Nigeria will save $1.5 billion yearly by investing in maternal health – UNFPA

The United Nations Population Fund, UNFPA, on Wednesday said Nigeria would be saving $1.5 billion annually by investing in maternal health.

The Deputy Representative of UNFPA, Eugene Kongnyuy, made the disclosure in Lagos at the Unveiling of the Regional Ambassador for Maternal Health in West and Central Africa Region organised by the fund.

The News Agency of Nigeria reports that renowned Nollywood Actress, Stephanie Linus-Okereke, was unveiled as the Regional Ambassador for Maternal Health in West and Central Africa Region by the Minister of Health, Isaac Adewole.

Mr. Kongnyuy said, “In Nigeria, the country will be saving 1.5 billion dollars yearly by investing in maternal health.

“Investing in maternal health is a smart investment; if you put one dollar in maternal health, it will yield 120 dollars.

“So, it is where the government should put its money, because it is yielding high returns.

“Globally, if you think of maternal health and translate it, the number of women dying, because when a woman dies, the baby is also likely to die.

“When you sum up all that globally, it leads to productivity loss of $15 billion every year of these women dying.’’

The representative said that the costs of not taking action now on maternal health would mean that poverty eradication efforts would be undermined.

According to him, economic growth will slow down, inequalities sustained and countries will miss out on a vast source of human capital needed to take sustainable development forward in the 21st century.

“While this is the role of the government, the mandate of UNFPA, and an area of interest of many organisations, the role of the community and individual champions cannot be underestimated.

“In particular, we need high profile public advocates for maternal health and the rights of young people to reach their full potential in Africa,” he said.

Mr. Kongnyuy said that more than 55 per cent of pregnant women still gave birth without any assistance from a skilled health worker.

He said that only 12 per cent of pregnant women who needed emergency obstetric care services received them.

“This means lots of women and adolescent girls are still at risk of dying from pregnancy-related conditions.

“Some progress has been made, but a lot still needs to be done.

“There is need to raise awareness on these development issues, engage communities and advocate for women and girls at the policy and decision making levels,” he said.

In his remarks, Omolaso Omotosehin, a Reproductive Health specialist with UNFPA, said, “Today, we celebrate the merging of two worlds – entertainment and development aid.

According to him, we leverage on both platforms to raise awareness on the issues that affect women and girls.

“We cannot underestimate the roles celebrities play in development or humanitarian aid.

“Celebrities are crucial in raising discussions on unpopular issues like child marriage, HIV Awareness, condom use, access to family planning and so on.

“They are significant partners in reaching many of the people that can foster change.

“In the real sense, we are all ambassadors, because we stimulate sensitive conversations and ask pertinent questions that serve as the bedrock for the change we want,” Mr. Omotosehin said.

 

Source: NAN

How Birth Attendants Cut Umbilical Cords With Broken Bottles – By Abang Mercy

In a world filled with absurdities, this news report compiled by Freelance Journalist Abang Mercy is about maternal health. Read the compelling true life story that bothers around the challenges indigenes residing in a riverine community of Ondo State face in terms of affordable healthcare especially, maternal health;
After losing her fourth child during delivery at the house of her regular traditional birth attendant (TBA), 42 year–old Kemi Ariyo contracted spiritualists to get to the root of her problems. “I was widely accused to be a witch as a result of the demise of my babies,” Kemi said. “So I approached the spiritualists who pray for pregnant women and see to the delivery of their babies”.
The delivery of the fourth happened in a thatched roof house with three spiritualists around her in her native Ode Ugbo, a riverine community of Ondo State. But in spite of their weekly prayers and their presence during the delivery,  the baby was lost to still birth.
Ariyo’s case may be extreme but generally indicative of the problems that women in rural Nigeria face. Almost on a daily basis, women in her situation consult spiritualists who charge between 15000 naira and 25000 ($48 -$79 ) per delivery – who claim to be praying and fasting and would consistently administer local herbal concoctions (Agbo) to these women between the period of pregnancy and delivery.
According to the National Demographic Health Survey, 2008, Ondo state had a maternal mortality ratio of 742 per 100,000 live births with worse indices at the facility level. Nigeria records one of the world’s highest rates of maternal deaths, with the country being the largest contributor of maternal deaths globally and second largest of under – five deaths with India being the first.
Most families especially those in rural communities – characteristically uneducated and economically disadvantaged – are at the mercies of spiritualists, and unskilled traditional birth attendants that they consult to deliver their babies. “We trust the outcome will be divine, we never trusted government hospitals” explains 60 year- old Taye Idowu in Yoruba.
One day however, Madam Taye, a former traditional birth attendant now maternal health evangelist approached Mrs Ariyo and appealed to her to stop patronizing spiritualists, “I told her that the unskilled birth attendants are the reasons she has been childless” she said.
Taye is part of a corp of maternal health evangelists, mostly reformed traditional birth healers under the Ondo state government’s ‘Agbebiye’ programme – an incentive based referral programme. The TBAs are encouraged to refer their ‘patients’ to the orthodox clinics and earn money. She and others in the 18 local governments of Ondo State are part of the Agbebiye Initiative – a community – based approach and a primary health care model aimed to further improve community ownership to reduce maternal health to zero.
When questioned how she succeeded in persuading the health care providers to stop tending to Ariyo, she explains that she simply reiterated the birth techniques and the dangers she was now aware of. “We were all together in the same community, and I was part of the trade – we use broken bottles to cut the umbilical cord immediately the women deliver their babies, some get home and die from infection. We did not know it was bad.”
I paid a visit to a Comprehensive Health facility Centre in Oba’ile – Ondo South where a 34 year- old trader, Aderoju Fumilayo strapped her new-born baby who was obviously dazed with the heat and noise to her back. As she waited within the premises while women gathered for antenatal care to be attended to, she narrated her experience birthing three of her four kids. She compared those births by the traditional birth attendants to what is obtainable at the health Centre.
“I was normally asked to give them kerosene, Omo, Dettol, Detergent, and 10,000 naira as payment and conduct my babies naming ceremony there before they deliver my babies – I lie on a bench (typically made of wood) sometimes on the bare floor to deliver my babies”, she said.
Standing beside Funmilayo at the health Centre is a 65 – year –old, Olayiwola Fagoroyo, observing as a middle age nurse attends to Funmi. I am told she’s an “Agbabiye Vanguard” – she moves around with the women she refers to this health Centre’ making sure they go for antenatal, deliver the babies at the referred health Centre’s, and ensure the children are properly immunized to prevent mortality.
Dr. Dayo Adeyanju, the state Health Commissioner explained that ‘Abiye’ (safe motherhood program is a prelude to “Agbebiye” a word in Yoruba that means “Safe Birth Attendant” which could also mean “Safe Pregnancy Delivery”, and conducted in partnership with Traditional Birth Attendants (TBAs).
“The Programme strives to ensure Universal Health Coverage for comprehensive sexual, reproductive, maternal and newborn health care” he said. “The traditional birth attendants refer their clients to the health facilities for a cash reward and training on vocational skills acquisition (soap making, hat and bead making, catering services and tie and dye making”.
For the commissioner, the incentive provided by government was the major driver in a country like Nigeria that ranks amongst the 10 worst countries in sub-Saharan Africa to birth a child – according to Save the Children Mothers’ index.
But for Madam Kikelomo, a former traditional midwife now registered with government in downtown Akure, “we’ve seen that traditional birth attendant methods are harmful to our women which is why we had to enroll in the “Agbebiye program” – reducing the number of women and children dying during child birth”.
With two dedicated Mother and Child Hospitals, the Ondo State Government has been able to reduce Maternal Mortality Ratio (MMR) by 84.9 per cent. From 745 per 1000,000 live births in 2009 the indices have drastically reduced to 112 per 100,000 live births in 2016 – a feat which made the state a recipient of a 400 million dollars grant from the World Bank.
“The women are treated free, from natural births and those that undergo caesarian operation, it is also done at no cost – that has helped us to scale – up the numbers”, the Chief Medical Director, Dr Adesina Akintan of the Referral centre (mother and child hospital) Oke’ Aro in Akure tells me. “Our objective is to make sure no woman dies during pregnancy or trying to birth a child”.
Another expectant mother, Mrs Oluwakemi Fagbe at the referral centre in Oba’ile, within Akure Municipality, tells me, “- They have specialists in this place and that is why I am here, Pregnant women from neighbouring states also visit this place to deliver because it is free, they even provide free blood donation for our children from age zero to 5 years.”
Outgoing governor Olusegun Mimiko of Ondo, a medical doctor, boasts of meeting the United Nations Millennium Development Goals (MDGs) targets “between 2010 and 2016, we were able to crash maternal mortality by over 75% since we came on board and of course that can be linked to the Abiye and Agbebiye scheme we introduced”.
“We created an incentive scheme, with every referral by the Traditional birth attendants to access healthcare by expectant women, they are given a coupon, which is N2000 each per referral – with that method, they convinced most of their clients to orthodox hospitals for proper care” said the governor.
For Mrs Ariyo and Mrs Fagbe the knowledge gained by attending antenatal will be passed on to their children as they were all birthed at home through the risky and life threatening traditional birth attendants methods.
A state government document explaining the concept of Agbebiye initiative claims that among those referred by traditional birth attendants, there was no single maternal death with 99% neonatal survival – and facility utilisation increased by 20.4% in the primary health care facilities and there was a reduction in the facility utilization of the apex tertiary hospital.
Whether the Abiye programme can be sustained, as fiscal allocations to states continue to decline is a question that time will answer.

 

Mercy Abang is a Freelance Journalist – Media Fixer with Sunday Times of London, BBC, Aljazeera and a former Stringer with the Associated Press – She tweets at @abangmercy.

@Lanre_Olagunju: A Tweet Might Just Save a Newborn’s Life

From all indications the Social Media has definitely come to stay. New media as it is fondly called is not just changing the way we live daily, many of its advantages and success stories live with us today. Social Media is not just changing how we buy and sell, it is redefining the concept of market. Social Media is gradually influencing election processes, and more importantly how elections will be conducted in few years’ time.

In terms of a reaching the world with a message in the shortest time possible, the word “impossible” has totally lost its essence in this regard. Gone are the days when you would have to wait till daybreak or evening to get updates on National Newspapers. We now live in a new era that mocks the jet age and most of what it stood for.

But what we make of the tool – social media-  is practically at the height of our readiness, doggedness and knowledge of what it can provide. Many who prefer to focus on the negatives of social media can remain in the dark as long as they want. There is practically no tool in the world that can’t be used for either good or bad. Is it not the same water wey no get enemy that floods houses, states and communities? Come on! The same fire that purifies gold is what destroys live and property. A rifle or pistol in the hand of a robber or terrorist serves an entirely different purpose in the hand of a police or soldier. That’s how social media is. At the end, a tool is just as good as what you make of it.

The transformative power of social media as it concerns the health sector was well exercised by Nigerians when the people of Bagega in Zamfara State were hit with lead poisoning as a result of wrong mining practices. In January 2013, Nigerians with the hash tag #SaveBagega on Twitter showed that citizens could get the government to act as fast as it should at a particular point in time.

Doctors Without Borders were ready to treat about 1500 children who were affected by lead poisoning; but before the treatment, remediation had to be done so the treatment can be effective. With an intensive and persistent campaign on Twitter and Facebook, young people with the help of social media were able to get the Nigerian government to release funds for remediation, so treatment for 1500 kids in Zamfara could commence. Bagega had been waiting for remediation since 2010 after 400 kids died and thousands were poisoned. Help never came until January 2013 when Nigerians said “enough is enough” not with guns or bullets, just an hashtag. That’s how effective social media can be when we are determined to engage it wisely.

It is surprising to realize that many knowledgeable Nigerians aren’t even aware that Nigeria presently accounts for the second highest number of annual maternal mortality in the world after India. Maternal deaths in Nigeria alone accounts for 14% of maternal mortality globally. India accounts for 17%, though India’s population is more than seven times that of Nigeria.

If we don’t collectively see this as a threat to the wellbeing of women and newborns, then what else would ever bother us as a people? The most frightening part is that we rarely see the deaths of women who die daily as an issue that demands national attention. No, we don’t! We are not concerned enough.

This is probably because we see such deaths as mere statistics. If we were any bothered, maybe we would have forced our politicians to get the right policies and result since that seems to be the language they understand best. Maybe we would have asked them some tough questions that puts a demand on accountability in this regard.

It is easy to point out that during elections, we rarely hear politicians promise to improve on the health of women and children, essentially as it concerns maternal, newborn and child health issues. They would rather promise; to improve power, provide good roads, free WIFI and we watch them say little or absolutely nothing about the shameful reality that of all the women who die globally during pregnancy or childbirth, 14% of them are Nigerian women. We must demand accountability from President Buhari and his team, most especially when he announces the new Minister of Health, regardless of which part of Nigeria he is from.

The World Bank recently approved $500 million dollars to improve maternal and child health in Nigeria, we all have to keep an eye and keep asking questions to ensure accountability. This mustn’t be another case of corruption as usual as this is not the first time funds would be made available by international agencies or donors. Media attention is also crucial to holding policymakers accountable so as to equitably maximize resources allocated for Sexual and Reproductive Health and Rights (SRHR) cum Maternal, Newborn and Child Health (MNCH) projects.

In every sense, we need to take issues that concerns Nigerian women seriously; not just the ones who live in cities who aren’t actually immune to avoidable and treatable pregnancy related complications, but also those helpless ones in villages. Those deaths aren’t even recorded, probably because no one cares. Even in a state like Lagos, I get to hear of cases of deaths that are avoidable, some due to lack of resources on the part of the mother, lack of blood in some hospitals, and the most painful part which is gradually becoming rampant… errors caused by medical experts.

Something has to give. No community, country or continent looks away at the agony of women and newborns yet expect to prosper.

It might be difficult to see how each Nigerian would practically solve this huge challenge; but I challenge all advocates across Africa to demand more from government. That was what saved Bagega. We can possibly save more women and children with the same approach. Many of the maternal mortality cases are preventable, yet these deaths comes with high costs in form of income and productivity loss and a whole lot of other social-economic pains attached to such loss. When a mother dies, the child’s health, education, growth and general wellbeing suffers. In fact, the pain gets to the entire community directly or otherwise.

We can also demand more from health agencies. It is very important that they carry Sexual & Reproductive Health Rights (SRHR) and Maternal, Newborn & Child Health (MNCH) advocates, journalists and social media influencers along with the policies that must be properly addressed in other to shape public awareness and opinion.
A good strategy to motivate, create and sustain interest among journalists and media influencers is to provide them with data, trainings and seminars which would intelligently aid their reportage. National issues only receive attention when they affect a large number of people or when citizens realize that inactions will lead to nationwide setback.

Across the globe, about 1,500 women die on a daily basis as a result of pregnancy and childbirth related complications. 98% of these deaths occur in developing countries. The giant of Africa is responsible for 14%. Yearly, an average of 15 million women who survive pregnancy and childbirth complications develop physical and mental disabilities thereafter. Bloggers, social media experts and all other media experts have an active role to play in ensuring that we reduce the number of women who lose their lives while giving birth across the continent of Africa. Maternal health advocate should be encouraged to extend their advocacy to radio as this media tool remains a vital source to educate and sensitize women on sexual health related issues. Unfortunately, many advocates get discouraged with the exorbitant cost of airtime. Media houses should bear in mind that sometimes we make money, other times we save and preserve lives with money and available resources.

***Lanre Olagunju is an MNCH advocate, blogs for the African Union on the Campaign on Accelerated Reduction of Maternal, Newborn and Child Mortality in Africa. He is @Lanre_Olagunju on Twitter.

Addressing Nutritional Needs for Child Development – @Lanre_Olagunju

Malnutrition in its different forms is the biggest cause of under-5 mortality in Africa, it accounts for almost half of all child deaths. Around the world a total of 162 million children under five years are stunted and approximately 52 million children suffer from wasting – a debilitating disease caused by extreme low energy intake, resulting in muscle and fat tissue wasting away.

In 2010, while delivering her speech titled “Change a Life Change the Future”, Hilary Clinton emphasized that improved nutrition during the first 24 months of life provides the child with a valuable “1000 day window of opportunity” for lifelong health and development. Nutritionists and scientists agree, and have shown that tackling malnutrition in children requires dedicated action to improve nutrition from pregnancy to 2 years of age. This implies that solving health problems related to a nutritional deficit will also require that pregnant mothers eat nutritious food at the right time and in the right quantity so that children get a good start in life.

The early days of a child’s life represent a key opportunity to ensure that a path to healthy living is guaranteed. Nutrition officer Dr. Abimbola Ajayi, former Deputy Director of Lagos State Ministry of Health on Nutrition and now a gubernatorial candidate running for Lagos, with over 27 years of post doctoral experience in Human Nutrition explained that “child nutrition is fundamental to a child’s wellbeing, far beyond how many development experts look at it.”

She illustrated her thesis saying that “in a third-world country like Nigeria where over 100 million people live far beyond the poverty line, feeding at all is a major issue, let alone expecting the poor to have appropriate nutrition. Malnourished adults can’t but give birth to malnourished children and sadly that’s how poverty strengthens, the cycle continues.”

Malnutrition can have such serious side effects as slowing brain development Dr. Ajayi explained, “after the age of 3 any delay in brain development or any other adverse effect of malnourishment on a child’s mental development becomes irreversible”.

However, there is a safe and nourishing way to ensure healthy development of a child –breastfeeding “Breastfeeding a child until the age of three will ensure that a child’s mental development is perfect, such that the child’s mental capability puts him/her on a level playing ground with any child in the world” says Dr. Ajayi. However, she was quick to identify why breastfeeding hasn’t yielded the phenomenal results in improving child malnutrition that it’s capable of … she asks “how many women feed their kids till age 3 to make ample use of this natural provision?”

Abimbola feels strongly that the Non-Governmental-Organisations can’t do it all, that the responsibility for feeding the populace lies predominantly with the government. She recognizes UNICEF as the main institution working and making major impact in combating child malnutrition but according to Abimbola many of UNICEF’s contributions fail due to lack of continuity, mainly as a result of inadequate backing from the government. The inability of government to put the right personnel forward to head nutrition projects or departments remains a huge challenge. In her opinion it is an error having medical doctors or those in medical professions head nutrition projects, and these decisions ensure that the projects don’t achieve their main goals “put a nutritionist where a nutritionist is needed and not a medical doctor” Abimbola reiterated.

She concluded “it is the main responsibility of the government to cater for its citizen’s nutritional nourishment” because “nutrition plays a major role in national development”. Good nutrition contributes to children’s mental development and, when people fall ill due to a lack of adequate nutrition, the government will inevitably end up spending more money on her citizens in a medical setting.

***This piece was first published on carmma.org but it has been republished with the permission of the author.

Lanre Olagunju is an hydrologist turned freelance journalist. An alumnus of American College of Journalism, he blogs for the African Union  on the Campaign On Accelerated Reduction Of Maternal, Newborn And Child Mortality In Africa. Follow @Lanre_Olagunju on Twitter.

Views expressed above are solely that of the author and not of Omojuwa.com or its associates.