In most African cultures, when a mother delivers a baby safely without the mother or child having to die, it calls for an elaborate celebration that often goes for days. A few days or weeks after birth in Nigeria, a child’s naming ceremony follows, which is another occasion for a huge celebration, especially among traditional people of the south western region of Nigeria. Why do most cultures in Nigeria celebrate so much when a woman delivers safely?
[Editor’s Note: This post was written by Job Imharobere Eronmhonsele, Head of the Policy Engagement and Communications Division of Nigeria’s Centre for Population and Environmental Development (CPED). It is the third in a blog series on think tanks and gender equality, edited by Shannon Sutton and Natalia Yang.]
Conception to delivery is one of the wonderful miracles of life. Unfortunately, this comes with mixed feelings among family members in Nigeria, especially women of reproductive age. The fear of losing an expectant mother in Nigeria, especially during delivery, is a serious concern. This is clearly hinged on the high rate of maternal, newborn and child mortality ratio recorded in the country over the past years. Maternal and child health statistics remain the most credible proxies for the state of human development worldwide and the rate of women dying during child birth has become worrisome in Nigeria. A UNICEF report indicates that 145 Nigerian women of child bearing age and 2,300 children under-five years of age die every single day, making Nigeria the second largest contributor to the maternal mortality rate in the world. Preventable or treatable infectious diseases such as malaria, pneumonia, diarrhea, measles and HIV/AIDS account for more than 70 per cent of the estimated one million under-five deaths in Nigeria.
These depressing rates illustrate the weak health system and social services available in Nigeria. The big question is: how long should we continue to see our sisters, mothers and children suffer and die from sicknesses, diseases and complications which are preventable, avoidable and treatable? To answer this staggering question, it is good to first of all identify and know which factors are responsible for these deaths across Nigeria.
Service challenges in Nigeria
In 2010, 2013 and 2015, the Centre for Population and Environmental Development (CPED) conducted a number of projects on Maternal, Newborn and Child Health (MNCH) challenges. This included: a survey of MNCH care challenges in 10 states across Nigeria, a research project on ‘Access to Primary Health Care Services in Underserved Rural Communities of Delta state, Nigeria,’ and the implementation of a project on improving MNCH services in Okpe Local Government Area of Delta State.
In all these projects, a thorough investigation into the challenges women face in receiving MNCH services was carried out, especially in rural communities. CPED policy brief series 2010, 2015 and other publications, captured some of these challenges: (1) weak referral systems in health care delivery; (2) high cost of receiving MNCH services in both public and private health care facilities; (3) illegal abortions being done by fake traditional healers/medicine vendors; (4) inadequate knowledge of family planning services; (5) non availability of skilled birth attendants and medical equipment at the facility level, with special reference to Primary Health Care facilities located in rural communities; (6) non availability of Primary Health Care in some rural communities; and (7) the attitudes of health workers including nurses in these facilities towards pregnant women as they receive antenatal care and deliver their babies. This has contributed to women refusing to access MNCH services in rural Primary Health Care facilities, even among those who have the means to pay for and receive services.
For example, in one community in Okpe LGA, Delta state, a female interview respondent said (in Nigeria Pigin):
“I stop to dey go the health centre wey dey this community the day wey snake nearly bite me for the compound. Na so so bush dey the place. Nobody dey clear am. If you reach there self, medicine no dey and the matron go tell you sey make you bring plenty money before e go treat you”. If you say you no get that kind money, she go sey make you go general hospital. Na this one make me no dey go there”.
How will these issues be resolved? Who will do what, to ensure that what can be prevented is prevented, what can be avoided is avoided and what can be cured is well treated and cured, thereby, reducing maternal and child mortality rates in Nigeria?
CPED recognised that if progress is to be made in improving access to, and the quality of, MNCH care services in Nigeria, efforts must be made to tackle the challenge of health care financing, especially at the rural level. In November 2016, CPED brought together policy makers in all the 25 local government areas in Delta state to interrogate, discuss and chart the way for a free and accessible health care service delivery at the rural level, with special reference to MNCH.
Among other things, it was agreed that free maternal and under-five health care services be extended to primary health care facilities in Delta state, in addition to the secondary and tertiary health care levels where such service is already enjoyed. In addition, community health insurance schemes must be implemented to ensure no one is turned away from care because of a lack of funds? This last issue is a key component of CPED’s implementation research project on improving MNCH services in Delta State is the establishment of a community health insurance scheme in ward 17 of Okpe Local Government Area as a pilot project to be replicated in other wards and areas of the state. After consultation and mobilization of participating communities and authorities, many households have embraced the scheme, have registered and have commenced receiving services.
These efforts have contributed to demonstrable improvements in MNCH in the region. There has been over a 50 per cent increase in antenatal registration as well as increased immunization uptake, an increase in the number of women who deliver in the facility, and the uptake of family planning services.
These efforts are positive proof that research can help improve lives. CPED is committed to using the power of research and evidence to improve healthcare for mothers and newborns, and under-fives, and plans to do its utmost to see the health status of women and children in Nigeria improve.
Please note: These are the author’s personal opinions and do not necessarily reflect those of the Think Tank Initiative.