Nigeria is 2nd in world maternal mortality —PATHS

Written by Hassan Ibrahim, Kaduna
The National Programme Director of the Partnership for the Transforming Health System (PATHS 2), Mike Egboh, has said that Nigeria is the second country in the world, after India, with the highest maternal mortality rate contributes 10 per cent to the world’s total maternal death.

Speaking at the kick-off of the Emergency Transport Scheme (ETS) for pregnant women in Kaduna State on Monday, Egboh said that statistics had also shown that Nigeria contributed only two per cent to the world population, but had one of the highest child and maternal mortality in the world.

Wife of the Kaduna State governor, Mrs Amina Ibrahim Yakowa, said on the occasion that the kick-off of the scheme in the state was an innovative mechanism for reducing maternal death in the state.

According to her, the scheme was aimed at improving access of pregnant women to emergency obstetric care in the state, especially in the rural communities where women and children found it difficult to access care due to lack of transportation to various health care centres.

The introduction of the scheme, she said, would enable pregnant women in the state to find easy access to health care within and outside their communities, even as the scheme would compliment the efforts of the state government in ensuring that the state achieve the health related Millennium Development Goals (MDGs) through the provision of free maternal and child health care.

Mrs Yakowa, therefore, appealed to drivers who had been trained to take the scheme very seriously so as to ensure its success, promising to personally drive the project to ensure its success.

Egboh explained that PATHS 2, a DFID sponsored programme, was poised to assist in the reduction of maternal mortality in the country and had, therefore, budgeted about 8.5 million pounds (about N2.3 billion) for the reduction of maternal mortality in Kaduna State.

http://tribune.com.ng/index.php/news/37492-nigeria-is-2nd-in-world-maternal-mortality-paths

CHAN tasks legislators to enact laws to engage FBOs in healthcare delivery

By SOLA OGUNDIPE
FEDERAL government has been tasked to enact laws that would specifically define the engagement of Faith Based Organisations in effective healthcare delivery activities in the country.

The National Advocacy Committee, NAC, of the Christian Health Association of Nigeria, CHAN, who made the call in Abuja, also wants government to legislate for the catering of salaries and personal emoluments of Mission Health workers.

Speaking in Abuja during a visit by the NAC to the Senate Health Committee, Chairman of the NAC, Dr. Wale Okediran, said government at the top needed to support budgetary increases in the area of health care service delivery and ensure equitable distribution of health resources such as, infrastructure, drugs and medical supplies, personnel and equipment in the country.

*From left: Chairman, Senate Committee on Health, Dr. Gyang Daylop Dantong; Senator Adegbenga Sefiu Kaka and Senator Chris Ngige during the presentation by the National Advocacy Committee of the CHAN in Abuja.


In a presentation to the Senate Health Committee, Okediran said it had become necessary to have in place a policy that recognises, encourages, supports and regulates the substantial contributions of CHAN and other FBOs to health care delivery, especially in the hard to reach areas of Nigeria.

According to the NAC Chairman, the deplorable condition of the Nigeria health system can largely be attributed to the lack of policies and legislation engaging the Faith based health institutions that provide health care services to 4 out of 10 Nigerians.

“This has resulted to high infant and maternal mortality in the rural communities and disadvantaged urban areas, thereby, threatening the continued existence of these Institutions that work 24 hours without strike, to save the lives of vulnerable and voiceless Nigerians,” he stated.

Noting that 40-70 percent of health care delivery in Nigeria is provided by the private sector, made up mostly of Faith-Based Organisation health facilities, Okediran lamented that Nigeria has no policy or legislation in place that recognises rewards and supports agencies that provide such magnitude of healthcare delivery to Nigerians particularly in the hard to reach communities.

Okediran said allocation of less than 6 percent of annual budget to health instead of the agreed 15 percent as recommended by the World Health Organisation, had created a gap in health services as a result of which there is a heavy burden placed on CHAN Mission Institutions and FBOs who self -finance the provision of health services they deliver.

He lamented that as a result of stiff regulatory standard from professional bodies, there was limitation to the functioning of CHAN as a result of which it was becoming increasingly difficult to meet their overhead costs.

Urging the legislators to abide by the suggestions of the NAC, he argued that “There will be increased political will and commitment to the health care delivery in Nigeria as well as increased public trust in the legislature for making access to quality health care a reality in Nigeria.”

http://www.vanguardngr.com/2012/03/chan-tasks-legislators-to-enact-laws-to-engage-fbos-in-healthcare-delivery/

Kwara Assembly to join crusade for child-spacing

By Adekunle Jimoh

The Kwara State House of Assembly has vowed to join the campaign for safe family planning and child-spacing.

It assured that family planning and child spacing projects would be given budgetary allocation in the next appropriation.

Speaker Razak Atunwa said this while receiving members of the Urban Reproductive Health Initiative (NURHI).

He said government’s intention under the Vision 2020 may not be achievable without due consideration for family planning and child-spacing.

He promised to direct the assembly’s Committee on Finance and Appropriation to liaise with relevant agencies in ensuring the inclusion of the two issues in subsequent budgets.

The speaker noted that statistics on maternal health showed that only one in five pregnancies in Nigeria is unwanted, adding that it is alarming that about 529,000 women die from pregnancy-related cases.

He appealed to members of the NUHRI to go to the rural areas and ensure that the people at the grassroots benefit from the organisation’s programmes.

Earlier, the ex-permanent secretary, Ministry of Health, Dr. Funmilayo Ambali, who represented NUHRI’s chairman during the visit, had decried the high rate of maternal mortality and morbidity in the country and appealed to stakeholders to support the call for sound health for mothers and a well- planned family life.

http://www.thenationonlineng.net/2011/index.php/news/39454-kwara-assembly-to-join-crusade-for-child-spacing.html

NGO Blames Inadequate Child Care For High Infant Mortality Rate

AFRIBABY Initiative, an NGO on baby-care in Nigeria, has attributed the high infant mortality rate in the country to inadequate child health care.

Chief Molade Okoya-Thomas, Chairman of the NGO, said at a press briefing on Saturday in Lagos that babies were less cared for in Nigeria when compared with developed countries.

Okoya-Thomas said that babies were very sensitive and any little infection could cause grave complications later in life.

"For instance, some mothers bathe their babies with well water, full of dirt and mud, and if the baby has a cut and the dirt gets into it, it could become a big health problem," he said.

According to him, parents need to provide adequate care for their babies to ensure their proper growth and development.

Okoya-Thomas said that although government had provided some basic amenities, most Nigerians were not hygienically conscious.

He said that another impediment to proper baby care was that many people had more children than they could cater for.

The NGO chief said that many people erroneously believed that the number of children they had showed their affluence.

"In countries like Japan and China, there are limitations as to how many children you can bear due to the growing population.

“In most countries of today, you do not see them having more than two children per family.

"In Nigeria, we do not have such laws, but people need to understand that having too many children is a burden to the family, the community and the nation at large," he said.

Dr. Oscar Odiboh, Founder and President of the NGO, said that it was a platform to educate members of the public on ways to take care of babies.

He said that the NGO started a nation-wide campaign on better health care for babies six months ago.

Odiboh said the initiative had also stressed the importance of breastfeeding and the need to give six months maternity leave for mothers at the National Assembly.

He said that many mothers did not breastfeed for six months because they had to resume work after three months.

Odiboh said that the NGO had also sent a proposal to the National Assembly to make child bearing once in three years for women to encourage child spacing.

Odiboh said that the NGO hold a three-day baby-care expo on April 3 at the Lagos University Teaching Hospital, Idi-Araba, Lagos.

He said that the theme of the expo is “Six months exclusive breastfeeding versus six months maternity leave: What options”.

The expo will be declared open by the First Lady of Lagos State, Mrs Abimbola Fashola, and the state Commissioner for Health, Dr Jide Idris.

The Special Adviser to the Governor on Health Matters, Dr Yewande Adeshina, is also expected to be in attendance.

http://leadership.ng/nga/articles/18764/2012/03/10/ngo_blames_inadequate_child_care_high_infant_mortality_rate.html

Solar Suitcase Lowers Maternal Mortality (VIDEO)

In 2008, Dr. Laura Stachel went to Northern Nigeria to study ways to lower maternal mortality in state hospitals.

"I found deplorable hospital conditions that impaired obstetric care," Stachel, an ob-gyn, told National Geographic. "Among the challenges were the lack of clean water, equipment and supplies. But most glaring was the lack of reliable electricity."

Without adequate power, Stachel told Fast Company, health workers struggled to provide care. Nighttime deliveries were attended in near darkness, cesarean sections were cancelled or conducted by flashlight, and critically ill patients were sometimes turned away.

Shocked by what she had seen, Stachel returned to Berkeley, Calif., and along with her husband co-founded WE CARE Solar -- an organization dedicated to improving maternal health outcomes in regions without reliable electricity.

Stachel's husband, Hal Aronson, who is a solar educator, immediately set to work designing a stand-alone solar electric system that was easy to deploy, simple to use and effective for medical settings.

The result? The Solar Suitcase, a rugged and portable solar electric kit, complete with solar panels, batteries, medical LED lights, headlamps and a fetal monitor.

More than 350,000 mothers die from pregnancy complications each year. According to the 2011 United Nations Millennium Development Goals report, "the majority of maternal deaths occur during or immediately after childbirth".

The majority of obstetric complications, Stachel told National Geographic, can be treated by skilled health providers. However, a lack of electricity and light means that even if those health providers are available, they often cannot provide the life-saving care that is needed.

Thanks to WE CARE's Solar Suitcases, which are providing reliable electricity to clinics in 17 countries, more than 15,000 mothers a year will be able to obtain emergency care 24 hours a day, saving countless lives.

Who knew a small suitcase could hold so much light?

Watch Stachel at Villanova University as she presents her work in bringing solar power to a maternal health clinic in Northern Nigeria:

http://www.youtube.com/watch?v=TssWElcAkhE&feature=player_embedded

http://www.huffingtonpost.com/2012/03/09/solar-suitcase-lowers-mat_n_1335374.html



http://www.youtube.com/watch?v=UIPGfxg8c_4&feature=player_embedded

YWCA Nigeria Sends Mixed Messages on Abortion to UN

New York, NY (CFAM/LifeNews) — The Young Women’s Christian Association of Nigeria (YWCA) sent mixed messages about their position on abortion when it presented a graphic documentary about “unsafe abortion” at an event held at the Church Center for the United Nations on Monday.

YWCA of Nigeria organized a parallel event titled “Women’s Burden of Unsafe Abortion: Implications for Nigeria’s Development” during the 56th Session of the Commission on the Status of Women (CSW). CSW is a functional commission of the Economic and Social Council of the UN that meets annually to address issues affecting women.

The centerpiece of the event was a 15 minute documentary detailing the consequences of so called “unsafe abortion” on Nigerian women. It uses graphic images to drive the point home. These included pictures of unborn babies that had been aborted, dead mothers, and a picture of the dilated cervix of a woman whose intestine was protruding as a result of a uterine perforation from an induced abortion. The filming was completed in Nigeria only a month ago, and the film will be used by the YWCA to raise awareness about unsafe abortion in Nigeria.

The documentary cited data on maternal mortality collected by the World Health Organization as well as the pro-abortion advocacy group the Center for Reproductive Rights. The YWCA representatives and the video claimed that the burden of “unsafe abortion” fell disproportionately on poor women. A Nigerian barrister, Chukwe Oduogba, who spoke at the event, called for a change in Nigeria’s laws consistent with the U.S. Supreme Court’s understanding of Privacy Rights.

Sussie Metu, the National General Secretary of YWCA of Nigeria told the Friday Fax that her organization does not promote abortion as a human right, and on the contrary is “advocating abstinence and being faithful first and foremost.” She told the Friday Fax that YWCA Nigeria is a Christian grassroots organization “primarily based in churches” that cuts across all age groups and that they were “not going to procure abortions.”

Ms. Metu said the documentary is in line with the global YWCA’s approach to reproductive health and rights, and in tune with the Millennium Development Goals and her organization’s consultative status with the Economic and Social Council of the United Nations.

The message from the YWCA is confusing. It appears they have adopted the maternal mortality mantra of United Nations agencies, like the WHO, that propagate a new doctrine of “unsafe abortion,” but they do not seem to understand the implications of this. For years abortion was called a woman’s right to choose, now it has become the right of women to be free from “unsafe abortion.” There is a false assumption that legal abortions are safe.

Nigeria is the country with the largest Christian population in Africa. Abortion is considered an abomination by most Nigerians, and is only allowed when the life of the mother is at risk. Unsurprisingly, some of those attending Monday’s event asked probing questions and proposed abstinence education and help to mothers as opposed to relaxing abortion restrictions. Whenever anyone mentioned abstinence and morals they were treated to cheering and thunderous applause.

LifeNews.com Note: Stefano Gennarini, J.D., and Susan Yoshihara, Ph.D.write for the Catholic Family and Human Rights Institute. This article originally appeared in the pro-life group’s Friday Fax publication and is used with permission.

http://www.lifenews.com/2012/03/08/ywca-nigeria-sends-mixed-messages-on-abortion-to-un/

Public health financing abysmally low, says CMD

‘Govt spends N4,500 per patient yearly’


The Federal Government spends N4,500 on a patient yearly, a medical practitioner has said.
The Chief Medical Director (CMD), Lagos University Teaching Hospital (LUTH), Idia Araba, Prof Akin Osibogun, made this known at a workshop by the hospital for health reporters in Lagos.

Comparing health financing in the United States to Nigeria’s, he said public expenditure per head on health care in the US is $7,681 while that of Nigeria is below $30. "Nigeria’s Gross Domestic Product (GDP) per head is $1,000 while in the US it is $22,000."

He said the yardsticks for measuring health care are indices of health outcome such as infant rates, death of under-five and maternal deaths.

He said patients should pay for treatment, because health care is expensive, and the government cannot do it alone.

On the saying that prevention is better than cure, he argued: "Preventive medicine should be embraced as curative medicine is expensive and unattainable by the poor especially."

According to him, the quality of health care that people want is capital intensive and the government cannot do it alone. "Whenever you match quality against equity, quality must suffer."

To achieve the best practices, he noted that technology is needed in health care, but "it is quite expensive, as it has to be managed and in some cases replaced."

Osibogun said: "Health is not merely the absence of diseases, but a complete state of physical and mental well-being. This requires a lot of things."

He said whereas private hospitals can charge a fee of N1million to enable to replace the equipment they use, adding that government hospitals can’t charge that high amount and may not be able to replace the items used.

He said technology advances the ability of experts to conduct diagnosis and detect diseases. This, he said, brings to the fore some of the challenges in defining health.

He said health is viewed from five Ds – death, diseases, disability, discomfort and dissatisfaction.

Osibogun said technology must be funded as it had economic implication to it. "An x-ray can perform limited functions, but a CT scan can do more while a Magnetic Resonance Imaging (MRI) can pick more information than the CT scan," he added.

He said further that defining disease is not also easy as economy and technology deployed have roles to play. "For example, on breast cancer some of the lumps can be benign, others may be malignant. You can diagnose with immunograph or biopsy. Technology can help make better diagnosis but it is expensive," he said.


http://www.thenationonlineng.net/2011/index.php/health/38796-public-health-financing-abysmally-low-says-cmd.html

Nigeria, Israel Partner On Emergency Medical Services

By Victoria Ojeme

The Federal Ministry of Health is partnering with the Israeli government towards capacity and structural development of Emergency Medical Service, EMS, in Nigeria.

Towards this end, a delegation of doctors from the University Teaching Hospitals of Abuja, Jos, and Maiduguri, is in Tel Aviv for a 2-week training.

The delegation, headed by Dr. Abdurrarazaq Gbadamosi, Director of Emergency Preparedness, FMOH, is attending the training which ends March 2, 2012, with focus on Emergency Medical Preparedness and Response; Mass Casualty Incident Management; Trauma Care and Disaster Management.

The partnership, facilitated by YBF Nigeria, the training arm of PlusFactor International Ltd, is in line with President Goodluck Jonathan's transformation agenda for the health sector - to reduce maternal, infant, accident, and disaster mortality rate in Nigeria.

Israel is a leader in advance medical infrastructure, paramedical research, and bioengineering and has one of the highest quality healthcare systems in the world.

The delegates will interact and interface with Israeli emergency healthcare institutional framework, and various process, content and policies implementation concerning EMS guidelines and protocolsfor adoption and adaptation in Nigeria utilising the Public Private Partnership model operating in Israeli healthcare and life support industry.

The FMOH through the selected University Teaching Hospitals will initiate emergency healthcare procedures, programmes, and projects for the sustainability of emergency services in Nigeria and its integration into all organisations of healthcare service in the health sector.

http://allafrica.com/stories/201203051004.html

Maternal mortality: Need for women to make their choice

By A’isha Biola Raji

Young Malama Asabe Inuwa, a 16 year old Arabic school instructor who lived in a satellite town in Abuja was forced into marriage with Dan Auta, a 56 year old petty trader. She became pregnant shortly after the marriage. On the day of her delivery a woman was brought to the house to deliver her of the baby of which after losing so much blood, Asabe died without seeing her first child. Apart from having immature uterus, Asabe was attended to by a non qualified mid-wife.
Bunmi was a mother of five children who were born with barely 1 year and 3 months gap in-between them; she gave up the ghost when she went to deliver the 6th baby. Doctor said she died as a result of shortage in haemoglobin level (blood level) which could have been easily solved with iron supplements.
Amaka was a young undergraduate, full of life and expectations; she lost her life after procuring abortion from a quack that could not differentiate her womb from her intestine. Amaka made a choice not to carry the baby to term because she was raped by a gang of armed robbers.
The situations above are referred to as maternal mortality cases where a woman’s death is linked to pregnancy before birth or 42 days after the delivery of that child. There are lots of issues relating to high maternal mortality in Nigeria.
The several roads that link to death of women before or after birth of a baby include: female genital mutilation, otherwise known as female circumcision, unwanted pregnancy resulting in the most dreaded topic ‘abortion’, early marriage, lack or inadequate sex education especially in the use of contraceptives, inadequate health care facilities and above all poverty.
One of the core issues that contribute to increase in pregnancy related deaths is the mostly avoided issue of abortion. What is abortion? Abortion according to Wikipedia “is the intentional termination of a pregnancy after conception. It allows women to put an end to their pregnancies, but involves killing the undeveloped embryo or fetus.” This definition surely makes abortion a controversial issue as it involves “killing the undeveloped embryo”.
In Nigeria, abortion is legal to some extent; it is accepted as legal when it is performed with the intention of saving the mother’s life. This brings us to the question, how do we recognize abortion performed with the intention of saving the mother’s life?
Apart from life saving, a lot of reasons can make a woman, irrespective of her religion seek for abortion, like the case of Amaka above, she made a choice to terminate the unwanted pregnancy but due to some reasons which could range from restrictive abortion laws to lack of health care facility within the range she could afford, having no choice, she decided to patronize a quack with only one thought of doing away with armed robber’s pregnancy.
Against the intention of the law makers, Abortion laws in Nigeria as restrictive as they are, have made unsafe abortion a silent and persistent pandemic, especially as it constitutes11% - 13% maternal mortality rate.
Where abortion is legalized and women are allowed to make their own choice, abortion is the safest procedure, where it is not; women who feel they desperately need to terminate a pregnancy resort to quacks and this lead to death which result in 70,000 maternal deaths and 5 million disabilities per year worldwide.
Unsafe abortion as major contributor to maternal mortality rate in Nigeria leads to about 34,000 deaths of Nigerian women each year. According to a study conducted in 1996, 610,000 abortions take place each year in which 142,000 resulted in complications. With increase in population, 760,000 abortions were recorded by 2006 which means the number of death is likely higher. This also means that, unofficially, one in 10 Nigerian women of child bearing age have had an abortion.
This signifies that, abortion cut across both married and single women with the circumstances of the pregnancy being the decision making factor.
Though government intensifies efforts in curbing the menace of maternal mortality resulting from child birth through the introduction of Midwife Service Scheme (MSS) which is an intervention born out of the goodwill of some well meaning Nigerians and have been paying off as maternal mortality death rate is reducing, but the bigger killer is the abortion which had become inevitable in various houses due to poverty level in the country.
Married women procure abortion because they dare not, due to poverty carry that particular child to term and have it delivered for fear of providing basic needs for that child as in the case of Bunmi who was not educated in the use of contraceptive as a measure of avoiding unwanted pregnancy.
For Nigeria to meet one of its targets of Millennium Developmental Goals (MDGs) there is need to reduce maternal mortality death to the barest minimum.
This can be achieved through sex education which starts invariably in children from birth. The need to advocate more on the use of contraceptives, initiate midwifery scheme in every nook and cranny of the country and also mobilise and sensitise women on the need to access the services by ensuring them it is available and free.
There is need for government to review the abortion law most of which had been there since 18th century and are no longer adequate for present day generation and are not in conformity with the Human Rights Implication of unsafe Abortion.
Since abortion is inevitable due to several factors as poverty, illiteracy, low moral standard resulting in lawlessness. Government should develop a political will of having a second look at these laws. If Nigerian women must procure abortion, there should be provision for cheap and save abortion within the confines of the law based on choice of the woman as the bearer of the brunt.
It is therefore recommended that all international and regional instruments that promote women’s health should be domesticated; harmful traditional practices such as female circumcision should be legislated against, more empowerment programs for women and also gender equality.
The bottom line is that women are dying of unsafe abortion everyday and our law should therefore be reformed to include areas that will proffer solutions.

http://www.peoplesdaily-online.com/news/healthy-living/31455-maternal-mortality-need-for-women-to-make-their-choice

UNICEF tackles Lagos on health disparities

Lagos - UNICEF on Friday told the Lagos State Government to reduce health disparities to facilitate the realisation of its mega city dream.

The UNICEF Regional Director for West and Central Africa, Mr David Gressly, gave the advice in Lagos at the launch of the state’s Health Sector Investment Case Document.

Gressly said that the government would achieve its mega city project easier, if a greater proportion of its population had access to healthcare services.

He said that as the centre of excellence, Lagos should deal with inequity in health and provide access to healthcare services to its residents both in urban and rural areas.

“One estimate suggests there are more than a hundred slum areas in the greater Lagos area. The challenges are obviously immense.

“Lagos can live up to its reputation by demonstrating how to deal with inequity in health. There should be equity in a great city,’’ he said.

He said that the launched document was a guide that should help to reduce health disparities.

“The investment case demonstrated that with an investment of 15 dollars per capita per year, by 2020, Lagos would have reduced child mortality by 50 per cent and maternal mortality would have declined by 30 per cent.

“Importantly also, Lagos would have reduced health disparities by directing investments where they are needed most,’’ he said.

The regional director said that it was important that everybody had access to essential health facilities.

The state’s Governor, Mr Babatunde Fashola, said that the document provided evidence in support of the existence of health disparities in the state.

He said that the document also suggested ways to reduce the disparities.

Fashola said that the government was committed to implementing child survival strategies through immunisation, maternal mortality reduction programmes and prevention and management of HIV/AIDS.

He called on donor-agencies, development partners and the private sector to support the government’s efforts in developing the state’s health sector.

Dr Kenneth Ojo who reviewed the document said that it presented a compelling case for investment in equitable healthcare in the state.

Ojo said that the investment case highlighted the challenges facing healthcare provision in the urban environment but recognised significant progress so far made. (NAN)

http://www.vanguardngr.com/2012/03/unicef-tackles-lagos-on-health-disparities/