Worry over Maternal, Child Deaths in Nigeria

Nigerian political leaders’ disdain for adequate funding of a healthcare delivery system continues to worry stakeholders involved in family planning, writes Ademola Babalola

The arrival of new born babies, are often greeted with fanfare but where the unexpected happens, the mood in such homes are better imagined than felt. Research says one out of the 13 pregnant women out there dies while giving birth to new born. More worrisome is another that says four women die at child birth per hour, making it more pathetic that 96 of our pregnant women die daily during delivery in Nigeria.

The fact that the infants also suffer similar fate in so many instances cannot be underestimated. For instance, the National Demographic Health Survey (NDHS) of 2013 put the figure of children dying at birth or before they reach age five at 37 in every 1000 live births. The NDHS 2013 estimated its Neonatal Mortality Rate (NMR) as 37 per 1000 live births which constituted about 54 per cent of infant mortality in the country.

Aside all these, lie the unkindest cut of all- the rise in number of abandoned babies left to die at will by unprepared ‘mothers’. Till date, several hundreds of babies, especially ‘day-old’ have been abandoned in obscure places like gutters, dust bins, bush paths, road sides, riverbank, streams, and refuse dumb sites to mention but few. While some ended up in the hands of good Samaritans, others are fed to the animals as garbages.

Several reasons have been adduced for abandoned babies to include; waywardness of the pregnant mothers, lack of source of livelihood, rejection by a supposed father, fear of the parents who may think such pregnant girl may want to drag the family’s name in the mud, diseases or certain medical conditions like down’s syndrome, cerebral palsy, hole in the heart and even HIV related issues among others.

Where some of the above are absent, a number of mothers with their irresponsible husbands opted for outright sales of their children, a development that reached an alarming rate of recent in Nigeria. The earliest time similar occurrence was reported were during ill-fated slave trade many centuries ago and till the famous 1948 episode in Chicago USA when “A mother, Lucille Chalifoux, 24, married to an unemployed man 16 years older, and pregnant with her fifth child in six years at the time put up her four children four sale” to the consternation of many. What appears infamous then is today a thriving business in many parts of the world.

What of the baby factories and so many other nefarious routes through which people of questionable characters denigrate what should be a bundle of joy and future of any nation?
And with Nigeria’s unimpressive ranking on health indicators (NDHS 2013), with newborn Mortality Rate of 37 deaths in 1,000 live births; Infant Mortality of 69 deaths in 1,000 live births; Under five Mortality Rate put at 128 deaths in 1,000 live births; and Maternal Mortality Rate of 576 in 100,000 live births, it behoves on all stakeholders to work assiduously in bailing the country out of these avoidable deaths of our mothers and children. Deaths of mothers and infants are said to be worst than the dreaded HIV/AIDS which our public officials are devoting more of their energies and resources.

It is in tackling this that the Nigerian Urban Reproductive and Health Initiative (NURHI) has continued to champion safe motherhood, as well as safeguarding the health of the nation in the face of leadership failure occasioned by the lack of clear cut blue print and policies geared towards tackling the aforementioned by our policy makers.

NURHI in conjunction with its Media Partners in Nigeria, Development Communications Network (DEVCOMS) had been shouldering the responsibility of removing Nigeria’s name from the log of never do well nations on issues relating to maternal and infant mortality in a way that Family Planning or child spacing can become a social norm.

From 2009 till date in Oyo State for instance, NURHI through its Team Leader, Mrs. Stella Akinso and team of family planning experts and other resource persons have been working relentlessly in areas like advocacy workshops, seminars, media roundtables, partnership and coalition building, targeting decision makers to ignite and inspire them to have passion for the funding and use of family planning methods and commodities, building emotional attachments, strengthening networks, developing consensus messages, and correcting some issues, myths and misconceptions working against the successful implementation of goals and focus of the organisation being funded principally by Bill and Melinda Gates.

Oyo State chapter of NURHI with 15 Local Governments areas of coverage has been combing the nooks and crannies of the state for the eighth year running with the goal to increase the Contraceptive Prevalence Rate at 37.4 per cent by at least 12.5 per cent points before long.

Other areas of its focus are the unmet needs for Family Planning 13.2 per cent. Infant Mortality Rate 69/1,000, maternal Mortality Ratio 262/100,000 live births. NURHI is therefore requesting government officials action in approving the integration of Family Planning or Child Birth spacing into the recently launched State Health Insurance by Governor Abiola Ajimobi.

While also calling for increase and ensure prompt release of budgeted funds for family planning services including capacity building, supportive supervision, monitoring, demand creation, procurement of consumables and other logistics to adequate staffing, and implementation of the State Costed Implementation Plan (CIP) for the programmes, NURHI is also harping on the recruitment of skilled service providers and engagement of legislative arm to approve and pass the Reproductive Health Bill and other enabling laws that would help in effective delivery of family planning.

The weak implementation of family planning programmes at the state and local governments levels, according to NURHI is largely due to inadequate funds as there is no specific budget line for the Child birth spacing. The avoidable deaths of pregnant mothers and their babies, can be averted through the religious implementation of the core initiatives of family planning in such a way that access to standard child spacing can avert high risk pregnancies, reduce morbidity and consequently reduce maternal deaths by above 40 per cent.

“The current implementation of the State Health Insurance Scheme under 5/MDG fund initiative in six LGAs (Atiba, Ibadan North East, Ibadan South East, Iseyin, Ogbomoso North and Saki East) should be expanded to cover the other LGAs of Oyo State through the State Insurance Agency,” NURHI remarked at a recent media roundtable.

Not done with its media Advocacy, just last month, NURHI in the state tops up its activities with the media champions to strengthen reporters’ work on family planning with an advanced module codenamed ‘Spitfire Advocacy Skills Training for Media’.

Anchored by a Kaduna State Team Leader of NURHI, Kabir Abdullahi, the two-day intensive coaching availed reporters the opportunity on how to report family planning from human angle perspective in a way to arouse policy makers’ interest to their responsibility of better funding of the family planning to nib in the bud incidences of mothers and infants deaths and its corresponding related issues like abandonment of babies by unprepared mothers and baby mothers now advancing the population explosion which in the long run would not do the nation any good.

While the Spitfire training lasted, more media champions were either recruited or won over as new strategies were developed to structure communication in a manner targeted at specific audience and policy makers in a way that the goals can ultimately evolve a synergy and consensus where family planning advocacy can achieve far reaching successes to a rather commanding height than its current not too impressive state.

The ongoing NURHI tool is therefore a veritable means of making more of the nation’s policy makers to be more alive to their responsibility by increasing their participatory approach to the funding, budget monitoring, budget tracking and provision and procurement of more commodities because funding and right policies are key to achieving better results in child spacing.

Also, eradicating weak political commitment to invest in family planning and insensitive nature of policy makers to maternal health and child survival to the unmet needs of family planning are issues germane towards realising the aims of NURHI to accomplish the vision of increased Contraceptive Prevalence Rate in Family Planning in its implementation states through a positive shift in family planning norms at the structural, service and community levels.