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The midwives service scheme: So far, so good

ONE of the most disturbing problems of the health sector in Nigeria is the high rate of maternal, neo-natal and infant deaths associated with pregnancy and child birth. Current statistics reveal that over 500 women die in every 100,000 live births; 40 neo-natal deaths in 1,000 births and 75 infant deaths in 1,000 births.

Any death is regrettable but deaths of the unborn, women during child birth and infants attributable to absence of midwives, nurses and other skilled birth attendants and childcare specialists are unacceptable because they are avoidable.

The cumulative figures of such deaths over the years will definitely be alarming and embarrassing for Nigeria considering its resources and ranking in the comity of nations.

It is therefore hardly surprising that a bold initiative has been undertaken by the National Primary Health Care Development Agency to halt this disturbing trend decisively with the Midwives Service Scheme (MSS). Introduced in October 2009 and supported by the office of the President’s SSA on MDGs, the MSS is aimed at taking midwives and other skilled personnel to rural areas across the country which are worst-hit by the scourge of avoidable deaths in order to stem the tide.

The MSS involves an initial 4000 midwives and covers 1250 health facilities in all states and the FCT comprising 1000 Primary Health Centres and 250 designated referral General Hospitals. It is described as one of the largest public sector-led medical intervention schemes in Africa.

It targets about 15 million people across the nation with areas of high mortality burden such as North East and North West zones getting more priority and has been structured to link clusters of primary health centres with nearby general hospitals to handle complications.

The midwives presence brings with it 24 hours attention for pregnant women, mothers and infants, antenatal care for pregnant women, skilled birth attendants for deliveries as well as family planning and immunization services.

This comprehensive package of much-needed attention and facilities in some of the most remote and hitherto neglected parts of the country is certainly a welcome development that is bound to have the desired impact on the tales of woe associated with pregnancy, child birth and the general health needs of women and children.

Although statistics are still being compiled, indications are that the dreaded death rates have dropped significantly and child survival rates have also improved with the enhanced access to immunization services. This heart-warming outcome has greatly boosted the moral of the benefiting communities whose confidence in government has also improved.

The National Primary Health Care Development Agency’s timely and effective intervention in curbing the high maternal, infant and child mortality rates in the country was further consolidated with various facility-support incentives and capacity building schemes for the primary health centres and the midwives and other community health workers covered by the MSS.

The Agency has, thereby, strengthened the primary health care delivery system across the country in one fell swoop using the Midwives Service Scheme as an arrowhead. This is a commendable commitment to fulfilling its mandate which is worthy of emulation by other agencies in the health sector in order to improve the health standards in the country.

Despite the initial successes achieved with the MSS, it is pertinent to advocate necessary measures to not only sustain the gains but to continue extending the scope of the scheme until the scourge of avoidable deaths is put behind us. This can be attained if the Federal Government accords appropriate fiscal and policy support to enhancement of delivery of qualitative and adequate healthcare services to the entire country under the auspices of the National Primary Health Care Development Agency.

The positive impact of the MSS and other projects of the Agency should serve as yardstick and challenge to state and local governments in Nigeria and an eye-opener to the people to appreciate how focus and commitment to addressing seemingly intractable health problems can have a positive impact and eventually overcome such problems.

While commending Dr Ali Pate, Executive Director of the National Primary Health Care Development Agency and his purposeful team for initiating and implementing such a purposeful and effective scheme which has won local and international acclaim, it is necessary to urge the Agency to apply similar strategies in addressing other challenges facing the delivery of qualitative primary health care services to our people.

Mr.   ABRAHAM OYEDELE , a public affairs analyst, wrote from Abuja.


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