Tackling Nigeria’s high infant-maternal mortality through workable partnerships
Infant and maternal mortality has been a recurring issue in the health sector, probably due to its pivotal place in human existence. As regularly as it gets attention, efforts to tackling the menace have over the years either shown minimal result or not working at all.
Else, how does one rationalise why the developmental goals on health, especially on this issue, as encapsulated in the earlier Millennium Development Goals (MDGs) and later the Sustainable Development Goals (SDGs) were hardly achieved by most countries, particularly the third world nations.
As interesting as the issue might appear, going by the enthusiasm it elicits when the matter is mentioned in quarters, it is, however, shocking to read year in, year out of the alarming rate it assumes every now and then.
Infant mortality, according to Wikipedia, refers to deaths of young children, typically, those less than one year of age. It is measured by the infant mortality rate (IMR), which is the number of deaths of children under one-year of age for 1000 live births.The under-five mortality is also an important statistic, considering that the IMR focuses only on children under one year of age.
Premature birth is the biggest contributor to the IMR. Other leading causes of infant mortality are birth asphyxia, pneumonia, term birth complications such as abnormal presentation of the foetus umbilical cord prolapse, or prolonged labour, neonatal infection, diarrhea, malaria, measles and malnutrition.
One of the most common preventable causes of infant mortality is smoking during pregnancy. Many factors contribute to the menace, such as mother’s level of education, environmental conditions, political and medical infrastructure.
Improving sanitation, access to clean drinking water as well as immunisation against infectious diseases and other public health measures can help reduce high rates of infant mortality.For emphasis, child mortality, which is the death of a child before his or her fifth birthday, measured as the under five child mortality rate (U5MR), has attracted disturbing national statistics over time with some even grouping the two mortality rate together.
Globally, 9.2 million children die yearly before their fifth birthday, more than 60 per cent of these deaths are seen as being avoidable with low-cost measures such as continuous breast feeding, vaccination and improved nutrition.
Infant mortality rate was an indicator used to monitor progress towards the fourth goal of the MDGs for the year 2015. It is, however, now a target in the SDGs for Goal 3- “Ensure healthy lives and promote well being for all at all ages.”
However, IMR fluctuates drastically, and according to Biotechnology and Health Sciences, education and life expectancy in a country are the leading indicator of IMR. This study was conducted across 135 nations over a period of 11 years with Africa having the highest IMR over any other region studied with 68 deaths for 1000 live births.
On the other hand, maternal mortality, according to the World Health Organisation (WHO), is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. Maternal mortality ratio and maternal mortality rate, both abbreviated as MMR. These are two performance indicators sometimes used interchangeably.
By 2017, global maternal mortality rate had reduced 44 per cent since 1990, yet 830 women die daily from pregnancy or childbirth related causes.
According to the United Nations Population Fund (UNFPA) 2017 report, this is equivalent to “about one woman every two minutes and for every woman who dies, 20 or 30 encounter complications with serious or long-lasting consequences. Most of these deaths and injuries are entirely preventable.”
UNFPA estimated that 289,000 women died of pregnancy or childbirth related causes in 2013. These causes range from severe bleeding to obstructed labour, all of which have highly effective interventionist measures.However, global MMR fell from 380 deaths per 100,000 live births in 1990 to 210 deaths per 10,000 live births in 2013 and many countries halved their maternal death rates in the last 10 years.
Despite this seeming cherry news, high mortality rates still exist in places, particularly in impoverished communities with over 85 per cent living in Africa and Southern Asia.Amid these mixed feelings, the UNICEF, again this year, alerted to the “alarming high rate” of deaths of newborns globally, especially in the world’s poorest countries.
Its Executive Director, Henrietta Fore, in a statement on her behalf by the Communications Specialist of the Bauchi Field Office of the organisation, Samuel Kaalu, had noted: “Majority of the deaths are preventable. In low-income countries, the average newborn mortality rate is 27 deaths per 1000 births. In high-income countries, that rate is three deaths per 1000. In a Multiple Indicator Cluster Survey (MICS) conducted by the government of Nigeria in 2016/2017, the rate of newborn deaths per 1000 births is 37.”
Fore said Nigeria ranks 11th highest in newborn deaths globally. From the foregoing, all global agencies noted that the factors of infant and maternal mortalities were preventable and sadly too, the incidents are still on the high side.It becomes sadder when Nigeria, in all the studies, has been seen to occupy unenviable positions on the rankings so far highlighted in report despite the supposed huge expenditure in the health sector by successive administrations over the years.
It is against this rather melancholic outlook that the interventions by MTN Foundation (MTNF) to tackle infant-maternal mortality by partnering with governments through its MTNF Yellow Heart initiative becomes a welcome development.Launched in 2016 in Abuja at a well-attended ceremony to salvage the situation through concerted effort by deploying cost-effective measures to tackle the menace in partnership with the Federal Ministry of Health, led by the Minister of Health, Prof. Isaac Adewole and represented by the Permanent Secretary, Clement Uwaifo, MTNF Chairman, Prince Julius Adelusi-Adeluyi, noted: “It is in working collaboratively that we can improve the health and survival rate of women and children in our country. We are truly excited to be a part of this movement. We stand with and applaud the Federal Government and the Ministry of Health, as they champion this project, which will create the much-needed awareness for improving maternal and infant health in our nation.
“ Our long-standing partnership with the government has facilitated the establishment of mammography centres, provision of equipment to maternal wards and primary healthcare centres (PHCs); improved access for primary healthcare through the Y’ello Doctors mobile clinics and the delivery of the much-needed services to expectant and new mothers. We have made a long-term commitment for the health, well-being and survival of our people. “
Earlier, the minister said: “The initiative is set up to address the high maternal and child mortality through targeted intervention, especially among the vulnerable and indigent families across selected locations in Nigeria.“The national launch will be followed by implementation in the selected states of the first phase of the project – Ogun, Oyo, Abia, Cross River, Kaduna and Niger.”
The foundation’s Executive Secretary, Nanny Ugboma, reiterated the telecommunications giant’s commitment to the better health needs of the people within its host communities, adding that the campaign stemmed from “our appreciation of the importance of women and children to our nation’s future.”
The train has since arrived Ogun and Abia states. During the unveiling of the Ogun leg in Abeokuta where the targeted audience reeled out their predicament, MTNF Director, Elder Dennis Okoro, said: “We are very sensitive to challenges within our society, which are why we go to extra miles to make lives of people brighter. It is against this backdrop that the foundation has resolved to improve the state of healthcare, education and economic empowerment.”
The Commissioner for Health, Dr Babatunde Ipaye, represented by the Permanent Secretary, Dr N.O Aigoro, said the partnership came at a time the state was taking serious steps to improve the health sector and ensure service delivery.
At the Abia launch of the programme in Umuahia, the wife of the governor, Mrs. Nkechi Ikpeazu, said the commissioning of the ‘impactful projects’ aligns with the healthcare objective of the current administration in the state.
She said: “In 2017, the Abia government and my office championed and supported a number of activities and initiatives in respect of neonatal resuscitation, maternal, newborn and child health. We are always ready to cooperate and encourage similar interventions.”
The Commissioner for Health, Dr John Akukannah, noted that the initiative would immensely help to improve the health and survival rate of women and children in the state.
His words: “It is noteworthy that we have put emphasis on the development and improvement of primary healthcare, especially with the vulnerable groups in the state. Abia is focusing on enhancing health services. This is very much in line with the Yellow Heart initiative and we call on Abians to take full advantage of this timely intervention.”