Measures To Check Maternal Mortality

Madam Eunice Ifejika, 75, recalls in anguish the death of her 25-year-old daughter during childbirth about 12 years ago.

“I saw my daughter die as nobody could help the situation because there was no medical expert around. The traditional birth attendant did her best but all to no avail.

“I lost her and the child amidst tears and pains. I hope that one day, Uguta women will have trained midwives and doctors in their hospitals to deliver them of their babies without problems,” she says.

Ifejika, a native of Uguta, near Ashaka in Delta State, is one of several mothers, who lost their children as a result of complications during childbirth.

Today, the old woman’s expectation may not be far-fetched after all, as the Federal Government is already executing the Midwifery Service Scheme (MSS), identified as a sure way to reduce maternal mortality rate in Nigeria.

Health analysts and various international organisations rate Nigeria as one of several nations with a high rate of maternal mortality. They insist that all stakeholders in the health sector needed to be carried along in the new scheme.

In fact, available statistics indicate that Nigeria is second to India in maternal mortality ratio of 1100 per 100,000 live births.

By February, the Federal Government had employed and trained 2,488 midwives in life-saving skills and integrated management of childhood illnesses under the MSS.

Showing concern about Nigeria’s high maternal mortality rate, Ms Agathe Lawson, Resident Representative, United Nations Population Fund (UNFPA), said recently that the country needed to strengthen its efforts on the overall prevention of maternal mortality.

She, therefore, called for proper training of midwives, to ensure effective coverage of all aspects of primary health care.

Dr Muhammed Pate, the Executive Secretary, National Primary Health Care Development Agency (NPHCDA), also recently interacted with principals of selected schools of midwifery, to explore ways of boosting the training of midwives under MSS.

“The scheme became necessary to address the poor maternal and child health schemes and get Nigeria on track toward the attainment of the Millennium Development Goals (MDGs),” Pate said.

He said that the agency would institutionalise functional mentoring mechanisms to ensure that midwives were always active at their duty posts, while their training would be intensified.

Pate described MSS as a home-grown health programme, aimed at enabling mothers, newborn babies and other children to benefit from quality health care.

To boost the scheme, he said, the Federal Government in April  last April began linking 160 primary health care centres and 40 general hospitals across the country with Information Communication Technology (ICT).

“The centres and general hospitals are being connected with ICT to enable voice and data transmissions through internet connectivity being provided by Galaxy Backbone Plc,” he said.

Pate stressed that “pregnancy and childbirth should be things of joy to the citizens and not a matter of life and death for women.

“We will continue to strive to make pregnancy and childbirth safer, while improving maternal survival through functional primary health care system,” he said.

The MSS, according to Pate, is being funded by the MDGs/Diagnosis-related Group, under which 163 general hospitals have been earmarked to serve as referral hospitals, as part of efforts toward enhancing primary health care.

He said that a Ward Development Committee had been formed under the scheme, adding that plans were also underway to initiate health interventions through mobile telephony.

At a recent ceremony where NPHCDA signed a memorandum of understanding with UNFPA, Pate appraised the success of the MSS so far and concluded that it had greatly improved the utilisation of primary health care facilities nationwide.

He said that reports from the agency’s field staff, partners and the secretariat of the Governors’ Forum attested to such improvements.

‘‘In July for example, about 54,000 women attended ante-natal care at the MSS facilities nationwide and the number will continue to rise.

“I was in Kebbi recently; you could find the midwives physically there at the centres and hospitals. They had been there for six months and they are actually delivering services.

“In one local government, about 160 women had accessed the facilities provided, whereas previous records showed only 20 women did so during the corresponding period,” he said.

Under the NPHCDA-UNFPA partnership, it is expected that the UN agency will complement government’s efforts at sourcing inputs.

Lawson gave the assurance that UNFPA would train doctors on extended life-saving skills at referral sites under the collaboration.

The Chief Matron of Bauchi Urban Maternity, Hajiya Laraba Mohammed, is among several health workers who lauded the MSS.

She expressed satisfaction with the increased number of expectant mothers who

attended ante-natal clinic at the Bauchi Urban Maternity Clinic in the Bauchi metropolis, saying that the daily average stood at 600 women.

The figure, she pointed out, sharply contrasted with past record of 300 expectant mothers, attributing the increase to sustained enlightenment campaigns on the importance of ante-natal care for expectant mothers.

“Because of the increase in number of pregnant women, we now run ante-natal clinics on Mondays, Wednesdays and Thursdays on weekly basis,” she added.

Laraba called on men to encourage their wives to attend ante-natal clinics and to ensure that they went to hospital for child delivery, so as “to reduce the high rate of maternal mortality in the state’’

A former Minister for Health, Prof. Babatunde Oshotimehin, conceded that the 2,488 midwives deployed under MSS were not enough, adding, however, that the scheme needed to start from somewhere.

Pate, however, disclosed that the Federal Government recently increased the number of midwives to 4,000, with additional 1,000 community health workers in 1,000 primary health care centres.

Observers say that these measures are quite salutary because they will appreciably reduce the incidence of maternal mortality in the country.

Oshotimehim also applauded the success of the scheme but sought greater support from state governments, saying that midwives should be encouraged to have direct communication with the communities to educate them on the importance of sanitation.

“The MSS is a pioneer programme in the country and if the funds allocated to it are properly used, the aims would be achieved,” he said.

Pate admitted that the tasks ahead were quite enormous but pledged his agency’s readiness to make a difference in maternal and child health care delivery in Nigeria through the scheme and other initiatives.

Health analysts expect that more women will no longer patronise unskilled traditional birth attendants but avail themselves of the services rendered under the MSS, with a view to attaining a significant reduction in maternal mortality in the country.

Ofili writes for NAN.

Franca Ofili