HIV/AIDS And Maternal Mortality In Nigeria

The HIV and AIDS scourge has been a major health concern across the world, particularly in the last two decades.

Health experts say that the disease is, perhaps, the most significant health problem ever encountered in human history and their worries stem from the fact that up till now, there is no known cure for HIV infection.

In Nigeria, efforts have been made to tackle the rising menace of HIV and AIDS, while a specific agency – the National Action Committee on AIDS (NACA) – is charged with the responsibility of managing the disease and controlling its spread.

Epidemiologists maintain that by 2009, not less than 3.3 million Nigerians were living with HIV, while the disease has drastically reduced the average life expectancy of the citizens.

Available statistics indicate that in 1991, for instance, average life expectancy was 54 years for women and 53 years for men. By 2009, however, the figures had fallen to 48 years for women and 46 years for men, due to certain factors including the HIV and AIDS scourge.

In an attempt to stem the tide, however, NACA in 2010, launched its comprehensive National Strategic Framework to cover 2010 to 2015, which requires N756 billion to implement.

The framework, among other things, aims to reach about 80 per cent of most at-risk segments of the population with HIV counselling and testing by 2015, while ensuring that 80 per cent of eligible adults and 100 per cent of eligible children are recieving anti-retroviral drugs (ARVs) by 2015.

The programme also aims at improving access to quality health care and support services for at least 50 per cent of people living with the virus by 2015.

But efforts to contain the disease have not been limited to particular agencies alone. For instance, the First Lady, Mrs Patience Jonathan, held a meeting with stakeholders in the health sector on June 13 to discuss ways of managing the HIV and AIDS scourge in the country.

The First Lady held the meeting with governors’ wives, heads of agencies, associations and parastatal agencies dealing with victims of HIV/AIDS and pregnant women at the State House in Abuja.

“The HIV/AIDS pandemic is a global challenge that affects emerging economies such as ours significantly and the impact of the disease is felt more among our womenfolk.

“Without adequate interventions, our women will become widows, children will become orphans and our children will be forced to live under harrowing conditions,’’ she said.

Jonathan, nonetheless, stressed the need to expand the people’s access to quality health care services, while initiating innovative programmes to tackle the menace of HIV and AIDS, as well as other diseases.

“Providing improved access to health care services, ensuring availability of drugs, preventing mother-to-child transmissions, discouraging stigmatisation and undertaking community mobilisation to prevent high-risk behaviour are some of the key interventions we must aggressively pursue if we are to succeed in tackling the scourge of HIV/AIDS,’’ she said.

The First Lady underscored the need to strengthen existing HIV and AIDS management programmes, so as to reduce and eventually eliminate the scourge in the country.

“At the just concluded UN Summit on AIDS in New York, which I attended, the UN Secretary-General, Ban ki-Moon, urged world leaders to do everything in their power to end the AIDS pandemic by the year 2020.

“It is, therefore, important for us to re-double our efforts, so as to meet the 2020 target. I regard you all as my partners in progress, as we step up HIV/AIDS grassroots campaigns and programmes,’’ Jonathan said, while addressing the meeting.

Another area of concern to the First Lady at the gathering was the issue of maternal health, as she minced no words in emphasising the need to promote the health of pregnant women.

“Maternal health is another area that must attract our critical attention because of our belief that no woman should die while giving birth. We should encourage improved services in our maternity clinics through material support, while making surprise visits to such health institutions.

“When you, governors’ wives, visit these hospitals and clinics, please pay attention to the state of their maternity wards and the state of the hospital equipment.

“This way, you will be able to note the state of affairs of these hospitals and clinics, while giving proper advice on the observed conditions to those in charge, especially on areas that require reforms,’’ she said.

On her part, Jonathan said that she would undertake impromptu visits to health institutions in the FCT, pledging to assist indigent women who could not pay for ante-natal care and blood transfusions through her pet project — Women for Change and Development Initiative (W4CDI).

“In this way, I will be able through my NGO, the W4CDI, to liaise with the heads of hospitals and clinics, so as to identify key areas where there is need for service improvement in order to enhance maternal health, while reducing maternal and infant mortality.

“The W4CDI is ready to offer assistance to women and health care providers to ensure that indigent women who cannot register for ante-natal care are provided for. In addition, women, who require but cannot afford blood transfusion services, will be assisted,’’ she said.

The First Lady had a word of advice for medical doctors and nurses, urging them to give excellent service delivery, particularly while providing maternal health care services.

“I appeal to doctors and nurses to exhibit high professional standards and refrain from any malpractice. We don’t want our hospitals to become death traps. The medical professionals should be friendly and sympathetic to women in labour, as the women often exhibit certain behavioural patterns caused by labour pains,’’ she said.

“With our collective efforts, maternal mortality will reduce and people will stop travelling overseas to give birth.  But we cannot run hospitals on charity, so please get in touch with the W4CDI and we will pay for the ante-natal care of poor would-be mothers. That way, we can collectively save lives,’’ she added.

Commenting on the forum, Mr John Idoko, the National Coordinator of NACA, commended the First Lady for her interest in efforts to control HIV and AIDS scourge in the country.

He, however, bemoaned the fact that HIV prevalence in the country’s rural areas was higher than that of urban areas, noting that 58 per cent of those living with the virus in Nigeria were women.

“It’s a good thing that governors’ wives are here because we are going to mount a massive advocacy and awareness campaign in the states because of the higher HIV prevalence in the rural areas.

“Our strategy is hinged on the fact that since 70 per cent of Nigerians live in rural areas, our advocacy should be higher in those areas.

“We have liaised with Dr Muhammad Pate, Executive Director of the National Primary Health Care Development Agency (NPHCDA), and we are touring Primary Health Care Centres across the country to give talks on malaria, tuberculosis, HIV and ante-natal care,’’ Idoko said.

Sharing similar sentiments, Pate said that such talks and advocacy campaigns would go a long way in making the citizens to be more aware of the HIV and AIDS pandemic and how to combat it.

Making reference to similar initiatives, the NPHCDA boss said: “In 2009, we had 51,000 cases of meningitis but in 2010, there were only 6,000 reported cases. This year, we have had less than 900 cases and we had similar reductions in polio cases; so we believe that this will work.

“I must add that midwives serving in primary health care centres should be commended because midwives in remote areas work under strenuous and unfavourable conditions. I, therefore, like to appeal to state governments to pay their wages on time,’’ Pate said.

However, Mr Waziri Dogo-Muhammad, the Executive Secretary, the National Health Insurance Scheme (NHIS), said that less than five million people had so far been registered under the scheme, adding that aside from Federal Government workers, only two states had signed up for the scheme.

“We have recorded such low progress because apart from the Federal Government, only Cross-River and Bauchi states had bought into the programme. We have undertaken advocacy visits to some states and we had to wait for days before seeing the state executives; at the end, nothing tangible was achieved,’’ he said.

Dr Nma Nwokocha, the President of the Medical Women Association of Nigeria, commended the First Lady for her efforts at eradicating maternal mortality, adding that her vibrant nature and her strategy for getting things done had not gone unnoticed.

“We are indeed happy that we have a First Lady who matches her words with action. We know that you have given the campaign against HIV pandemic and maternal mortality in Nigeria a tremendous boost,’’ she said.

Hajiya Ramatu Usman, the President of the National Council for Women Societies, particularly urged medical doctors to strive to foster sound health care delivery in the country.

“I will like to urge doctors working in general hospitals to concentrate their efforts on providing good services in the general hospitals, while those in private hospitals should remain private.

“Part of the problems in our hospitals today is that some doctors do refer patients to their private clinics; this aberration should stop,’’ Usman said.

Also speaking, Mr Edward Ogenyi, President of the Network of People Living With HIV/AIDS in Nigeria (NEPWHAN), told the gathering that “more than three million Nigerians are living with HIV/AIDS, while there are over 800 groups working with victims of the virus.

“I thank the First Lady for her support; she donated a bus to us and she has been giving monthly grants to members of NEPWHAN to help them feed well, get drugs and seek medical care faster,’’ he said.

Hajiya Asmau Abubakar-Yari, wife of Zamfara State’s Governor, said that the session was an eye-opener.

“I have learnt a lot today and I now have a clearer vision on what to do. I will focus on two areas, health and education. Under health, we will examine ways of reducing maternal mortality, while under education; we will strive to eliminate the street children syndrome.

“We will place the street children in schools or assist them to acquire skills like carpentry; this will help in getting them off the streets, while empowering them at the same time,’’ Abubakar-Yari said.

Similarly, Mrs Omolewa Ahmed, wife of the Kwara State Governor, said: “There is a lot to take home, the First Lady has opened our eyes to a lot of things. I had an idea before but there will now be a paradigm shift in the way we approach things.

“I will focus my efforts on how to reduce maternal mortality. We are aware of the health problem all along but with today’s emphasis, we will go back to our states better equipped to tackle the problem.’’

Observers maintain that the concerted efforts of the First Lady, the governors’ wives and other stakeholders will go a long way in addressing some of the health problems of women, maternal and infant mortality, in particular.

Bada writes For NAN.

Yetunde Bada