Nigeria: Ekiti Council Moves to Curb Maternal Mortality

Ado-Ekiti — Ekiti South-West Local Government Area of Ekiti State has procured a multi-million naira medical equipment to check maternal mortality.
Caretaker chairman of the council, Dr. Azeez Olaniyan, who disclosed this at a news conference yesterday at Ilawe, the headquarters of the council, said the equipment would treat pregnancy related issues and save women the agony of travelling to Osun and Ondo States for scanning and other pregnancy-related issues.
The council boss said some of the equipment, which had been installed at the council's health centre in Ogotun Ekiti, include SR 500D and SR 2 Ultrasound scanning machines and drugs that are vital for safe delivery. Olaniyan, who lamented that some women had lost their lives during labour due to poor medical attention and lack of intermediate medical facilities, said he would work hard to ensure that maternal mortality is reduced to the barest minimum in the council.
Medical Officer of the health centre, Dr Olusola Amodu commended the council chairman for the facilities, adding that the gesture would go a long way in addressing the problem faced by pregnant women in the council.
He appealed to the local government to post more medical personnel to the medical centre to handle the machines for better service delivery and durability.
http://allafrica.com/stories/201107081166.html

Infant, maternal mortality rates

The recent visit to the country by the United Nations (UN) Secretary-General Ban ki-Moon to see for himself the level of government’s intervention as it relates to infant and maternal health, has once again brought to the fore the extent of the country’s commitment to women’s issues in terms of providing the appropriate policy base and requisite investments for achievement of the health targets of the Millennium Development Goals (MDGs).

During the visit, which was to further propagate the "Every Woman, Every Child" global health campaign launched last September during the MDGs Summit at the UN headquarters in New York, USA, Ki-Moon visited the Dutsen Makaranta Primary Health Centre in Bwari and the Maitama District Hospital, all in the Federal Capital Territory (FCT), Abuja.

The two projects are supported by the UN Population Fund (UNFPA), the World Health Organisation (WHO) and the UN Children’s Fund (UNICEF).

Apparently impressed by what he was shown, the UN boss commended the efforts of the President Goodluck Jonathan government towards improving health care in the country, including the passage of the health care bill by the National Assembly.

However, the Global Strategy for Women’s and Children’s Health, spells out what countries need to do to accelerate progress in the area of infant and maternal health, and calls for a bold, coordinated effort, building on what has been achieved so far, locally, nationally, regionally and globally.

It equally calls on all partners to unite and take action through enhanced financing, strengthened policy positions and improved service delivery on women’s and children’s health.

The summary of the commitments include saving 16 million lives by 2015, preventing 33 million unwanted pregnancies, protecting 120 million children from pneumonia and 88 million children from stunting, advancing the control of deadly diseases such as malaria and HIV/AIDS, and ensuring access for women and children to quality facilities and skilled health workers.

The international community mobilised $40 billion for the global initiative, specifically to tackle maternal and infant mortality.

President Jonathan on his part, pledged $500,000 for the next three years as part of the country’s commitment to women’s issues, while receiving in audience the UN boss at the State House, Abuja.

We urge him to ensure that the money is judiciously used for what it is meant, because the issue of infant and maternal mortality in the country is still far from the ideal.

That hundreds of Nigerian women are dying daily in what ordinarily should be a joyful occasion -giving life - at a time most countries of the world are channelling their energies to more technical issues, is to say the least, a big irony, considering the huge natural resources the country is endowed with and the fact that majority of these deaths are preventable.

More than 144 women are said to die daily in the country from pregnancy related complications.

A breakdown of this disturbing picture shows that between 800 and 1,500 women die in every 100,000 live births as pregnancy-induced deaths claim one woman every 10 minutes. Thousands of others experience injuries, infections, diseases or disabilities that can cause lifelong suffering every year.

Ki-Moon’s commendations on efforts of the Jonathan government notwithstanding, WHO and UNICEF statistics rate Nigeria second, only to India in maternal mortality, thus contributing over 10 per cent of the world’s total estimate of maternal deaths.

And for every such deaths, 15 - 20 other women suffer short or long term disabilities, among them obstetric fistulae also known as Vesico Vaginal Fistulae (VVF), ruptured uterus and paralyses.

This is in addition to Nigeria ranking high in infant mortality rate of about 105 to 1,000 live births, and rising under-five mortality rate of about 178 to 1,000 live births.

Most of these deaths and disabilities are avoidable. Where deliveries are overseen by skilled health personnel with access to emergency obstetric care, and where women receive adequate nutrition and basic health-care services, the risk of maternal death is less.

So, a situation where one Nigerian woman dies every 10 minutes of this preventable epidemic is unacceptable and makes nonsense of the MDGs target of reducing the maternal mortality ratio by three quarters before 2015.

Various tiers of government must come to terms with the fact that preventing maternal deaths and disabilities are pressing human rights issues demanding urgent attention in terms of increased resource allocation and political commitment.

Interventions must, indeed, be scaled up so that essential care can be provided throughout pregnancy and childbirth, and also during the post-natal period.

We believe that significant reduction of maternal mortality and other illnesses can easily be achieved, considering that among the factors inhibiting provision of maternal health care in Nigeria are inadequate or lack of implementation of laws and policies, prevalence of systemic corruption, weak infrastructure, ineffective health services and lack of access to skilled health care providers.

Therefore, basic measures such as prevention and treatment of malaria, providing mothers-to-be with adequate nutrition and ante-natal care, training of traditional birth attendants and ensuring that health centres offer emergency obstetric care, would go a long way towards saving the lives of women and their children.

Incorporation of traditional birth attendants into the policies of government will help, since most rural women rely on them for delivery.

Doctors and nurses must be attracted and kept to man primarily health care facilities in the rural areas, where high incidences of these deaths occur. This is in addition to the introduction, by various states, of sustainable and free maternal/child care programmes as well as adult literacy schemes to educate both the women and their husbands on the need for proper child spacing, attendance of ante-natal programmes and immunization of their babies.

Concrete steps must, indeed, be taken to stem the tide of maternal mortality in the country if the contributions of women to the economy are truly central to the wellbeing of the nation.

This is why President Jonathan’s promise to the UN boss on Nigeria’s commitment to achieving the eight MDGs by 2015, must be fulfilled in the interest of all.

http://www.champion.com.ng/displaycontent.asp?pid=9753

Nigeria: Unicef Worry Over High HIV/Aids Infection in Rivers

By:Dennis Naku
Port Harcourt — The United Nations Children's Fund (UNICEF) has expressed its readiness to assist the Rivers State Government with technical inputs to boost the Universal Basic Education programme there.

This is as the international organization expressed worry at the high rate of HIV/AIDS infection in the state, saying a recent sentinel survey reveals that HIV prevalence rate in the state is six per cent, while the national average rate is 4.1 per cent.

UNICEF Country Representative in Nigeria, Mr Charles Nzuki gave the indication on Tuesday during the signing of the 2011 Programme Implementation Agreement (PIA) between Rivers State and UNICEF at Government House, Port Harcourt .

Nzuki therefore appealed to the governor Chibuike Amaechi-led government to expedite action in the eradication of HIV /AIDS infection in the state.

Nzuki, said his organization was committed to providing technical assistance to the state government in its effort to give the children of the state qualitative education, adding that UNICEF came to the conclusion following successes attained by the state in the implementation of the education strategic sector plan.

"UNICEF commends the state for the child friendly schools in the state as a result of the construction of over 373 model primary schools that are equipped with state-of-the-art facilities like libraries, computers etc for training primary school children", he stated.

He however enjoined the state government to put in place mechanism that would ensure that children in "hard to reach communities" of the state access same opportunities that would promote child survival and enhance the potential of the state.

The UNICEF country representative said such effort would boost Nigeria 's effort in meeting the Millennium Development Goals (MDGs) four and five which include reduction of child mortality and improvement of maternal health.

Mr Nzuki also indicated the preparedness of the world body to partner with the state in the area of data generation which, according to him, is strategic to planning and economic development.

Responding, Governor Chibuike Rotimi Amaechi said the State Government would continue to partner with UNICEF even beyond the issues raised.

Amaechi who signed the 2011 Programme Implementation Agreement on behalf of the State Government further reaffirmed that his administration would collaborate with UNICEF in data generation, especially the maternal mortality rate in the state.

On the HIV/AIDS prevalent rate, he explained that government needs to know the impact of the presence of new 100 health care centres in the rural areas, to ascertain if the maternal mortality rate in the state has improved.

The governor assured them of the readiness of the Rivers State Government to release its counterpart funds to ensure speedy implementation of the agreement.

http://allafrica.com/stories/201107060785.html

Nigeria: 900,000 Children Immunised in Benue

By: Peter Duru

More than 900,000 children have been immunised against childhood killer diseases in 22 local government councils of Benue State at the just concluded Sub-National Immunisation and Maternal-New Born Health (MNCH) week organised by UNCEF.

Benue State Director of Public Health, Dr Joseph Kumba disclosed in Makurdi during the exercise, children and mothers obtained free doses of the oral polio vaccines, vitamin A and iron supplements and other drugs.

He informed that no cases of rejection were recorded in the course of the exercise thanks to collaboration between the communities and health workers.

Kumba who regretted that the exercise did not take place in Buruku local government area however assured that steps were being taking to address the situation in a mop up exercise.

Good Health Weekly gathered from immunisation centres visited in Kwande, Vandeikya and Tarka local government areas that the exercised turned out a huge success as parents took advantage of weeklong exercise to have their children immunised against childhood killer diseases.

In Vandeikya, the Local Immunisation Officer LIO, Mr. Justin Ngyah told Vanguard that he got adequate supply of drugs adding that he was satisfied with the turnout and enthusiasm shown by parents although the exercise.
"The turnout was quite impressive and the enthusiasm shown by parents was indeed a morale booster for everyone involved in ensuring the success of this exercise", Ngyah said.

While his Kwande Local government counterpart, Mr. Daniel Hundu noted that the exercise went on smoothly stressing that his ward and field officers ensured the complete coverage of the local council.

Hundu stressed that this year's exercise was a great improvement compared to the previous exercises adding, "Reports from the fields showed that the people have embraced the exercise and that is good news to the quest to ensure that our communities are free from childhood killer diseases".

http://allafrica.com/stories/201107050677.html

HIV/AIDS SCAM: How 7 NGOs took Nigeria for a ride, by ICPC

*Says millions were diverted in to private pockets

By Ikechukwu Nnochiri

According to a latest report by the World Health Organisation, WHO, HIV/AIDs, malaria and tuberculosis are the most significant public health problems in Nigeria today!

Whereas Nigeria was ranked 5th among the 22 high TB-burden countries that collectively bear 80 per cent of the global burden of TB, WHO, in a report it issued early this month, maintained that “the economic cost of malaria, arising from cost of treatment, loss of productivity and earning due to days lost from illness, may be as high as 1.3 per cent of economic growth per annum”, adding that “the disease is a major cause of maternal mortality and poor-child development,” in the country.

Going further with a breakdown on the rampaging scourge of the diseases in Africa, the health body disclosed that “the number of TB cases notified in the country increased from 31,264 in 2002 to 90,307 in 2008, more than 450,000”, noting that “the TB burden in Nigeria is further compounded by the ongoing HIV/AIDS epidemic and the emergence of multi-drug resistant tuberculosis (MDR-TB).

Moreso, it is undisputed that the prevalence rate of HIV/AIDs in the country is so high, warranting pundits to call for a declaration of a state of emergence on the issue.

It is, however, worrisome that despite these creepy facts on the health condition of the country, funds made available by the international community to fight the menace of these dreaded diseases reportedly found their way into illegal private pockets.

This fact came to light week Monday, following an alarm that was raised by the Independent Corrupt Practices and Other Related Offences Commission, ICPC, which said it had concluded plans to probe seven non-governmental organisations, NGOs, over allegations that they diverted millions of dollars earmarked to fight Aids, tuberculosis and malaria in Nigeria.

The anti-graft agency stressed that the probe became imperative sequel to a pronouncement by an international financing institution that invests the world’s money to save lives under the global fund initiative.

ICPC said it was concerned over threat by the international ‘good Samaritans’ to terminate its funding to organisations in Nigeria owing to the massive fraud.

Specifically, it was the Office of the Inspector-General of Global Funds to Nigeria that called the attention of the commission to this alleged fraud.

The donor-body insisted that it discovered the heinous fraud in a recent audit of 15 grants amounting to US$474,519,260, which it said was disbursed between 2003 and 2009, for the purpose of saving lives in the country.

Meantime, ICPC, upon receiving the complaint, vowed to use the said audit report to confirm the veracity of the allegations with a view to bringing all the erring officials of the NGOs to book.

In a statement issued by the Head, Public Enlightenment Department of ICPC, Mr Mike Sowe, in Abuja last week, the agency named the seven organisations fingered in the alleged fraud, and gave a breakdown of how the said monies were allegedly utilized illegally.

The anti-graft body alleged that, “The funds were disbursed to the following beneficiaries in Nigeria; the Yakubu Gowon Centre for International Co-operation, the National Action Committee on HIV/AIDS in Nigeria (NACA), the Society for Family Health (SFH), the National Malaria Control Program (NMCP), the Association for Reproductive and Family Health (ARFH), the Christian Health Association of Nigeria (CHAN) and the CHAN-MEDIPHARM (MEDIPHARM).”

In its breakdown, the commission alleged that “the Yakubu Gowon Centre for International Cooperation illegally transferred funds outside the country amounting to $15.5 million, incurred extra-budgetary expenditures of $5.2m, and had undocumented expenditures amounting to $3m. The unretired expenditures of the centre for the period under review amounted to $1.2m while the management fee not accounted for was $659,000.

“The National Action Committee on HIV/AIDS in Nigeria incurred extra-budgetary expenditures of $71,000 in addition to $679,000 as unretired expenditures; while the Society for Family Health had 861.000 admin charges not accounted for and $68,000 unretired expenditures

“The National Malaria Control Program had $711.000 unretired staff advances and $10,000 underfunded balance of rent grant. The audit report also indicated a lack of transparency in the programme’s procurement management process which resulted in price inflation. The report pointed out that some suppliers could not be located at their given addresses.

“The Association for Reproductive and Family Health could not account for $335,000 listed as admin charges while its unretired expenditures amounted to $168,000.

“The audit report further indicated that the Christian Health Association of Nigeria illegally transferred foreign currency amounting to $11.6m to non-programme-related account abroad and later refunded the money in local currency. The association was also accused of having a weak procurement and logistic management resulting in inflation of prices.

“The report further accused the CHAN MEDIPHARM, of over-charging on distribution of products to the tune of $256,000; with $77,000 as unexpended amount on training.

Consequently, ICPC maintained that in view of the potential damage the audit report poses to the reputation and image of Nigeria, as well as the danger these organisations through their alleged unwholesome practices are subjecting millions of Nigerians suffering from HIV/AIDS, tuberculosis and malaria, that it would use all available legal instruments to bring the culprits to book, adding that it would equally conduct a system study and review to forestall a recurrence of this kind of embarrassment to the country.

Though the innocence of the accused organisations will remain intact pending when the authenticity of the allegations are proved, the onus is, however, on ICPC to match its words with action.

http://www.vanguardngr.com/2011/07/hivaids-aids-scamhow-7-ngos-took-nigeria-for-a-ride-by-icpc/

Medical Experts Harp On Reproductive Health of Women

Submitted by peterakpochafo on Thu, 06/30/2011 - 23:07

Following the persistent alarming maternal mortality rate in Nigeria, a call has gone to government at all levels and other stakeholders to ensure that sexual and reproductive health and rights of women are always placed on the front burner in both policy formulation and implementation.

The call was contained in several papers presented at the inaugural meeting of the Youth Wing of Post Abortion Care Network, PAC-Net, Imo State chapter, held at Trendy’s Hall, Owerri.
Speaking at the occasion, Prof. J.I.B.Adimma, South-East coordinator of PAC-Net, explained that sexual and reproductive health of women is an issue that should concern everybody, not women alone, in view of the far-reaching consequences to the larger society.

The medical expert who frowned at the poor attitude of government and stakeholders towards the issue of women’s reproductive health and rights, pointed out that the problem of ever increasing maternal mortality rate could not be checked if the youths were not made to appreciate the dangers of illicit and unprotected sex, unsafe abortion, sexually transmitted infections, etc.

Adimma who observed that youths were handicapped and vulnerable on sexual/reproductive health issues, said that youths need information about their reproductive system, health and rights in order to live aright.
He stated that PAC-Net was a non-profit, non-governmental organisation in Nigeria concerned with reducing maternal mortality that result from incomplete and unsafe abortions and its associated complications with the view to enhancing women’s reproductive health and rights.

The South-East coordinator of PAC-Net disclosed that the essence of participation in the network is not intended to teach the participants how to do abortion or how it is done, but to expose them to the realities of the need to stay sexually safe always.

PAC-Net, Prof. Adimma noted, is an agency of Ipas which carries out advocacy, training of medical personnel, clinical services and research, adding that the network was established in 1996 by Ipas International.

In her keynote address, Dr Emily A. Nzeribe, Imo State PAC-Net coordinator, disclosed that attention was being focused on youths because more than 111million new cases of curable sexually transmitted infection,sSTIs, and 50 percent of all new HIV infections occur among young people every year.

She added that rates of reported sexual abuse in 19 countries range from 7-34 percent for girls and 3-29 percent for boys, while a young person commits suicide often due to emotional and social problems related to sexual and reproductive health, such as sexual violence and breakdown of relationships.

Dr Nzeribe, who told the young lads to always be vigilant about their sexual heath and rights to avoid abuse, notified them that going to quacks to obtain abortion or contraceptive services was unsafe and dangerous to their lives and future aspirations, urging also them to always seek counseling from experts.
Nigeria’s country director of Ipas, Dr Ejike Oji, in his paper titled, “A t Special Risk; Nigerian Youth” noted that the current restrictive abortion laws of the country contribute to the high maternal mortality rate.
Represented by Chudi Ene, Dr Oji called on all to pay attention to the sexual/reproductive health of women especially the young girls and review of the current abortion law describing it is obsolete.

By Athan Agbakwuru

http://nigerianpilot.com/?q=content/medical-experts-harp-reproductive-health-women

UK Development Minister Announces Support For Nutrition And Family Planning In Nigeria

26 June 2011

The UK’s Department for International Development (DFID) has announced two major new six-year programmes to build on the UK Government’s existing health portfolio in Nigeria.
UK Development Minister Announces Support For Nutrition And Family Planning In Nigeria


Ministerial Announcement:

The UK Government is committed to improving the health of Nigerian women and children. The UK’s Department for International Development (DFID) has announced two major new six-year programmes to build on the UK Government’s existing health portfolio in Nigeria. A programme to prevent malnutrition for six million children in Northern Nigeria. And a family planning programme which will help one million couples each year who wish to delay or space their families.

The UK Secretary of State for International Development, Andrew Mitchell announced today in Abuja two new programmes. A family planning programme will provide couples increased choice and improved access to modern contraceptives. A nutrition programme will provide essential micronutrients, breast-feeding support and treatment for severe malnutrition amongst women and children. These new programmes are part of the UK’s global efforts to stop 10 million children from going hungry and enable 10 million women to use modern family planning.

There is an urgent need for nutrition support and family planning in Nigeria. Nigeria is one of six countries that together account for half of all child deaths from malnutrition worldwide. 10% of all children who die under the age of 5 worldwide are Nigerian. Only 10% of women currently use modern family planning, substantially lower than the average for sub-Saharan Africa. Modern family planning can reduce maternal deaths and provide women with choices to space their children.

The two new programmes are fully aligned with Nigeria’s Development Plans. Nigeria’s National Strategic Health Development Plan (2010) has ambitious targets to increase contraceptive prevalence rates and reduce malnutrition. A recent announcement to remove fees for family planning services in public health facilities illustrates Nigeria’s commitment to women’s health.

DFID will work with the Nigerian government, UNICEF and international NGO partners to deliver the new £50 million nutrition programme through the community and health sector in states most affected by malnutrition. These states are in northern Nigeria. DFID will work with Nigerian government and UNFPA to provide £18 million of family planning products through public health centres nationwide.

The new programmes add to DFID’s existing substantial health portfolio in Nigeria, including health systems strengthening, maternal and child health, Malaria and HIV.

In announcing the new plans, Mr Mitchell said ‘I am pleased to support these two important programmes which will improve the lives and health of Nigerian women and children. This additional UK aid support will add further energy to Nigeria’s efforts to meet the Millennium Development Goals.’

Notes for Editors:

Mr Andrew Mitchell is a Cabinet Minister in the UK Government, as Secretary of State for International Development.

Mr Mitchell is in Nigeria to step up bilateral relations in the aftermath of the recent successful elections and announce new commitments of UK aid to Nigeria. His visit includes calls and visits to UK aid projects.

UK aid is delivered by the Department for International Development (DFID). UK aid to Nigeria will help government improve infrastructure, improve the environment for business, create new jobs and raise the incomes of 600,000 people; it will improve nutrition for 6 million children, give nearly 3 million people access to safer water and sanitation, and provide 800,000 children with education.


DFID Nigeria, British High Commission Abuja
24 June 2011

http://www.fco.gov.uk/en/news/latest-news/?view=PressR&id=621811082

Nigeria: Govt, UNICEF, WHO Plan Better Immunisation Coverage

BY Ben Duru:

Umuahia — Abia State Ministry of Health, UNICEF and the World Bank have marshaled out action plan that will ensure best practices and help in reducing maternal and infant mortality in the area.

According to the consultants of the two international organisations and the Acting Director of Public Health, the on-going Maternal, Newborn Child Health Week in the 17 local government areas has thrown up huge challenges that must be addressed before the next round of the programme.

Some of the areas that require more attention include the birth registration, exclusive breast feeding, hand washing, administering immunisation drugs properly, proper disposal of used items as well as proper documentation among others.

According to Ruth Andrew, UNICEF Consultant in Abia State, the week-long programme is designed to reach children from zero to five years with the overall aim to capture children and their mothers in order to confine child killer diseases to the dustbin of history, adding that from the reports from monitors, efforts must be intensified.

She explained that there is a satisfactory evidence of total coverage of the state, but that such reports that were not in consonance with the best practices will be addressed.

According to her, the state's team will not leave any stone upturned in its efforts to see that all irregularities discovered in the course of the event among the field team are corrected.

In his submission, the World Health Organization consultant in the state, Dr. Sebastian Okwu, said all reports from the field would be thoroughly investigated before any conclusion is made and drew attention to some reports of measles and cholera which were found to be isolated cases.

He urged field officers to liaise constantly with the state's team in order to have firsthand information on the happenings in the communities, stressing that the welfare of mother and child which is the heartbeat of the event is non-negotiable.

Permanent Secretary, Eme Onyekaba, said efforts will be geared in future to ensure that mothers and their children were not kept for too long before receiving attention.

He assured that additional training will be given to the field workers to prevent the lapses observed during the event.

http://allafrica.com/stories/201106300614.html

Multiple birth: Reactions from medical experts

On June 17, 2011 · In Special Report
By Sola Ogundipe

At first, Prof. Oladapo Ashiru, an experienced endocrinologist and joint pioneer of In-vitro Fertilisation (IVF) Research in Nigeria and the entire West African region, couldn’t comprehend the statement.

“Could you please repeat your question,” he remarked. Ashiru, who is the Chief Medical Director, Medical ART Centre, Maryland, Lagos, and also Adjunct Professor at the University of Illinois, Chicago, had just been asked to comment on the case of Precious Donatus, the woman reported to have allegedly given birth to seven babies within the space of 11 months.

Speaking on the telephone from the United Kingdom, Ashiru paused briefly before responding. “There is no way that can happen. The normal human gestational period is nine months, so how can someone give birth normally to several babies serially in just weeks apart? To the best of my knowledge, what you’ve just told me is quite difficult to comprehend,” he noted with finality.

The fertility expert who was evidently puzzled about the claims of the woman probed further. “When did this happen and where? What was the birth weight of the babies? This information is vital; the scenario you’ve described is not normal for humans. Things don’t work out that way. Human babies are not born that way.”

But if Ashiru was taken aback by Precious’ story, another fertility expert, Dr. Abayomi Ajayi of Nordica fertility Centre, Lagos and Asaba, was not impressed. “I don’t believe it. It’s impossible,” he remarked without much ado.

Ajayi, an obstetrician and gynaecologist of several years standing dismissed the alleged incidence with a wave of the hand.

“Where is this woman? Which doctor delivered her the first time? Her story doesn’t ring true, but even if we are assuming she is telling the truth, I need to see her first. If she would subject herself to examination, I wish to see her myself and if possible, examine her to be sure she is telling the truth.”

Probed further as to why he felt Precious could not be telling the truth, the fertility expert stated: “Once a woman has given birth, the uterus is open and must be closed up as soon as possible to guard against infection. For her uterus to remain open for such a long period would have exposed her to high risk of infection.”




Multiple birth: Sweet taste with sour flavour
When a mother gives birth to a large number of babies at one time, the world never ceases to be fascinated. Twins, triplets, quadruplets, quintuplets, sextuplets, septuplets, octuplets, etc; the list appears endless. Multiple births can be multiple blessings as well as multiple problems.

Multiple births could be a bundle of joy one minute, and a bundle of grief the next. For instance, the high cost of raising multiples alone, can bring many families to the brink of financial ruin.

On August 5, 2010, a set of quadruplets was successfully delivered at the Lagos University Teaching Hospital, LUTH, Idi Araba, Lagos.

The babies, three girls and a boy, weighing 1,056g, 1,156 g, 1,006 g and 1,006 g respectively, were born premature at a gestational age of six months and three weeks, to Mrs. Queen Itama. It was her third pregnancy, having had two girls in the first two pregnancies. Amazingly, just a week later, another set of quadruplets were delivered at the same health institution!

By all means, multiple birth is not an uncommon occurrence in the country, particularly in the southwest. From Igboora, the land of Twins in Oyo State, to Ekiti, Ondo and Ebonyi States, the story is the same.

Saturday Vanguard gathered that multiple birth is a type of multiple birth in which the mother gives birth to two or more offspring from the same pregnancy. The occurrence and frequency, however, varies dramatically.

Factors such as maternal age, socio-environmental factors, increase in the use of contraceptives, the race of human population, increase in the spontaneous abortion rate, and seasonal variations are among the factors that could influence multiple birth including twinning (two babies), triplets (three babies) and quadruplets (four babies)
Assuming they are alive, Nigeria’s first known multiple birth babies (sextuplets) would be 103 years old today.

Historical and medical records show that the birth of the first set multiple babies in the country actually dates back over 100 years ago to 1907 when an unnamed 19-year-old woman from the South East region was delivered of six babies in a row after a short labour.

Although it is not known what their male/female sex ratio was or how many of the babies eventually survived, the event, like that of the controversial multiple birth babies, elicited as much drama, and graphic insight as to just how demanding all multiple births can be.

For several decades, multiple birth has been a regular feature in Nigeria. Multiple births refers to the delivery of twins and higher order multiples (eg, triplets, quadruplets, quintuplets, etc). Multiple births occur when multiple foetuses are carried during a pregnancy with the subsequent delivery of multiple births. Specifically, since the late 1970s, the prevalence of multiple births in Nigeria has been increasing.

A combination of factors including the widespread use of assisted reproductive techniques and advancing maternal age at conception is associated with this phenomenon. Records are scarce, but it is believed that a plateau in the prevalence of multiple births is yet to be observed. The Yoruba tribe with a birth rate of 45 twins per 1000 live births, are the world beaters when it comes to twinning.

A recent study at the Obafemi Awolowo University teaching hospital (OAUTH) showed frequency of twin births of around 46.5 per 1000 deliveries and 46.2 per 1000 deliveries was recorded for Ilesa and Ile-Ife respectively. The frequency recorded for Ogbomoso and Ado-Ekiti was 38.5 and 22.1 per 1000 deliveries respectively.

The overall average frequency of 40.2 per 1000 deliveries for the four hospitals ranks among the highest recorded rates of twin births in the world. The maternal age group of 25-29 years had the highest occurrence of twin births, while the lowest was recorded in the 45-49 years age group.

In the world today, there are over 100,000 multiple births occurring each year of which high order births (three and above) constitute less than three per cent. With increasing medical advances, particularly in the areas of infertility and care of pre-term births, the number of multiple births has increased dramatically, and the need for correct care and support as well as information and support to multiple birth families and health professionals, has never been greater.

According to medical experts, multi-foetal pregnancies are high-risk pregnancies, and are complicated by a higher incidence of hypertensive diseases such as anaemia, preterm labour, and several delivery complications such as Ceasarean Section, operative delivery, mal-presentation, cord accidents, etc.

The mean gestational age at delivery is approximately 37 weeks for twins, 33 weeks for triplets and 28 weeks for quadruplets. Divergence from singleton growth curves occurs at approximately 32 weeks’ gestation in twins, 29-30 weeks’ gestation in triplets, and 27 weeks’ gestation in quadruplets.

Multiple birth has devastating physical consequences and complications both for mother and babies. . “Unfortunately, once we get more than triplets, we’re really having a lot of problems with both complicated pregnancies for the mother and certainly complications for the babies,” noted , an infertility specialist at the Lagos University Teaching Hospital, LUTH, Idi-Araba Lagos.

Why are so many women having so many babies all at one time? Part of the reason is that treating infertility has improved tremendously but causes of most of the unassisted cases remain unknown. In a study entitled “Higher-order Multiple Births in Abakaliki, Enugu State, Umeora O.U, AneziOkoro E.A and Egwuatu V.E of the Department of Obstetrics and Gynaecology, Ebonyi State University, reported that higher-order multiple births have implications for perinatal and maternal morbidity and mortality.

Indeed, the incidence of multiple births in the black race as a whole has constituted a poser to scientists for centuries. Among possible explanations put forward is that a form of malnutrition is important.

But there are arguments that the multiple birth rate in a hospital cannot be taken as a true reflection of the incidence of a whole community, but in the absence of registration of births, they are the best figures.In a 1960 report by Knox, Senior House Officer, Gynaecology, Bristol General Hospital, and one-time Medical officer, Queen Elizabeth Hospital, Umuahia, Imo State, and Morley of a detailed survey at a village near Ilesha, Osun State, first time deliveries constituted 12.4 per cent of the total.

The study entitled “Incidence and Aetiology of Multiple Births in Nigeria” concluded that the true incidence of multiple births in the whole community could be 50 percent higher than the hospital rate.

World record
The incidence of multiple births in the Yoruba and Ibo tribes was actually estimated to be about 3.5 times the incidence in England and Wales.

According to Knox and Morley, about the incidence of multiple birth in Nigeria is about 1 in 17 of all maternities, compared to the national average of 1 in 22, unarguably one of the highest rates in the whole world.

The world record for high-order or multiple births, notably twins, belongs to the Yoruba race. For decades, it has been established that the South Western zone of the country perpetually holds the gold medal for the highest number of twin births worldwide. Statistically, Igboora in Oyo State has what is arguably the highest incidence of twin births on the planet, a fact documented far back as the 1960s.

Reasons proffered range from diet to heredity. According to a medical expert, a woman with a family history of twinning has a high possibility of giving birth to twins. Same argument goes for the man. However, trends in assisted conception are another major factor.

Use of ovulation induction agents usually lead to multiple pregnancies. They are drugs used to stimulate ovulation in women who are not naturally ovulating. They help control the menstrual cycle.









http://www.vanguardngr.com/2011/06/multiple-birth-reactions-from-medical-experts/

[Post-election Nigeria] muddling through or economic disaster?

I present a very perfect piece of article...
By Nasir el-Rufai, former minister of Federal Capital Territory and former director of the Bureau of Public Enterprises

Nigeria, a nation of over 150 million people, generated only 2,000 megawatts of electricity this week. Ethnic, religious and political crises have claimed thousands of lives and displaced countless more. Maternal mortality is among the highest in the world. Not a single university in the country appears among the top 5,000 universities in the world. Infrastructure, where it exists is broken and neglected.

Yet, this year, government will spend more to subsidize petrol (about USD 5 billion) than on roads, education, health and power combined. This prioritization is symptomatic of the political economy of today’s Nigeria.
At issue is whether Nigeria remains a “Clique Democracy” or a real, people-driven democracy; whether the current leadership, sworn in again on Sunday has the character, vision and will to defy vested political and business interests to govern decently and grow the economy. Without a major change in the way our country is governed there is reason to fear that what should be Africa’s leading economy, will instead be courting disaster.

President Goodluck Jonathan’s first 18 months at the helm did not bode well. The politics of division has pitted northerners against southerners and Christians against Muslims to the point that obtaining the cohesion and social harmony necessary for economic development will be very difficult.

In the last 4 years, the administration led first by Umaru Yar’Adua, then by Jonathan spent over $200 billion of oil and non-oil revenues, including over $23 billion the previous administration left behind in the Excess Crude Account (ECA) – designed to create savings from revenues above the budgeted price of oil. There is little to show for it. No single major infrastructure investment or policy initiative has been concluded. About a third of that amount was spent under Jonathan’s watch. As Acting President and then President, he ran down the ECA to less than $500 million from the over $6 billion he inherited – sharing out the nation’s savings account to State Governors and traditional rulers to win their support for his presidential bid.

Not content with spending our savings, Jonathan borrowed massively. Nigeria’s domestic and external debts also increased rapidly. According to the Debt Management Office, our domestic debt rose from N2, 051 billion (US $14 billion) in 2007 to N3, 228 billion ($21 billion) by 2010 in the three years Yar’Adua was in charge. Jonathan ramped up domestic borrowing within a year to N4, 869 billion (US $32 billion) – borrowing a massive $11 billion in less than 12 months. Our external debt also increased from $3.719 billion at the end of 2009 to $5.227 billion by March 2011. No one can point to a new power station, seaport, rail line or interstate road completed.

Worse still, oil revenues for the year will not cover the salaries and running cost of the Federal Government according to projections in the 2011 budget. This is in a country where around 30 million people have no jobs. There is little or no investment in physical and human capital, even with very high oil prices the administration has enjoyed. The consequence is militancy in the Niger Delta, extremist violence in the north. Nigeria is now more divided – along religious and ethnic lines – than at any time since the civil war in the 1960s. Internal security must necessarily be the priority.

The administration must also re-establish macroeconomic stability. Sadly, election spending, policy reversals and falling exchange rates have pushed inflationary trends upwards, left the economy unproductive and scuttled domestic and foreign investments in many sectors.

Few countries have road networks as poor as Nigeria’s. The country has no functional railway system; seaports are decrepit and in need of massive investment. And yet there is no sense of urgency in government circles to stimulate activity in these critical sectors – and take advantage of the employment opportunities they create.

Even if Jonathan develops the vision to implement urgently needed developmental strategies, he still has to contend with corruption. Corruption drives up the cost of doing business, derails government policy and is a major disincentive to foreign investment. But does he have the wherewithal to fight it? Does he have the impetus to fight mass poverty on the one hand and vested interests on the other?

His supporters think Jonathan will somehow turn things around. But good governance requires more than good luck. We have to wait patiently and as we always do in Nigeria, pray. While we are praying however, the signs are scary. Because of the nature of his ascent to power, Jonathan is beholden to vested interest groups who helped him on his way and from whose grip he may struggle to fight free.

Even before he was sworn in for his first full term, he indicated that four years would not be enough to achieve much. This implies that he may spend the next four years working for his re-election – with all the consequent squandering of resources that we saw before the elections just gone. In these circumstances simply muddling through may prove to be an achievement.

Nasir el-Rufai is the former minister for the Federal Capital Territories

http://blogs.ft.com/beyond-brics/2011/06/01/post-election-nigeria-muddling-through-or-economic-disaster/