Thirty five years old
Jemina died recently while giving birth to her 8th child. Her husband, Sobomate, 42, a fisherman, could not bear the loss because, according to him, she was his favorite and the eldest amongst his three wives, all of whom were cohabiting with him in a fishing settlement.
As he lamented, in almost all his utterances, one sentence he kept repeating was “I told her not to get pregnant again, but she refused. She said she only feels my love when she is pregnant”.
He explained that he already has seven children with her, and that their first child, a girl, is 14, and that the 7th child by her just turned one.
Mr. Sobomate said he has eight other children with two other women (five by the second wife and three by the last wife). All of these children are less than 14 years.
From the explanations he gave, shortly after he impregnated his second wife, the late Jemina started complaining that the only time he treated her as a woman was when she was pregnant.
She therefore decided that she will continue to get pregnant as much as she can so he will not have the time “to look at other women”.
The result was that Jemina started getting pregnant almost yearly, even after she was warned after her 6th birth by an experienced Traditional Birth Attendant (TBA) that she was endangering her life.
According to him, all his pleas fell on deaf ears as she later had her 7th child and got pregnant for the 8th, which led to her death.
A critical analysis of the events leading to the death of Jemina revealed that one major cause of her death was that she patronized TBAs rather than health facilities, where she would have been counselled on the implications of not spacing her children, and the need to enroll in family planning programmes.
Family planning (FP) refers to the conscious efforts by a couple to limit or space the number of children they have through the use of contraceptive methods.
It is also described as a practice that helps couples to avoid unwanted pregnancies, bring out wanted births, and ultimately determine the number of children in the family.
The United Nations Conference on Human Rights at Teheran, Iran, in 1968 recognised it as a basic Human Right and as a concept beyond just birth control.
Family Planning has been added to the 5th Millennium Development Goals (MDGs) as an indicateor for tracking progress in improving material health.
Modern contraceptive methods include male/female condoms, female/male Sterilization, the pill, the intra-uterine device (IUD), injectibles, implants, the diaphragm, foam/jelly, lactation amenorrhea (LAM) and emergency contraception.
The traditional methods include Rhythm (periodic abstinence) and withdrawal methods. Modern contraceptives with short-term and reversible features such as pill, injectible and male condoms are more commonly found in Africa and Europe than elsewhere in the world.
The long term methods such as IUD or sterilization, on the other hand, are more common in Asia and North America.
The most common contraceptives in Nigeria include injectibles, male condoms and the pill. Other modern methods used by some women include IUD, implants, diaphragm and emergency contraceptives.
Family planning can also reduce maternal mortality by 20 per cent or more, and infants are twice more likely to survive if the previous birth interval is at least two years.
Access to family planning services can bring about a drop in unintended pregnancies by 77 per cent. This can lead to a corresponding reduction in the number of women requiring medical care from complications of unsafe abortions.
This will result in important health benefits to individuals, families, and the nation at large. It will subsequently contribute towards the control of population growth and the achievement of the MDGs.
The implacable from the case of Jemina, is that when family planning services are provided and made easily accessible, it will reduce maternal mortality.
In the same vein, if Jemina had accessed family planning, she would have been counseled by health care providers on the dangers of getting pregnant almost yearly. Now, she is dead, her case may be just one of a considerable number of women, whose cases were not noticed.
To ensure quality family planning, palladium, a United States-based organization that works towards improving livelihood and economies of countries, especially developing countries recently inaugurated the advocacy working group on family planning in Port Harcourt to increase its contraceptive prevalence rate in the state.
According to the Adviser, Health System Strengthening, Health Plus Project, Palladium , Dr Emeka Nwanchukwu “one of the objectives of the inauguration is rally support for family planning issues among political leaders and various stakeholders to improve on budgetary allocation for family planning communities in the state”.
As part of efforts to ensure improved family planning services, according to the Rivers State programme officer, Planned Parenthood Federation of Nigeria (PPFN), Emmanuel Owor, “you must have very good work force”.
For this reason, he said, the PPFN in the state has made man-power development in family planning an annual priority.
According to him, in 2015 the PPFN trained 50 family planning services providers in the state. They include Doctors, midwives, and pharmacists. Due to the economic crunch, however, the organisation has been able to train only 25 personnel’s this year. These trainings, he noted, commenced in 1979, a year after establishment of the PPFN.
Towards enhancing effective family planning service delivery, Owor said a project called “Cluster Model”, by PPFN also ensure that private clinics are brought in as partners with relevant memoranda of understanding (MoU) signed.
Staff of such clinics are then trained to provide family planning services accordingly, under the close supervision of the PPFN.
From these private clinics, the PPFN gets monthly records of those accessing family planning services.
Investigations reveal that so far, the government is mainly involved in the provision of health facilities and man-power, and because most of these health facilities are situated in the urban areas ,family planning services are mostly concentrated in the urban areas.
The rural, especially hard-to-reach areas are virtually cut-off from accessing the family planning services. This explains why most key cases such as that of Jemina occur in the rural areas.
Even when family planning services are available in the urban areas, there is as much ignorance and or negligence as there are people of productive age who find it extremely difficult to access good health, due mainly to economic down turn.
For the government to be able to reasonably check maternal mortality and neonatal death in this wise, it has to go beyond merely provision of health facilities and manpower development.
The government needs to come up with more equipped health facilities and free family planning commodities in all communities, as well as institute relevant legislation that would make it mandatory for every adult to access family planning services when the need arises.
This also means that it behoves of the government to provide a conducive environment, such as increased budgetary allocation to family planning, improved man-power development and ensure accessibility by the lowest class of the citizenry.

Sogbeba Dokubo