billion in GDP to vitamin and mineral deficiencies as many staple foods are low in essential micronutrients, hence the need for home fortification.

He said bio-fortification provides one of the best ways to achieve improvements in nutrition and explained that out of over 20 varieties earlier identified, more intense selection and conventional breeding work have brought at least three varieties that compare favourably in pro Vitamin A.

"These Pro Vitamin A or beta carotene varieties of cassava would go a long way in correcting the deficiency of this nutrient in diets, particularly those of the poor and the vulnerable.

http://allafrica.com/stories/201203200846.html

MATERNAL MORTALITY: Experts blame high rate on women illiteracy

Health experts have blamed high rate of illiteracy among women for the increasing maternal mortality in the country.


They made their submissions in Abuja at a three-day workshop to review maternal deaths in the country, organized by the Society of Gynecologist and Obstetrics of Nigeria, SOGON.


One of the guest speakers from the International Federation of Gynecologist and Obstetrics, Prof. Gwyneth Lewis advocates adequate health education for women as recipe for the reduction of maternal deaths in the country.


In a message, the Minister of Health, Prof. Onyebuchi Chukwu, described as unacceptable the high maternal deaths in the country.


The Health Minister, represented by Dr. Bridget Olaogbele said maternal death review had a potential to improve the quality of maternal health care and reduce maternal deaths figures



In an interview with Radio Nigeria, the President SOGON, Dr. Fred Achem said the workshop would proffer solution to many causes of maternal mortality, especially in Nigeria.


Participants at the workshop agreed that most maternal deaths in the country can be avoided if adequate care is provided for pregnant women.

A communiqué is expected at the end of the three-day maternal death review workshop.

http://ww2.radionigeria.gov.ng/frnews-detail.php?ID=4115

UNFPA Nigeria Jobs Vacancies March 2012

UNFPA Nigeria Jobs Vacancies March 2012 INTERNAL/EXTERNAL VACANCY ANNOUNCEMENT The United Nations Population Fund (UNFPA), the leading UN organization in Reproductive Health and Population and Development, is recruiting personnel for the following position: PROGRAMME SPECIALIST – REPRODUCTIVE HEALTH – KADUNAPOST LEVEL: NOC (ICS10) http://recruitment-nigeria.comPOST NUMBER: 00012251DUTY POST: KadunaTYPE OF CONTRACT: Fixed TermDURATION: One Year [...]

For how to apply, go to: http://recruitment-nigeria.com/maternal-health-services

. NIGERIA MAY MISS MDGS DUE TO POOR STATE OF PHC, SAYS HOPE WORLDWIDE

HOPE Worldwide Nigeria has said that the poor state of Nigeria's primary health care (PHC) centres may make her miss the Millennium Development Goals (MDGs) if urgent steps were not taken now.

Chief Executive Officer of the organisation, Clement Ola, at a media briefing in Lagos recently, condemned the low ratio of the numbers of social health workers at PHCs to the Nigerian populations of 0.02 per 100,000 to make meaningful difference in the nation's healthcare drive.

Ola added that because of the poor and inaccessible state of primary healthcare centres in the country, many pregnant women were patronising traditional birth attendants (TBAs) and faith healers, thus increasing the nation's maternal mortality rate (MMR).

Nigeria has the second highest rate of maternal deaths in the world after India. In Nigeria, one out of every 18 pregnant women would die before delivery. This ugly scenario has made the country solely responsible for 10 per cent of global maternal deaths.

He added that because of the presence of TBAs in maternal healthcare, Nigeria's state of Mother-To-Child-Transmission (MTCT) of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) has continued to escalate, making Nigeria only second to India as country with highest rate of MTCT in the world.

He said the nation's healthcare system has made the poor to suffer a 'double jeopardy' in the hands of disillusioned healthcare workers and insensitive government.

According to him, unless communities were involved in providing social amenities, the nation would never get it right in having efficient healthcare and educational systems.

Ola said such realisation made Hope Worldwide to partner with the United States Agency for International Development (USAID)-sponsored Assistance and Care for Children Orphaned and at Risk (ACCORD) four years ago.

He revealed that the project has benefited over 60,000 vulnerable children in areas bothering on psychosocial care, education and health.

ACCORD's main objective is to improve access to quality care for orphaned and vulnerable children (OVC) in Lagos, Osun, Oyo, Ogun, Cross River, Ebonyi and Anambra states and to increase the adoption of safer sexual behaviours by 10,000 adults and youths and 2,000 people living with HIV (PLHIV) in Kogi State.

http://www.thenigerianvoice.com/nvnews/85256/1/nigeria-may-miss-mdgs-due-to-poor-state-of-phc-say.html

Towards reducing maternal deaths in Ondo State

Written by Sade Oguntola

A beautiful piece, this is a must read!!....

IT was a room filled with women and their common denominator was that without appropriate and timely treatment, they were candidates for death because of reasons ranging from excessive bleeding after childbirth and high blood pressure to big babies.

The room, which had about three beds, contained women from different socioeconomic status and age ranges. The women, from Ondo and neighbouring states, were at the Mother and Child Hospital, Akure, Ondo State.

From the corridors running through the wards and treatment centres, were children and women. “This is a busy hospital where we take deliveries of between 27 and 30 babies every day,” stated Mrs Victoria Owolabi, a staff nurse at the hospital, which provides free integrated maternal and childcare service to as many women and children that care to knock on its door.

Ironically, the hospital, instituted by Ondo State government as part of its mandate to offer qualitative and critical interventions towards reducing deaths in mothers and children, is a little over two years.

Mrs Jumoke Ibitoye, a civil servant with her second baby, came from Ekiti State to deliver her baby at the hospital. “This is my second baby. I decided to come to this health facility because it is very good. I had a Caesarian operation on Tuesday because my baby weighed 4.1 kilogrammes, but now I have started to walk around and would be discharged by tomorrow.”

Jokingly, Mrs Ibitoye stated, “I am okay. I have started to walk around and currently waiting for my third meal of the day.”

Mrs Toyin Ojo, a 38-year-old woman with her fourth baby boy, seated and breastfeeding her baby in the ward, recounted her journey to the hospital. She stated that she was brought in by her husband from the state’s General Hospital. “I have paid nothing since I was rushed in by my husband. They treated me promptly, in fact I have really enjoyed favour from God,” Mrs Ojo stated in an emotion-laden voice.

What is more, Mrs Rebecca Aribisala stated that the rumour that nurses and doctors in Mother and Child Hospitals usually expected gratification could not stop her from seeking medical assistance at the hospital.

The hospital serves as a referral centre for pregnant women that community health workers, under the health ranges scheme, pick out to be at a higher risk of dying from complications in pregnancy.

Mrs Aribisala, who declared that a huge medical bill would have been incurred if she had had her baby at another government or a private hospital as she had developed pregnancy induced hypertension.

Like Mrs Ganiya Afolayan, a-20 year old new mother, who was referred from a maternity centre in Igbaraoke to the Mother and Child Hospital, Akure, over 40,000 patients, including 21,000 children, are living witnesses of what interventions like the Abiye safe motherhood programme, which commenced with the administration of Governor Olusegun Mimiko of Ondo State, could do to improve Nigeria’s health indices.

Abiye is the Yoruba translation of safe motherhood. But in the context of Ondo State, it is more. It was borne out of the determination to ensure that when abiye is said to mothers on the way to the labour room, they actually come back alive with their babies.

Governor Olusegun Mimiko (middle), his wife, Kemi, and Commissioner for Health, Dr Dayo Adeyanju, carrying some of the babies delivered at the Mother and Child Hospital.





Globally, more than 1,500 women lose their lives every day from pregnancy to childbirth-related complications.

The four major killers of these women are severe bleeding, infections, hypertensive disorders (such as preeclampsia) and obstructed labour.

Prior to the inception of Dr Olusegun Mimiko as the governor, Ondo State had the worst health indices in South-West of Nigeria with its material mortality rate far above the national average of 545 per 100,000 live births.

“This unacceptable figure of women and children that were dying unnecessarily and the promise of providing exceptional qualitative health care led to the home grown Abiye programme,” said Dr Dayo Adeyanju, Ondo State Health Commissioner.

This was piloted in Ifedire Local Government Area and with amazing results. Dr Adeyanju stated: “Out of the 3,817 pregnant women registered since the commencement of the project, 1,035 babies have been delivered safely. Also, there was an addition of 2,600 new registrations to the initial 1217 pregnant women previously registered and we had recorded only one death. The woman, who only came to deliver under the programme, succumbed to disseminated tuberculosis.”

According to the health commissioner, “we have recovered from a mortality rate that was far above the national figure of 545 per 100,000 live births and by extrapolation to 100 in 100,000 live births.”

Conversely, “Before the Abiye programme, out of 240 deliveries, 160 were delivered by traditional birth attendants. Now post-Abiye, we have had over 5,000 antenatal registrations and have delivered over 2000 of them and only 40 were carried out by traditional birth attendants.”

How did the programme succeed in restoring confidence to women and making them patronise government hospitals to access skilled deliveries? According to Dr Adeyanju, through the use of mobile phones and motorcycles, the health rangers, a group of community health extension workers who were assigned to the programme in each community establishes interact well with pregnant women.

“We track the women through the health rangers to ensure that they come back to the health facilities and by this ensure that their deliveries are done by skilled birth attendants. Childbirth is a critical moment in pregnancy.

What is the role of health rangers in ensuring safe delivery?

Dr Adeyanju stated, “there are 25 pregnant women assigned to an health ranger. Even if they check on a pregnant woman a day, the health ranger would be able to go round before the end of the month. Their work includes emphasizing on good nutrition in pregnancy; use of insecticide treated nets; immunization, focused antenatal care and family planning.”

The health rangers also help the women to develop a birth plan as well as do what is referred to as complication readiness plan. Women who are at increased risk of complications of pregnancy include those with short stature, small pelvis and big babies.

Basically, women in labour use their phones to call for assistance at the health centre where midwives could easily attend to them. When the case is beyond that of a midwife, such a pregnant woman is then referred to the comprehensive health centre, where they are attended to by the doctor.

What is more, ensuring that pregnant women receive appropriate backing by their relatives to seek skilled birth deliveries has been further made easier, especially with the 2011 legislation that stipulated a penalty for cases of deaths of women that were not reported to the government.

The legislation on confidential enquiry into maternal deaths while making it mandatory that all deaths in women should be reported, is not for any punitive purpose. Nonetheless the failure of patient’s relatives to report attracts a N100,000 fine or a jail term of six months.

“The implications of the legislation, is that when they know that there would be enquiry into the cause of the death, then they will not take a pregnant woman into the place of a traditional birth attendant and allow such a woman die,” stated Dr Adeyanju.

Conversely, the legislation again is now making traditional birth attendants to bring pregnant women that they know they cannot handle to the health facilities because they do not want any enquiry linking them to the death of any pregnant woman.

Meanwhile, as the Abiye programme is being scaled up to cater for at least 10,000 pregnant women in the other 17 local government areas in the state, Dr Adeyanju stated that now health rangers had been provided with mobile ambulance tricycles to further address the areas of delay to safe motherhood.

Already the registration of pregnant women has commenced as part of the scaling up of the Abiye programme.

According to the health commissioner, based on the last statistics, 30, 000 women would be pregnant at every point in time and that is why our target is to look at an average of 10,000.

Dr Adeyanju stated that the opportunity that the phone gives the women to healthcare providers, their co-pregnant women and even the policy makers, inclusive of the commissioners, wife of the governor as well as Ondo state governor had been a great incentive, bringing both the educated and uneducated to want to register and partake of the free health comprehensive care to reduce the hitherto high maternal and child death ratios in the state to possibly zero.

He added, “Even after delivery, the women, with the help of these prepaid user groups and with unlimited access to phones can still call for advice if their children fall sick. If it is a critical case, the health ranger will be there to pick up such a child in the tricycle ambulance. Many of the health rangers are women and driving the tricycle ambulance would further enhance their work.”

The 100 tricycle ambulances can easily move from the remote parts of the community to health facilities where a four wheel-ambulance can pick such a patient up for transfer to the appropriate hospital to access health care.

With the scaling up of the Abiye programme, he stated that Ondo State, by 2015, would attain all the Millennium Development Goals (MDGs) of reducing deaths in mothers and children below five years of age.

“We succeeded in reducing maternal mortality by 15 per cent in 2010 and by extrapolation would have attained 75 per cent reduction by 2015.”

In addition the Mother and Child Hospital, a referral centre, designed to handle emergencies, has been filling the vacuum of the absence of referral centre for “at risk” patients in the state.

The hospital, currently being replicated in Owo, and meant to treat referred pregnant women and children below five years free, irrespective of the severity of their health problem, social status and residency, has been witnessing an influx of patients.

The pioneer Chief Medical Director, Mother and Child Hospital, Oke-Aro Akure, Dr Lawal Olawale Oyeneyin, stated that the 100-bed hospital, which has being in operation for over two years was indeed addressing the gap in tertiary healthcare services.

“We serve as a model that apart from giving that quality care, we must be able to attract people back to the public health service. To a large extent, the public has been disenchanted with public health services. And you can see for yourself the crowd coming in here.

“In terms of our impact, we registered and treated almost 40,000 patients, including over 21,000 children and almost 19,000 women in a spate of two years. Also, we have safely delivered almost 10,000 babies, out of which almost 1,700 were by Caesarian operation, all 100 per cent free of charge.

“We discovered that at least 20 per cent of the clients that come in here, actually reside outside Ondo State, including Ekiti, Kogi, Osun and Edo states,” Dr Oyeneyin said. “They are attracted to this facility, not only because we offer 100 per cent free services, regardless of where they come from, but because they are sure of quality care.”

Dr Oyeneyin, who remarked that the mother and child hospital was able to cater for more mothers and children because it instituted clinical guidelines and protocols for treating common life threatening ailments, invested in its personnel, adopted task shifting and task sharing concepts as well as a unique drug procurement system that prevented out-of stock drug syndrome.

He stated, “Our unique drug procurement system has practically eradicated the out-of-stock drug syndrome of essential drugs that are pertinent to saving lives in particular of mothers and children. In fact, this had attracted lots of encomiums in this facility.”

Dr Oyeneyin, who remarked the accumulative effects of the scaled up Abiye programme and the completion of another Mother and Child Hospital at Owo town would be tremendous, stated that indeed, all that was being experienced and done to ensure pregnancy was no more a death sentence but “is a service to humanity.”

Obviously, Abiye and its constituent-the Mother and Child Hospital have distinctly proved to be a dire need of our society if we must drastically reduce death rates in mothers and children as well as save the nation from the resultant anguish and losses.

The overall effect of all these will culminate in longevity and a quantum leap in the socio-economic life of the people bearing in mind that women remain the driving force of any economy.


http://tribune.com.ng/index.php/features/37639-towards-reducing-maternal-deaths-in-ondo-state