BY CHIOMA OBINNA
Undoubtedly, it is widely accepted that health is a fundamental need for all but despite this fact, health conditions are found to be much inferior in rural communities compared with those in urban areas. In developing countries like Nigeria today, efforts to improve health conditions have had only modest impact on the health of the vast majority of the people, especially those living in the rural and remote areas of the countries.
Statistics available have also shown that following the gaps in healthcare services patients in the rural communities are forced to remain out of medical care system or seek urban care, which is often unaffordable.
The most hits in this situation are usually the pregnant women. Today, the maternal mortality ratio in Nigeria is so high as to make it seem like getting pregnant is a reckless adventure fraught with life threatening risks. For some people, getting pregnant in Nigeria is like a death sentence. Unconfirmed data based on reported cases indicate that an estimated one in 18 live births takes the life of the mother.
Observers say this alone puts pregnancy high up there as a leading cause of death in this part of the world.
They are of the view that the adversity of maternal mortality Rate is a terror by all imaginations especially because it robs the expectant mother of her life in the most grievous manner while bringing to life another being among others.
Every year, around eight million children die of preventable causes and more than 350,000 women die from preventable complications related to pregnancy and childbirth. About every 10 minutes, a Nigerian woman dies as a result of complications of pregnancy or childbirth and hundreds of thousands more are disabled in birth related accidents every year.
According to a UNICEF report, women in developing countries are 300 times more likely to die than those in the industrialised world. 80 per cent of those deaths could be prevented by simple, often low – cost treatments, and quality obstetrics care.
Unfortunately, more than two decades into the war against maternal deaths, Nigeria still has one of the worst maternal mortality statistics in the world. With a maternal mortality ratio of 545 per 100,000 live births, Nigeria is second only to India in the global estimates of maternal mortality. India’s population, however, is about eight times that of Nigeria.
However, whether or not pregnancy becomes a plague – like condition in Nigeria akin to serious terminal diseases depends on the efforts of families, communities, businesses and government together to assure an environment that supports women to go get healthcare and equips those care centres adequately to give good health care when the women do show up.
According to Mrs. Osaze Ebinda, President and Founder of Oops . . . I’ m Pregnant (OIP), the 1 in 18 women that cannot make it alive through the experience of pregnancy and child birth in Nigeria could be saved by simple steps and proper awareness. According to her although the statistics seems dire and gloomy, with simple steps more than 30 per cent of the lives lost could be reversed.
In Nigeria, the reproductive class of women is usually age bracket 18 to 47 and are typically the economically strong that contribute to the earning power of their families and are actively committed to the well being and upkeep of their children and families.
Findings on the incidence of maternal mortality rates in West Africa and Nigeria in particular, have also identified three delays as the major factors fueling maternal mortality. These are delays in seeking medical care, delay in transportation, and delay in providing the care at the care centre. And these delays have been seen in numerous manifestations such as economic reasons like non – affordability of antenatal costs, delivery costs and post – natal costs and poverty, healthcare centre bottlenecks like delay in seeing staff, incessant strikes etc., delay in referrals, doctors and nurses refusing rural postings, cultural and religious beliefs among others.
In the words of Ebinda, “To cry out against maternal mortality is a great cry and a powerful stance that decries every dimension of waste it involves- personal, family, gender, social, economic and national. The fight against deaths is a fight that has a positive implication on many fronts that are implicated in the massive struggle.”
Also a statement credited to the United nations Seceratry- General, Ban Ki-moon, while drumming the importance of the fight against maternal deaths stressed that the millions of women and children that die from preventable deaths are not just mere statistics but are people with names and faces adding that their suffering is unacceptable in the 21st century.
According to him, “We must therefore do more for the teenage girl facing an unwanted pregnancy, for the married woman who has found she is infected with HIV Virus and for the mother who faces complications in childbirth and for newborn who succumbs to infection for want of simple injection and for the young boy who will never reach his full potential because of malnutrition.”
To tackle the three most dangerous factors fueling maternal deaths, health watchers are of the view that there is urgent need to step up reproductive health awareness in the rural areas. According to them, even in this 21st century, many rural women have no access to antenatal care and about 10 per cent pregnant women have no knowledge of ante natal.
However, in line with the statement of the UN Secretary General, many organisations have engaged themselves with quick impact projects both in the urban and rural communities to provide a broader range of service delivery and improve access to medical and health related services to the people living in areas with poor accessibility to health services and information. In Nigeria, Oops . . . I’m Pregnant through its initiative, Reproductive Health Wellness Outreach (RHWO) is working currently to reduce the rates of maternal deaths in communities across the nation.
Narrating her experience during one of their reproductive outreach programmes in some communities in Abia State, President of Oops . . . I’m Pregnant (OIP), Mrs. Osaze Ebinda stressed the need to prioritise Reproductive Health (RH) in the communities.
According to her, “The use of RHWO could moderate the effect of the twin barriers of distance and isolation that often keep the rural people out of the loop of healthcare services and facilities. The viability of RHWO projects will contribute to the gradual expansion of coverage and effectiveness of reproductive healthcare for the lagging mass of people.
“The need for quick impact developmental interventions such as the OIP’s RHWO that could contribute to uplifting the unattractive conditions of women living an ignorance-darkened, disease-prone, poverty-hit and tough, rural existence is urgent. RHWO projects serve as a suitable approach to creating an intermediate solution until regular and effective services become fully available. And the foregoing, she said, forms the backdrop from which OIP executed the first of its direct intervention series of RHWO.
Noting that activities of RHWO in the communities revealed an estimated 720/100,000 live births in the State, Ebinda explained that RHWO was established to provide free access to information to women and families on pregnancy, antenatal care & post – natal care, increase contraceptive’s prevalence through promotion of education, access to and quality of family planning services, enlightenment on other reproductive health issues, prevention and treatment of reproductive tract infections, referral services of reproductive health cases.
Others are providing a platform to have unfiltered glimpse into the peculiar RH attributes of the communities and the local government areas reached vis – a – viz the gaps and needs in such areas visited as well as to generate data for planning effective relief and intervention.
Ebinda who further pointed out why Nigerian women should not be allowed to die said she was motivated into the business of reducing maternal mortality in Nigeria following her personal experience with post-partum Eclampsia, one of the many complication that comes after childbirth. Eclampsia – usually characterised by convulsions that appear in a person with high blood pressure and protein in their urine – is one of the leading causes of maternal mortality in the country.
According to her, she survived the life threatening condition “by the grace of God” and by heeding her mother’s advice to seek medical help.
According to the United States Agency for International Development (USAID), 52,000 Nigerian women die annually, with most of the victims between the ages of 15 and 45.
“My sad experience and others had made me pursue, vigorously, the reduction of maternal mortality rate in Nigeria via my organisation OIP and by extension, the RHWO. Our vision is to bring down the rate of maternal mortality in Nigeria through enlightenment, education, research and advocacy.
Positing that the unacceptable statistics on maternal mortality in Nigeria is very depressing in Nigeria, she posited that the causes could be addressed through simple ways like creating awareness and improving education on the problems..
According to a USAID report, Unsafe practices after childbirth cause, on average, the death of 144 Nigerian women every day. This means that every 10 minutes, one Nigerian woman dies due to childbirth and pregnancy related causes.
“Recommending such projects like OIP’s RHWO in rural communities, she said, “Oops, I have no money! Oops, am not ready for a baby! Or Oops! What do I do next?
And for others it’s just the oops… anxiety of being pregnant, the triumphs and travails of the journey that lies ahead. This is where OIP, RHWO comes in… OIP is aimed at ‘Turning Pregnancy Oops! to wow.
“ The possibility that something could go wrong makes pregnancy less appealing for many. There is need for government to show greater willingness and enthusiasm to have communication and collaboration with ad-hoc health service providers and strive to provide government machineries to reach and serve relatively more deprived areas and people.”