By Sola Ogundipe
WHEN Aina Tomilola put to bed at 1.55 AM onÂ February 27, 2010, it was a celebration of firsts. TheÂ baby girlÂ born to the 31-year-old school teacher was her first child, and she was the first woman to ever give birth at the newly built Maternal and Child Hospital (MCH), Oke Aro,Â Akure, OndoÂ State.
An apexÂ health facility on record as the first of its kind, it would also be the first time a woman would be giving birth in a first class health facility in the State completely free of charge.
â€œIt is a sweet experience for me being the first woman to give birth in this wonderful facility,â€ the elated mother recounted to Good Health Weekly few hours after later fromÂ her bedside in the hospital.
â€œI registered at the State Hospital, Akure, but when I fell into labour, I was brought here by my husband because it is closer. I was well attended to; the staff are friendly and very professional. There was no problem at all and my baby was born at exactly 1.55 AMÂ early this morning. I am really a happy woman.â€
In several ways, Ainaâ€™s words re-echoed expectations of several hundreds of thousands of expectant and would-be mothers in the State. WithÂ seven basic health centres in Owo, Ondo, and Odigba LGAs, access of the people to good health careÂ appears to be on the way to being assured.
The grand opening of the imposing 100-bed ultra-modern maternal and child health facility, which took place the same day Ainaâ€™s baby was born – culminated the highpoint of the week-long series of activities to mark the one-year anniversary of the current administration in the State.
Expected to service a cluster of hospitals, the MCH is an apex referral centre servicing a cluster of hospitals around Ifedore and Akure Local Councils. In a chat afterwards, Ondo State Governor, Dr. Olusegun Mimiko told Good Health Weekly,Â that there is no questioning the fact that many of the people cannot afford healthcare services and there is the problem that even those that are available are not equitable in terms of distribution.
â€œSoon after we took the mantle of leadership, the World Bank visited the State and declared that from data available, Ondo State had the poorest health indices in the South-West of Nigeria which means that our state lagged behind all other states in the South-West in all the indicators of maternal and child health care measures.
This was not palatable news although it gave us insight into the kind of challenges in the health sector especially with respect to attaining the Millennium Development Goals (MDGs).â€ The Governor said it became apparent that the strategies adopted over the years were ineffective in addressing or proffering solution for the problem.
Mimiko, who was two-time Commissioner for Health in the State,Â is well equipped to understand and tackle the hydra-headed problem of maternal and child mortality stated: â€œWe looked at the totality of the magnitude of maternal mortality in the State and concluded that we must intervene, so we have put together what we call the ‘Abiye programme which is based on the philosophy that every pregnant woman in Ondo State must be reckoned with as an individual.
The Governor explained that this move is based on the philosophy that there was the need to keep track of every pregnant woman,Â with the objective of making the health facilities and services available to her at the critical moment she needs intervention.
â€œWith this, it is believed that we can reduce maternal death to a considerable level. Under the Abiye programme, every pregnant woman is registered, and a group of paramedics has been trained for this purpose. Each paramedic is equipped with a motorcycle that has a First Aid kit and they are thus ableÂ to handle emergencies and can attend to 50 pregnant women.
“On daily basis,the paramedic goes around on patrol and there is a checklist of his activities as monitored by a Health Ranger. To keep track of the pregnant women, each of them is equipped with a cell phone. It has usage limited among the caller groups – the Health Rangers, midwives, doctors, the Commissioner for Health and Mr. Governor. It is a caller user group phone. When fully set up, I can take my own phone and call any pregnant woman to find out whatever it is I wish to find out.
The women can also call me or the Health Rangers and doctors and midwives at no cost whatsoever. The general idea is o keep track of them. Pregnant women who are registered are also assigned to particular healthcare facilities that is nearest to them. Each has an arrangement to refer to the next level of care.
The Abiye programme, he itemised, includes training and retraining, facility upgrade, re-equipping of hospitals, and deliberately creating a referral structure that is predictable and functional. â€œThe MCH is an apex referral centre. Initially we planned to build six in Akure alone, we may not be able to do so, but we will build at least three of such centres. Others will be built in Ondo, Okitipupa, Owo, Ikare and in all the major centres. Our goal is to reduce, within four years, maternal and infant mortality by 75-80 per cent, and it is achievable. A novel aspect is that we have tried to collate statistics. we have our own in-house costumised in-house baseline to obtain the maternal mortality reate in each local council. in another one year we should be able to have an objective way of measuring this.Â What we are putting together, will be a global benchmark.
â€œWe want to develop a real global benchmark for measuring, and this health facility survey does not really tell the story. Much of the maternal deaths take place outside of the health facilities. Therefore we are doing a law called the Confidential Enquiry in Maternal Death.â€ The Law, currently before the Stateâ€™s House of Assembly, stipulates that if a mother or child dies in the consequence of pregnancy in a facility, the incident must be reported.
â€œIt does not matter how the woman dies or where she dies, the important thing is that no maternal death must go unreported. If any facility fails to report, it could be closed down, with an additional individual liability of a fine and jail term. We have put up structures at community and local council areas on where to report, so that within a year or so, we would know aboutÂ every maternal death, if the law is enforced. It would enable us have the essential databank of causes and incidences of maternal deaths in the State. The question has been why not the best for the downtrodden in Ondo State?Â We are running the MCH like one of the best facilities in the world.â€
Recounting the Yoruba adage which notes that There is no respect for any king without princesses in the palace,Â Ondo State Commissioner for Health, Dr. Lawrence Adegbemiro observed that the era in which men mournÂ their wives and unborn babies during child birth had gone for ever in the State. â€œThe mother and child hospital we are gathered to commission today is not an empty hospital as it used to be in those days. This hospital has been stocked with world class equipment. The trainedÂ doctors, nurses, and other support staff are already in place to swing into action of service to humanity.
Further, he said: â€œW ith the kind approval of Mr. Governor, all the services to be rendered in this hospital will be free, ranging from normal delivery, to Cesarean Operation and drugs for children under five years. This makes the hospital to be the first of its kind in the country. The administration is planning to build additional mother and child hospitals in other Local Governments of the State before the end of the year.â€