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Proactive care as a solution.

Nigeria has a maternal mortality problem. Scratch that. Nigeria has a maternal mortality crisis. One of the epic proportions.

Every 11 minutes, a woman loses her life due to childbirth-related complications. Put more graphically, every day a plane full of women crashes them to their deaths. The pilot? Maternal mortality.

Some days ago, a lady reached out to me to tell me about the death of her friend Mama J. Mama J had gone in for childbirth with severe shortage of blood, medically called “Anaemia”.
Her PCV was 16%. She was reportedly transfused and operated on. She developed a stroke afterwards and died.

I was so sad and hurt to hear this. I’ve not yet gotten to the point where I view humans as just medical cases. I’m not even sure I want to. So I grieved.

Grieved for yet another needless death. Grieved for yet another family losing its member. Grieved for the lack of proactive maternal care to remain ahead of the marauding monster.

At this point, let’s state what maternal mortality is. It is, simply put, the death of a woman within 42 days of her giving or attempting to give birth, directly as a result of the event and not because she stood outside and got hit by a palm tree. That one would be village people.

Maternal mortality affects families who lose their daughters, wives, sisters, mothers, aunties & cousins.
It affects organizations, societies, and groups.
It affects economies -micro and macro.
It affects the well-being of children left behind…nutrition, hygiene, school attendance, delinquency, child molestation, and child trafficking. The list is endless

This begs the question: Why are we still here?

A lot has been said about maternal mortality over the years. From MDGs to SDGs, conferences to conferences, meatpie to meatpie. Yet we are still here.

Most of, if not all, governor’s wives have reduction of maternal mortality as a key component of the interventions they carry out in their domains.
Several agencies of government and aid organizations do this also. Yet the problem lingers like a stench that just won’t go.

Is it a failure of consistency? Strategy? Or both?

We are notoriously reactive. We wait for an adverse event to occur before mobilizing to intervene. This is however more expensive, more energy-intensive and not as effective overall.

I should know, I’ve been involved in a number of them myself.

Having deployed creative solutions to providing medical care and seeing a significant difference, a shift in strategy is inevitable if we are serious about effecting change.

It is time Nigeria takes a different approach to our maternal health problem – It is time to deploy proactive maternal care.

We know the factors that can take a woman’s life within 24 hours are linked to hypertensive events in pregnancy and bleeding.

So?

1. Priority-train our health care providers on how to manage such events.
2. Sensitize and educate pregnant women on how to prevent the development of obstetric crises, rapidly identify danger and seek help quickly; early detection makes all the difference.
3. Make more intelligent use of data, continuous monitoring and evaluation to double down on what works and scale back on what doesn’t.
4. Empower every local government area across the country with at least one health centre that can handle , at a minimum, the two obstetric emergencies that can end a woman’s life within 24 hours.
5. Sensitize and empower the support systems of pregnant women on how best to help them in this journey.
   This is where creative solutions to maternal health using technology comes in.
   It means maternal care one step ahead, continuously vigilant, detecting and warning of danger signs before disaster strikes.
6. Empowering the woman’s support system to be continuously aware and alert to rapidly intervene.

Pregnancy is a physiological project and it takes a village to see it to successful completion with both mother and child alive and well.
Having previously deployed mostly reactive, responsive approaches, it is time to integrate proactive maternal care into obstetric protocols to reduce the numbers of women who experience unwanted outcomes in childbirth.

Too many have died needlessly like Mama J. For their deaths not to be in vain, it is time to drive back the beast that is maternal mortality.

Everybody, every hand, every voice involved.
Together we can do it.

Dr Idara Umoette is a Director of MoreHealth Africa and founder of maternal tech solutions Project AMBA.

She tweets as @idarajune and provides maternal health education and sensitization at @birthsafeng on Instagram.

Reach her at [email protected].