*World Bank: Facility by Mimiko is model to stem maternal mortality in Africa

By Wale Akinola

“I was rushed to the Mother and Child Hospital in a critical condition after prolonged obstructed labour. My family had spent all resources to save my life. I was abandoned by my husband in the midst of the challenge.”

With these words, Rhoda Michael, 24, narrated how she survived complications arising from childbirth after the Mother and Child Hospital, Akure, Ondo State intervened in her situation. But for the intervention, according to the woman, now a nursing mother, and resident at Omu Iyadun compound, Benin Garage area, Akure, she may have died.

She went on: “In the hospital, I went through four surgeries and was administered with eleven pints of blood. I was discharged hale and hearty after two months.”It is not only the fact that she survived the childbirth horror that today delights Rhoda but also the fact that the estimated cost of her treatment in the Mother and Child Hospital was in excess of N2 million but ended up not paying one kobo. The entire cost was borne by Ondo State government.

Rhoda said: “Cost of operation was over N2 million but I paid not even one kobo. I am full of gratitude to Governor Olusegun Mimiko who put this specialist hospital in place, the doctors who work tirelessly to see that their patients get well, the nurses and the entire staff of the hospital. But for them I should be dead and in the grave now.” Rhoda is not the only one coming out of the hospital with testimonies.

Ogunwolere Adesola, who was delivered of twins in the facility, has her own story to tell. “In the past 17 years, I have seen many good hospitals, but this one is not comparable to them. It is so well equipped to take care of any health challenge of women and children. And the staff are simply wonderful.”  Another beneficiary, James Mary, 37, of 16 Aduralere Quarters, Ijoka, Road, Akure, had this to say, “The hospital is very special for its prompt services. The staff are very caring and hard working. I enjoyed free treatment including free drugs.”When the Mother and Child Hospital was established in October 2009, the Governor Olusegun Mimiko – led administration of Ondo State had one thing in mind: To reduce maternal deaths by 50 percent and child deaths by 30 percent by the year 2013. The vision was to run an efficient, integrated maternal and child care facility fully poised to offer critical and qualitative interventions when required.

The year set aside for the attainment of the goal (2013) could not have been accidental. It is the year the governor ends his first term. So the attainment in the health sector, among others, should be enough to say ‘I have delivered.’

Being a medical doctor, the need for the Mother and Child Hospital must have been borne out of Mimiko’s deep understanding of the frightening maternal and child mortality rate and driven by his passion for humanity to confront the challenge frontally.

According to statistics, for instance, more than 1,500 women lose their lives everyday from pregnancy or childbirth complications. In 2005 alone, an estimated maternal deaths of 536,000 reportedly occurred worldwide with 99 percent of them coming from Nigeria and other developing countries. More worrisome was even the situation in Ondo State which was adjudged as having the worst health indices in South-West Nigeria in a report by the World Bank focal officers in the first quarter of 2009. This was traceable to the lack of access to reliable medical services especially in the rural areas, thus forcing the women to patronise traditional-medical practitioners, quack doctors and self-styled birth attendants. The devastating effect of this was not only in terms of wanton destruction of lives but also in its debilitating grip on the economic advancement of the state.

It was against this backdrop that the Mimiko administration conceived the Mother and Child Hospital to tackle maternal mortality not only from the point of view of healthcare but also from the perspective of the Millenium Development Goal (MDG) which seeks to reduce maternal mortality in appreciation of the role of women in the growth and sustenance of the family, the economy and ultimately in the overall interest of the people of the state.

Two years after (the second anniversary of establishment was Friday, Oct 28, 2011), the hospital continues to fill the vacuum of the absence of referral centre for “at risk”patients in Ondo State. The premier hospital, located in Akure, the state capital while three others are planned to be established in the three senatorial districts of the state, treats all emergencies, referred pregnant women and children below five years free. The records of performance are mind-boggling, according to the state commissioner for information and strategy, Mr Kayode Akinmade. “Built to peak at 30 deliveries per day, the hospital ,right now has an average of 25 deliveries daily making it one of the busiest maternity hospitals in the country,”Akinmade said.

“To avoid it being overstretched, the hospital instituted clinical guidelines and protocols for treating common life threatening ailments.  Average cost of care being borne by government is N6,642 for mothers and N4,700 for children under five years.”Due to the examplary services engendered by quality staff and the state-of-the art equipment, the Mother and Child Hospital is recording an influx of patients not only  from  the state but from outside of it. Officials claim that 20 per cent of their patients come from neighbouring states of Ekiti, Kogi, Osun and Edo. And beyond Nigeria, the good news about the Ondo Mother and Child Hospital continues to reverberate. It has been internationally accredited to conduct a Multi-Centre Scientific Research in collaboration with the London School of Hyper and Tropical Medicine.

The trial is on a new intervention on combatting excessive bleeding after delivery. Also impressed by the potentials the Mimiko innovation offers to cut maternal and child mortality rate, the World Bank has recommended it as a model to combat the challenge not only in other parts of Nigeria but also in other African countries. In addition, the Bretton Woods Institution is offering a 50 million dollar grant to bolster the efforts on the Mother and Child Hospital among other health programmes initiated by the Ondo government. The World Bank’s gesture followed a presentation on the hospital and other health programmes of the state government by Mimiko to the bank at its headquarters in Washington, United States (US). A five-man team from the World Bank visited Ondo State ahead of the Mother and Child Hospital second anniversary, last week, as part of the implementation process of the 50 million dollars grant.

Giving the state administration’s health care delivery a pass mark after inspecting the facilities across the state, the leader of the team, Dr Dirnesh Nair, said the success had become an inspiration to the World Bank, hence the award of the grant.

According to Nair, the fact-finding team came to ascertain the human resources available for health care delivery in the state and see if they were enough and competent to make the workability of the approved grant possible.

Revealing the team’s satisfaction at what it met on ground, the World Bank team leader  confessed that the Abiye model safe motherhood – of which the Mother and Child Hospital is a constituent being operated by the state-could  be a good resource base of health programme globally.

He observed that the Abiye project is the best health care intervention to fight maternal and infant mobility in the world.
According to Nair,  apart from Ondo, two other states have been selected to benefit from the facility based financing of the World Bank, adding that this will improve the performance of government in the area of health care delivery.

Disclosing that the brief of the visiting team included ascertaining the benefits due to health workers operating the healthcare programme, number of patients benefiting from the state’s immunization programme and sundry health delivery processes, the World Bank team leader said the implementation of the grant will begin in the first quarter of  2012  after the memorandum of understanding with which the facility will be implemented would have been signed.

The testimonies coming from the Ondo Mother and Child Hospital and the endorsements of the international community as voiced out  by the World Bank and the London School of Hyper and Tropical Medicine point in one direction: The facility is living up to its slogan aptly declared in a plaque at the entrance of the Akure facility that ‘Pregnancy is not a death sentence in Ondo.’

Akinmade and the chief press secretary to Mimiko, Mr Eni Akinsola, believe the “good works the governor is doing on maternal mortality intervention and the larger medical spheres as well as the other sectors in the state  will speak for him at the 2013 polls when he is due for re-election.”