FacebookTwitterGoogle+RedditEmail

Bringing Maternal and Child Health Care to Northern Nigeria

by CESAR CHELALA

Abuja, Nigeria

Every day, 2,300 children under-five and 145 women of childbearing age die in Nigeria, making the country the second largest contributor to the under-five and maternal mortality rate in the world, according to UNICEF statistics. This situation is particularly painful since most of those deaths could have been avoided with simple, low-cost interventions.

Although recent trends show that the country has made progress in reducing infant and under-five mortality rates, it will still be unable to achieve the Millennium Development Goals of reducing child mortality by two thirds by 2015. At the same time, the deaths of newborn babies –the majority of which occur in the first week of life- represent 25 percent of the total deaths of children under-five in the country.

Although there are wide regional disparities in child health indicators, the North-East and North-West zones of the country have the worst child survival and maternal mortality figures in the country. Malaria, pneumonia, diarrhea, and measles are among the preventable or treatable infectious diseases that account for more than 70 percent of under-five deaths in Nigeria.

A woman’s chance of dying from pregnancy and childbirth in Nigeria is approximately 1 in 13, an extremely high figure and among the highest in the world. Regarding maternal mortality, it is known that women who have good pre-natal care stand a much better chance of delivering safely.

Despite government efforts, the coverage and quality of health care services for women and children continue to be poor in Nigeria. In addition to the government, several UN agencies and national and international non-governmental organizations (NGOs) are trying to improve the situation, particularly in remote regions of the country that are far away from Nigeria’s main cities.

A program called Partnership for Reviving Routine Immunization in Northern Nigeria; Maternal Newborn and Child Health Initiative (PRRINN-MNCH) is presently being carried out in the four northern states of Jigawa, Katsina, Yobe and Zamfara, which have particularly poor child and maternal health indicators. The program aims to improve the quality and availability of all maternal, newborn and child health services in those areas.

It is working, for example, with the federal, state and local governments in close consultation with the communities to improve the quality and availability of health services including antenatal and postnatal care to have safer deliveries, better care for newborns and infants, better nutrition and wider routine immunization against the most common vaccine-preventable diseases.

At the same time, the program is working simultaneously with governments and local staff to strengthen primary health care services (PHC). As Dr. Ahmad Adbulwahab, PRINNN-MNCH National Programme Manager told me, “We are working as catalysts to help the government make its job better.”

Through such program interventions, numerous health care centers have been rehabilitated. There is now a more active and effective integrated management of primary health care services, from state level to grass roots levels and, as a result, greater and better responsiveness to patients’ and communities’ needs.

An important aspect of the program has been the regular collaboration not only with development partners and government bodies but also with traditional and religious leaders to ensure that health messages are widely distributed and assimilated in the communities. This also facilitates the implementation of planned activities and ensures communities’ participation.

One important result has been the decline in the infant mortality rate (IMR) in the clusters where the program has been active. One measure of the impact of the activities on the IMR is that in all the clusters covered by the program infant deaths have declined from 70,000 to 48,000 per annum. This decline in IMR was helped by the improved routine immunization activities being carried out under this program.

In countries in development, high rates of low-birth-weight babies are due to pre-term birth and to impaired uterine growth. They contribute significantly to high rates of neonatal mortality. Since effective interventions are limited, a technique consisting in pre-term infants carried skin-to-skin with the mother (Kangaroo Mother Care) has proved effective for thermal control, breastfeeding and bonding with newborn infants. This technique that has been increasingly used in this program and has probably also contributed to the decrease in IMR observed.

Maternal death rates, particularly in developing countries, are related to the quality, accessibility and coverage of pre-natal and obstetric services. Dr. Fatima Adamu, a sociologist working with the program, told me in Abuja, “There is no reason why a woman should lose her life in the process of giving life.”

By using a holistic, comprehensive approach to the health problems affecting mothers and children in the North-East and North-West areas of the country high infant and maternal mortality rates have decreased and the technical skills of the medical and paramedical personnel have improved, thereby creating the basis for a consistent, steady development in the country’s health care system.

Dr. Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.

Dr. Cesar Chelala is a co-winner of the 1979 Overseas Press Club of America award for the article “Missing or Disappeared in Argentina: The Desperate Search for Thousands of Abducted Victims.”

More articles by:
July 27, 2016
Richard Moser
The Party’s Over
M. G. Piety
Smoke and Mirrors in Philadelphia
Jeffrey St. Clair
The Humiliation Games: Notes on the Democratic Convention
Arun Gupta
Bernie Sanders’ Political Revolution Splinters Apart
John Eskow
The Loneliness of the American Leftist
Guillermo R. Gil
A Metaphoric Short Circuit: On Michelle Obama’s Speech at the DNC
Norman Pollack
Sanders, Our Tony Blair: A Defamation of Socialism
Claire Rater, Carol Spiegel and Jim Goodman
Consumers Can Stop the Overuse of Antibiotics on Factory Farms
Guy D. Nave
Make America Great Again?
Sam Husseini
Why Sarah Silverman is a Comedienne
Dave Lindorff
No Crooked Sociopaths in the White House
Dan Bacher
The Hired Gun: Jerry Brown Snags Bruce Babbitt as New Point Man For Delta Tunnels
Peter Lee
Trumputin! And the DNC Leak(s)
David Macaray
Interns Are Exploited and Discriminated Against
Brett Warnke
Storm Clouds Over Philly
Ann Garrison
Rwanda, the Clinton Dynasty, and the Case of Dr. Léopold Munyakazi
Chris Zinda
Snakes of Deseret
July 26, 2016
Andrew Levine
Pillory Hillary Now
Kshama Sawant
A Call to Action: Walk Out from the Democratic National Convention!
Russell Mokhiber
The Rabble Rise Together Against Bernie, Barney, Elizabeth and Hillary
Jeffrey St. Clair
Don’t Cry For Me, DNC: Notes From the Democratic Convention
Angie Beeman
Why Doesn’t Middle America Trust Hillary? She Thinks She’s Better Than Us and We Know It
Paul Street
An Update on the Hate…
Fran Shor
Beyond Trump vs Clinton
Ellen Brown
Japan’s “Helicopter Money” Play: Road to Hyperinflation or Cure for Debt Deflation?
Richard W. Behan
The Banana Republic of America: Democracy Be Damned
Binoy Kampmark
Undermining Bernie Sanders: the DNC Campaign, WikiLeaks and Russia
Arun Gupta
Trickledown Revenge: the Racial Politics of Donald Trump
Sen. Bernard Sanders
What This Election is About: Speech to DNC Convention
David Swanson
DNC Now Less Popular Than Atheism
Linn Washington Jr.
‘Clintonville’ Reflects True Horror of Poverty in US
Deepak Tripathi
Britain in the Doldrums After the Brexit Vote
Louisa Willcox
Grizzly Threats: Arbitrary Lines on Political Maps
Robert J. Gould
Proactive Philanthropy: Don’t Wait, Reach Out!
Victor Grossman
Horror and Sorrow in Germany
Nyla Ali Khan
Regionalism, Ethnicity, and Trifurcation: All in the Name of National Integration
Andrew Feinberg
The Good TPP
400 US Academics
Letter to US Government Officials Concerning Recent Events in Turkey
July 25, 2016
Sharmini Peries - Michael Hudson
As the Election Turns: Trump the Anti-Neocon, Hillary the New Darling of the Neocons
Ted Rall
Hillary’s Strategy: Snub Liberal Democrats, Move Right to Nab Anti-Trump Republicans
William K. Black
Doubling Down on Wall Street: Hillary and Tim Kaine
Russell Mokhiber
Bernie Delegates Take on Bernie Sanders
Quincy Saul
Resurgent Mexico
Andy Thayer
Letter to a Bernie Activist
Patrick Cockburn
Erdogan is Strengthened by the Failed Coup, But Turkey is the Loser
FacebookTwitterGoogle+RedditEmail