Stop the carnage on women and children

The reality of the pervading maternal and infant mortality dawned on me last week when I went home for the burial ceremony of one of my relations. A woman in her early thirties, a widow and mother of four reportedly died while bringing to the world the next child.

Prior to this, she was said to be suffering from pregnancy-induced hypertension (pre-eclampsia). Medical attention was sought when it became very late for obvious reasons bordering on poverty, low level of education and attitude to issues of maternal and child health especially in a rural setting.

The death of the woman and subsequently her unborn child is one story that has become a common feature of the Nigerian health situation for some time now. Year in year out, the statistics keeps coming and reminding us of the grim nature of the problem which appears to be abetting at a low pace in some areas while alarmingly increasing in some others.

Over time, Nigerian government and its health authorities have vowed to reduce drastically the high incidence of morbidity especially in pregnant women and infants. They have emotionally sounded the unacceptability of women dying in hundreds while bringing forth babies into the Nigerian world. They have theoretically mapped out programmes in primary health care to help checkmate this problem.
But official statistics emanating from the Nigerian branch of the United Nations Children’s Fund (UNICEF) is as alarming as it is baffling.

According to Dr. Eather Obinya of UNICEF Office Abuja, the situation is growing worse everyday. Her talks on Accelerated Child Survival and Development (ACSD) and Integrated Maternal, Newborn and Child Health (IMNCH) at the recent Calabar meeting of journalists and UNICEF as well as officials of Child Rights Information Bureau of the Federal Ministry of Information and National Orientation provided much food for thought and bird’s eye view of the threatening health condition.
According to her, the worldwide distribution of such deaths are predominant in Africa. And Nigeria being the most populous country in the continent presents more of these deaths.

For instance, maternal mortality ratio in the country in 1999 and 2003 stood at 704 deaths for every 100,000 live births and 800 deaths for every 100,000 live births respectively. Infant mortality rate was reportedly 90 for every 1,000 births in 2003. The death of children under five years of age rose from 168 for every 1,000 births in 1999 to 201 for every 1,000 live births in 2003.

The grim picture of infant mortality is higher in the troubled oil bearing region of South-South and the three geo-political zones in the north. The reasons for this are largely due to high level of illiteracy of women in these areas and unavailability of basic health facilities and skilled health officials that attend to these women especially during child delivery. In most cases, these women deliver their babies at home at the mercy of the local unskilled birth attendants.

The situation in the South-West and South-East, which recorded low number, was traceable to the fact that more women here attend schools and as such are well informed about caring for their health and that of their unborn children. The case of the South-South is not helped by the upheavals and restiveness in the region occasioned by the festering militancy. The activities of the militants have invariably led to wanton destruction of health facilities which has made it virtually difficult and sometimes impossible for families to seek urgent medical attention.

The hostilities in the region have driven away health workers and sort of put a stop to any health intervention programme either by Nigerians or donor agencies.
The ACSD is a regional strategy to combat child mortality, which is one of the eight aims of Millennium Development Goals (MDGs) while the IMNCH is a national strategy to achieve MDGs of reducing child mortality as well as improving maternal health. The Women and Children Friendly Health Services (WCFHS) are the ways and manner services are offered in ACSD and IMNCH to achieve the MDGs of child and maternal health.

The MDGs are meant to, by 2015, eradicate extreme poverty and hunger and achieve universal primary education. It is also meant to promote gender equality and empower women. Its other goals include reduction of child mortality and improvement of maternal health. The MDGs would combat HIV/AIDs, malaria and other diseases, ensure environmental sustainability and evolve a global partnership for development. But how far has the nation gone in achieving these lofty goals? The prevalence of malaria has reduced from 1, 116, 982 in 1990 to 1,875,389 in 2004.
The HIV prevalence among 15-24 year old pregnant women has reduced from 1.8 percent in 1990 to 5.1 per cent in 2004.

The maternal mortality ratio was 1,000 deaths for every 100,000 births in 1990 and 704 deaths for every 100,000 live births in 2004. In 1990, the proportion of births attended by skilled health workers was 45 percent while in 2004 it was 36 percent whereas the target is 100 percent. The proportion of pregnant women with four or more Antenatal Clinic visits was 52 percent in 1990 and 45 per cent in 2004.

Under-five mortality rate was 191 deaths for every 1,000 live births in 1990 and 201 in 2004 while infant mortality rate was 91 for every 1,000 live births in 1990 and 100 in 2004.
With these grim statistics, it is very unlikely that Nigeria will meet the MDGs goals in reducing child mortality, improving maternal health and combating HIV/AIDs, malaria and other diseases.
Presently, Nigeria is the second largest contributor to maternal mortality rate globally. About 52,900 Nigerian women die annually due to pregnancy related causes.

Over one million children under five years of age will die this year. Daily, 145 women and 2,300 under–five children die, about 30 per cent being new born. Nigeria bears 13.5 per cent of the global burden of HIV in pregnant women yet access to antiretroviral drug is still very low.
Causes of maternal deaths include hemorrhage (23%), Infection (17%), Toxemia/Eclampsia (11%), Unsafe abortion (11%), Obstructed Labour (11%), Malaria (11%), Anemia (11%) and others (5%).

This is the time our various tiers of government should act in concert to stop this carnage on women and children. The resources to achieve this are available. What is needed now is a demonstration of the will to combat the scourge. Let our legislators and other political leaders rise up to this challenge. The MDGs initiatives are laudable and achievable. Let President Umaru Musa Yar’Adua galvanize other leaders in the country to achieve them and reduce the increasing number of child and maternal deaths whose figures have risen to an unacceptable range. Until then, see you after my vacation.

Source:www.sunnewsonline.com