Promoting Safe Pregnancies, Maternal Health In Nigeria

From time immemorial, pregnancy has been a source of joy to most couples, especially the newly wedded ones, as they set out on the journey toward parenthood. This is because in African setting, childlessness is traumatic experience a serious glitch in affected homes, as it often results in broken marriages.

Even though pregnancies are a source of joy to most married couples, they could also be a source of misery to some families if there are unexpected complications.

For instance, Hussain Abdulkadir, a resident of Banda village in Kogi State, has been married to Salamatu for five years without a child. A fervent Muslim, Hussain has interminably been making supplication to God to grant his wife the fruit of the womb and end their misery. Sometime last year, Hussain’s prayers were answered, as Salamatu, after a medical diagnosis, was found to be two months pregnant.

“I cannot describe my happiness when my wife told me that she was pregnant after five years of our marriage,’’ Hussain recalls.

“However, I never knew that my hope of becoming a happy father one day would be dashed, as my loving wife died shortly after giving birth to a baby boy,’’ he moans.

Family sources say that Salamatu died, few hours after childbirth, as a result of some complications that led to excessive bleeding that could not be controlled at the nearby maternity centre manned by an untrained birth attendant. Although Salamatu died, her baby is alive, all in a dramatic irony of joy mingled with sorrow.

Hussain’s plight mirrors many others, particularly in the rustic setting where there is an apparent lack of good heath facilities to cater to the pre-natal and post-natal needs of prospective mothers.

As Hussain still continues to ponder over the tragic loss of his wife, health experts say that thousands of pregnant women in Nigeria die daily during or after childbirths.

Medical experts say that maternal mortality rates are still high in the country in spite of several government intervention programmes.

Dr Kamaldeen Ali, a consultant obstetrician and gynaecologist, blames the high incidence of maternal mortality on bacterial infections, obstetrical hemorrhage, ectopic pregnancies, unsafe abortions, uterine ruptures and gestational hypertension, among others.

He says that Nigeria accounts for 10 per cent of the 600,000 pregnancy-related deaths annually recorded across the world and stresses the urgent need for all stakeholders to redouble efforts to arrest the problem.

Mrs Amina Abdulkarim, a nurse, shares similar sentiments and argues that many of the maternal deaths could have been avoided if adequate public enlightenment campaigns on pre-natal health care are carried out.

“Pregnant women should be effectively enlightened about the precautionary measures which they should take during pregnancies, while their access to adequate health facilities should also be guaranteed,’’ she says.

Abdulkarim bemoans the harrowing experiences of most pregnant women in rural areas, saying that the hapless women often have to travel to faraway places in search of health care.

She says that the federal, state and local governments should make tangible efforts to provide good health facilities, particularly in the rural areas, to stem the alarming rate of maternal mortality in the country.

Dr Mohammed Abdulkadir, a Lokoja-based medical practitioner, identifies delay in treating complicated pregnancy cases, harmful traditional practices, inadequate antenatal care and poverty as some of the factors responsible for the high incidence of maternal mortality in Nigeria.

“Apart from the medical factors behind maternal deaths, poverty is another major factor responsible for the deaths. Some people do not have the wherewithal to pay for ante-natal and post-natal medical care,’’ he says.

Abdulkadir, nonetheless, suggests the need to fine-tune the National Health Insurance Scheme (NHIS) to cater to the medical needs of indigent couples, particularly pregnant women.

The growing menace of maternal mortality has been a source of concern to government, non-governmental organisations (NGOs) and other stakeholders and observers say that efforts are being made to address the issue frontally.

One of the NGOs, the White Ribbon Alliance, at a recent meeting in Abuja, noted that although Nigeria had been able to record a decline in maternal deaths, a lot still had to be done to ensure safe pregnancies and childbirths.

Mr Jeremie Zoungrana, the National Coordinator of the White Ribbon Alliance, urges the government to evolve purposeful policies and strategies to safeguard the lives of pregnant women and newborns.

Zoungrana, who harps on the importance of reproductive health policies and programmes, estimates that in every minute, 380 women around the world become pregnant, adding that at least, 190 of the pregnancies are not premeditated.

He notes that while 110 women experience pregnancy-related complications worldwide every minute, many of the women die during pregnancies or at childbirths.

Zoungrana emphasises that government must necessarily stage public enlightenment campaigns to educate the citizens on safe pregnancy and childbirth procedures to stem the menace of maternal mortality.

Dr Muhammed Pate, the Executive Director, National Primary Health Care Development Agency (NPHCDA), says that the agency is striving to tackle the causes of maternal mortality in the country, adding that the efforts have been somewhat successful.

He says that NPHCDA is making efforts to ensure that every health care facility in the country has at least one midwife, adding that the government has so far recruited 2,819 midwives to implement the policy.

He says that the midwives are to provide emergency obstetric and neonatal care services to pregnant women, among other functions.

Pate notes that midwives are trained in life-saving skills, management of child diseases and other ailments, stressing that they will be useful in managing many of the health problems, including those relating to maternal care.

He discloses that the midwives have been deployed to 652 primary health centres that are linked to 163 government hospitals across the country.

Analysts commend the government for these efforts but stress the need to initiate more programmes to reduce maternal mortality in the country in a pragmatic way.

However, efforts to promote safe pregnancies and childbirths in the country received a boost recently when officials of the Nigerian office of the Planned Parenthood Federation of America (PPFA), led a delegation from the U.S. on a visit to Lafia, Nasarawa State.

The leader of the team, Mr Remutha Francis, said that the tour was undertaken to enable the organisation to assess the activities of its partners in efforts to improve the women’s quality of life through increased access to reproductive health services.

Besides, the need to promote maternal health has also been the focus of ECOWAS, as the sub-regional organisation has repeatedly called on member countries to adopt a holistic approach to family planning so as to reduce the menace of unwanted pregnancies.

For instance, ECOWAS, at its 11th Ordinary Assembly in Sierra Leone, harped on the need for member states to put in place good primary health care systems, equipped with adequate human resources and facilities, and aimed at expanding the people’s access to quality health care delivery.

The sub-regional body also called for more information on the current state of the proposed African Fund for Maternal Health, aimed at making interventions in reproductive health care delivery in member states.

Beyond that, the Nigerian Medical Association (NMA) has expressed its determination to partner with Ipas Nigeria, a health-related NGO, in the crusade to stem maternal mortality in the country.

The NMA’s President, Dr Omede Idris, who disclosed this during a recent visit to the Abuja office of Ipas, stressed the need for a policy that would create an enabling environment for the reform of the legal framework guiding reproductive health care delivery in the country.

Women politicians in the country have also been calling for the reduction of maternal mortality rates in the country. The women politicians participated in a recent workshop in Abuja that was organised to look into ways of curbing maternal mortality in Nigeria.

The workshop was organised by Advocacy Nigeria for Reduction of Maternal Mortality, Women Rights Advancement and Protection Alternative (WRAPA) and other agencies involved in reproductive health care.

The workshop participants pledged to work for a reduction in maternal deaths in the Nigeria, while striving to make maternal mortality reduction a major focus of political campaigns and government programmes

The workshop urged politicians to make conscious efforts to integrate maternal mortality reduction strategies in the manifestoes of their political parties and in their campaign agenda.

Analysts stress the need for the government to exhibit a strong political will in tackling issues relating to reproductive health care and maternal mortality, while soliciting the active support of all stakeholders in that regard.

Through such concerted efforts, they add, maternal mortality rates in the country will consequently be on the decline.

Ahmed writes for the News Agency of Nigeria

Dada Ahmed