By Olanrewaju Akojede
Nigeria’s rating as the second country with highest maternal death rate in the world and its contribution of 15 per cent of annual global death is causing anxiety in health sector.
Experts say the worrisome situation calls for concerted efforts of all stakeholders to bail the country out.
The medical experts described the situation as unacceptable as recent rating puts Nigeria’s maternal mortality at 58,000 in 2015.
The rating is contained in a joint report by the World Health Organisation (WHO), United Nation Population Fund (UNFPA) and the United Nations Children Fund (UNICEF).
The report was presented by Dr Olusola Odujinrin at the 2017 Annual Faculty Day Lecture by the Faculty of Public Health and Community Medicine, National Postgraduate Medical College of Nigeria.
In an interview with NAN, Odujinrin, a community health expert, said Nigeria had not done well in the provision and maintenance of Primary Health Facilities (PHF).
“Our country is off the track in meeting all Millennium Development Goals (MDGs). We are on the back row because we lack healthcare infrastructure which necessitated the high mortality rate.
“Our first goal is to eradicate extreme poverty and hunger according to the World Bank’s projection for sub-Saharan Africa has not been met. Nigeria and Democratic Republic of Congo has fared badly.
“At present, the report that says Nigeria contributes about 15 per cent of the annual global death, this is alarming and we must act fast on it because it is no favourable.
“Albeit scary as the report may, however, seem to be, we can still address these challenges if we have the political will to do just that,’’ she said.
Odujinrin, a fellow of the West African College of Physician (FWACP), said that the appropriation to the Primary Health Care (PHC) was grossly inadequate, thereby putting the lives of the mother and child at risk.
“PHCs need lots of commitments and we need to scale up of financial commitment not minding the cost. These days, no programme comes up without high costing.
“The funds are not enough to go round; if they are, we won’t have any problem. Things are changing now; we need to work on the quality and better condition of service.
“Those working in the PHCs in the rural areas are also entitled to respect, they need to have a sense of belonging, and many want to work there now save for the condition of service.
“There are lots to be done in the rural areas where they still go through unsafe traditional birth attendants to keep the maternal mortality rate down,’’ she said.
Prof. Bayo Onajole, from Lagos University Teaching Hospital (LUTH), told NAN that the multiplicity of programmes in the PHCs was a hindrance to its effectiveness.
“The major problem is that there have been so many programmes in place as regards the PHC. There is a need to review all these programmes.
“For the ones that are working, we need to appraise and for those that are not working, we need to modify them.
“If we do that, we will be moving a step close to solving the problem in the PHCs as regards the global paradigm in terms of maternal health.
“We are not calling for a complete departure, but for a change to reinforce the project to tone down the high mortality rate,’’ he said.
Onajole said that government could help to bring down the mortality rate through appropriate financing and monitoring of the fund allocated to PHC.
“We can reduce the Maternal Mortality Rate (MMR) through an effective government spending adequately monitored to check graft.
“We can also have periodic personnel training and infrastructure development. We need to look at what we are doing and see that there are no gaps which are hindering the desired outcome.
“With this, we need to tinker with our programmes and see what the high MMR has caused us by some unfavourable policies even at the level of human resources.
“To get results, we need to have `Tag Shifting’, that means where manpower is not enough to tackle the present demands from the PHCs, we should provide,’’ he said.
Onajole said that the main problem of PHCs rest in the rural areas where there were minimal access to PHC, hence, more attention given to the rural settlers.
“If we look the Human Development Index (HDI), then we have given too much attention to the urban areas at the expense of those in the rural areas.
“The Three Quarter rule says that the population reside in the rural areas, but in contrast, our own three-quarter spending on PHCs resides in urban areas.
“Hence, we should discover what we are saying about inverse care; which means, most of those that need the PHCs are not getting it, I mean the rural dwellers that cannot afford health bills.
“The PHCs in the urban areas are not effectively used because those in the cities can afford the bills, the subsidy should be enjoyed much in the rural areas and not the urban centres,’’ he said. (NAN)