Combating high rate of child and maternal mortality

Mrs Olanike Adebayo of Pipeline Area, Ilorin never knew that her joy over her child Olamide, a six-month-old baby would be short-lived moments after he was diagnosed lately of jaundice as Olamide later died of complications arising from the ailment.

In the same vein, Abdullahi Aruna, a 35-year-old peasant farmer from Pada, a sleepy village in Edu Local Government Area (LGA) of Kwara wept uncontrollably due to the sudden death of both his 27-year-old pregnant wife, Aminat and the foetus after a prolonged child birth labour.

These and many other tragedies are common occurrences in numerous Nigerian settlements where child and maternal mortality are on the increase by the day.

But recently, PharmAccess Foundation and its implementing partner – Hygeia Community Health Care in conjunction with the state government held a workshop in Ilorin the state capital where notable traditional rulers were assembled with a view to sensitising them to overt rise in child and maternal mortality rate in many African countries.

According to the Country Director, PharmAccess, a Dutch Community rural health insurance scheme, Dr Njide Ndili in an interview with The Guardian at the epoch making event, “we are using the acronym ‘SLAB’ Saving Lives at Birth, to sensitize every stakeholders around to the need for safe deliveries in every parts of Nigeria, most especially, Kwara state. Not that the statistics of maternal and child deaths are highest here but we are aiming towards making the state a model for others.

“That is why we have assembled our highly rated traditional rulers to be briefed of the importance of safety for our women and children. We expect them to go back to their domains, spread the news and give out the panacea for a drastic reduction in the number of deaths among these targeted group of the population.”

Conspicuous at the programme were some of first class traditional rulers in the state; Elerin of Erin-Ile, Oba AbdulGaniyu Olusookun; Olosi of Osi Ekiti, Oba Salihu Adasofegbe; and Emir of Shonga, Dr Haliru Yahaya among others.

The traditional rulers in attendance were cleverly chosen across the communities within the Kwara Health Insurance Program. The workshop provided a strategic platform to re-engage and better seek the buy-in of traditional leaders who are community gatekeepers and major stakeholders within the scheme.

Ndili added, “in societies like ours where culture and religion are critical, traditional leaders who have been instrumental to revolutionary changes and political stability at the grassroots should serve as agents of positive behavioural change for health improvement as well. Their influence at the community level should be leveraged upon to reverse these daunting figures of colossal and preventable deaths.

“The objective is to leverage on the traditional structure within the state to drive the needed support for effective community mobilization to achieve good coverage of the target groups with the approaches on the SLAB Programme.”

The SLAB Programme is a flagship program for the USAID and its consortium of donor-partners like – the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and the UK Government.

PharmAccess had been implementing the SLAB project since 2015 to support the improvement of health of women within reproductive age group and children under five, by focusing on improving the accessibility, affordability and quality of maternal and child health care (MNCH).

Emir of Shonga, Dr. Haliru Yahaya delivered a key note address at the event

The project has activity work streams on the demand side and the supply side of health care, including mobilization and education of communities and quality improvement of MNCH.

According to a 2015 report from the World Health Organisation (WHO), approximately 830 women die from preventable causes related to pregnancy and childbirth every day and a high percentage of all maternal deaths occur in developing countries, including Nigeria. And even more specific representation is provided by the United Nations Children’s Emergency Fund, UNICEF, which reports that ‘every single day, Nigeria loses about 2,300 children under five and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.

More alarming is the situation in rural and hard-to-reach areas in Kwara State where access to care is limited, impacting on maternal and child morbidity and mortality. Whereas, findings reveal that high illiteracy rates and strong traditions contribute to poor health-seeking behavior and harmful cultural practices among pregnant and nursing mothers in Nigerian rural communities.

The Ilorin forum therefore explored the possibilities and potentials that abound within the traditional structures to effectively mobilize and influence the communities for improved maternal and child health in Kwara. Over 70 invited guests attended the event including 28 traditional rulers drawn from communities in the state.

Besides, at the event were heads of women groups among other notable and relevant stakeholders. The Kwara State Commissioner for Health Suleiman Atolagbe Alege, his counterpart in the ministry of Local Government and Chieftaincy Affairs, Alhaji Tani Mohammed, the Executive Secretary of Kwara Health Insurance Program – Alhaji AbdulSalam AbdulRazak and officials of the state’s Primary Health Care Development Agency.

Alege, who praised the state government for keeping the project of the Community Health alive, said the government would ensure timely spread of the system across the existing 16 LGAs of the state.

Besides, he said the government having recently upgraded all the general hospitals in the state via supply of state of the arts facilities and employment of more skilled medical personnel, “has shown its readiness to reduce maternal and child mortality rate in the state.”

The chairman of the event, Emir Yahaya, who apart being a major stakeholder on the Kwara Health Insurance Program, and a medical doctor of note, said the available statistics on child and maternal deaths in Nigeria demanded for an urgent rise against the “avoidable carnage.”

The workshop successfully stimulated dialogues and proffered solutions on how to adopt locally appropriate strategies and measures in curbing harmful cultural practices and eliminate barriers that greatly contribute to the alarming maternal and child health indices in Kwara.

According to the Emir, “for every woman who dies, more than 30 others suffer complications and conditions that compromise their health in the long term. Statistics show that over four million newborns die in their first month of life, with 25-45 per cent (depending on their location-rural or urban) dying within the first 24 hours after birth. Meanwhile, three out of five births in African rural communities occur without a skilled healthcare provider.

“One of the most overwhelming misfortunes that have endured throughout history is the death of a woman during pregnancy and labour. This adversity is one that comes with so much disappointment and carries a huge burden of grief and culminates into another menace of orphans and vulnerable children. The menace of maternal deaths is one that is aggressively damaging to numerous households, terminating innocent lives and resulting in alarming unwarranted and preventable deaths.”

The traditional leader while extolling the existing traditional structures and the leadership role of the traditional rulers in mobilising communities and stimulating buy-in at community and household levels; urged his colleagues to convene stakeholders meeting at the community level where the SLAB issue would be discussed, towards bringing together and involving the large groups of market women, faith based groups, artisan, farmers’ unions, youths and other interest groups.

In the same vein, some of the women participants said the forum has opened them up to new vista of opportunities just as it is expected that there would be increase in the number of hospital visits for antenatal care, increase in-facility deliveries, neonatal and postnatal care, and adherence to immunization and other child survival measures for improved maternal and child health care in Kwara State.