No Govt Presence: Maternal, Newborn Deaths Still High – Local Residents
(A girl having her sibling strapped at her back while returning home from farm in one of Kaduna communities – Photo Credit To Shola Ojo)
About three and a half years ago, the administration of Governor Nasir El-Rufai came to power in Kaduna state with so much election campaign promises including improved healthcare services – especially, as it affects maternal and under five children across the state.
For example, due to shocking statistics of women dying around pregnancy, presented to the governor by civil society organizations working around maternal health, the governor in his wisdom decided to see where he could start to address the issue.
Among steps mapped out to be taken through the Kaduna State Ministry of Health and Human Services (MoHHS) and other related agencies like Primary Health Care Development Agency, the governor came up with the idea of renovating/building one primary healthcare centre (PHC) in each of the 255 political wards, created budget line for family planning, recruited and recruiting front line health workers, healthcare under one roof and lately introduced save one million lives.
These were some of the vast approaches the state government under El-Rufai arrived at to see the possibility of reducing maternal, new-born and under five children across the 23 local government areas of the state. Bye and large, these are necessary steps in the right direction for state whose health sector has been relegated to the background by previous governments.
However, as good as these policies sound and appear to many especially those benefiting from them, several old and emerging communities said the interventions are yet to reach their side because they still lose women and new-born around childbirth. This seems like counterproductive to government’s efforts in this direction but it is a reality that must be looked into.
It is expected that, there will be at least six clinics within the catchment area (two kilometres) of each of the PHCs to render services to women and children thereby reducing maternal death rate, according to vision of the state government.
Sometimes, even when the ruralists know where to get help during pregnancy, access road to medical facilities in town or neighbouring community especially during raining season is another challenge as they get trapped within until the season is over. The smart few plan pregnancy during dry season when they can at least get the service of commercial motorcycle fro and to their abode.
Some of such communities are Kanrafi A, Kanrafi B, Kanrafi C, Kurmi Shata, Lokotoko and Izam all in Chikun local government area of Kaduna State. Local residents who are predominantly farmers and herders here say, government has abandon them to their fate even though they do participate in elections.
Due to the environment, it was observed that, the fertility rate in these communities is very high with challenges that come with it. There is no any health facility nearby let alone of having access to facility that offers family planning services by the reproductive age women. Hence, difficult to control birth. These interwoven challenges make it difficult to reduce maternal complications leading to miscarriages and even deaths at point of delivery in the hands of trial and error birth attendants.
What this means is that, over the years, governments have failed in including emerging communities due to the population growth into their plannings and budgeting. This lack of plans for these emerging communities however, hindering government drives at improving healthcare needs of citizenry because, death of women in these forsaken communities affect the overall life expectation statistics of the government at any giving point in time especially, before the international community.
Local Residents Speak
A traditional leader at Kanrafi A, Sarkin Fada, Ayuba Kajere decry lack of hospital within reach to take care of minor ailments like malaria, “let alone of maternal care for our women and children here. We have to go as far as Angwan Rimi or the private clinic at Danhonu II.”
The senior citizen who spoke through an interpreter said, “to make the matter worse, no motorable road. So, when it rains and there is need to get medical help, our lives are just in the hand of God because we would be trapped within. When it becomes unbearable, the person will be supported in motorcycle. When we move awhile and get to extremely bad spots, we have to stop and convey the person by hand to next manageable sport to continue with the journey.
“You can then imagine what it will look like if a pregnant woman is involved. It is even worse if one or his neighbour do not have motorcycle and you have to first run round the village to get one. During raining season, this place is like prison. We are shut in and at the mercy of God.
“My daughter lost her new-born to delay in getting to a nearby clinic because of bad road and distance. The baby died inside her before we reach the hospital and was evacuated through operation.
“We were lucky not to lose her but, we spent our savings. We have to sell everything including the seedlings for this year’s planting season. I borrowed a lot too. Despite poor harvest, we have sold all we can lay our hands on to offset parts of the debt and our survival till next raining season is largely depend on God”, he lamented.
Also speaking is Middle-aged Abigail Ayuba who claimed to have heard of about 15 women’ death around pregnancy and more than 20 new-born and infants in her 17 years of her marriage in the community.
“Here, pregnancy is a big issue for us the women and to our loved ones by extension. Worse is when it happens during raining season. My husband just shared our personal experience with you. It was a sad one. I felt as if heaven was let lose against us. We saw hell.
“Lack of PHC close by was the major problem. Many of us don’t go for antenatal care when we are pregnant. So, even if there is any issue that needs medical attention, many of us will not know until it become unbearable.
“We have no road to go to hospital during emergency. Even water we don’t have. It’s only during raining season we do have water in the well. Now, we have to go to other communities like Doka, Sabon Jero. The most important thing to us is hospital. We need a PHC even if it’s just two rooms. We need clean water and road”, she requested.
To pregnant Pambolo Joseph, 20, mother of one, Kanrafi B, the idea of going to health facility for antenatal care is a dream, “I don’t go for any antenatal and so are many of us here. They said there is one maternity at Doka Maijamah which is very far. I don’t go at all because of distance.”
Another resident, Lemuel Guwam, husband of two wives said, despite the fact that the Kanrafi B has being existing for decades as food hub of Kaduna state, development indicators still far from there.
(An FP service provider at one of the FP facilities in Kaduna – Photo credit to Shola Ojo)
A nurse with Abyelo Clinic, a mini private clinic at Kurmi Shata, Biyayya Simon confirmed the challenges people in this clustered communities are experiencing in seeking medical help especially, during pregnancy.
“We do have cases of women with complications during birth. Some of them don’t come for antenatal. They are sometimes brought to our clinic when it became difficult to give birth. What we do in such cases is to refer them to hospital in Kujama.
“The major problem is that of access road. As you can see, no any major road from here to Lokotoko from where you can get tipper that will take you to the main road. So, it is a difficult task to be pregnant here. A PHC at the Centre of these communities which is Kanrafi B will relief many reproductive age women of age long burden associated with pregnancy”, she said.
Another nurse with Community Clinic and Maternity, Danhonu II, New Millennium City, Chikun local council area of the state who did not want her name in press said, “we also have cases of complications due to use of expired drugs.
“You know, because of lack of patent medicine store or hospital close to the people, what they do is to get some essential drugs whenever they have the opportunity of entering the town.
“They buy and keep the drugs which they may not use for a long time. These drugs are not properly stored. They are on many occasions exposed to high temperature and dust. The drugs get expired without them knowing so when the need arises, they just take the drug and that sometimes affect their health.
“Due to our location, we are like save haven for many women around here. We admit where we can and we refer to hospitals like 44 Army Reference Hospital in Kaduna and other hospitals”, said.
Kaduna Primary Healthcare Agency Speaks
Reacting, Assistant Director, Kaduna State Primary Health Care Agency (KADPHCA), Hamza Ikara reiterated the commitment of the state government through the agency in improving health care services of our people up to those hard-to-reach communities.
“Despite the fact that the state government has put in place a lot of measures to improve to improve its health care services. Upgrading of minimum of one PHC per ward is ongoing.
“We still have more than 1,100 facilities across the 23 LGAs and immediately after the completion of the upgrade of the 255 PHCs, we will continue with upgrading of other facilities.
“We also have programme for hard-to-reach communities where we are providing services at over 400 of them across the state. We attend to immunization and other minor ailments”, the government official said.
But these governments’ efforts seem not to be enough or acceptable by a leading non-governmental organisation working around maternal health and other social issues in Nigeria, Women Advocates Research and Documentation Centre (WARDC).
The organisation noted regrettably that, rating the country second to India in worse scenarios like high maternal mortality rate was shameful and unacceptable, hence, the need for government at all levels to go beyond window policies to add human face to what they do in this regard.
Director, WARDC, Dr Abiola Akiyode-Afolabi said, the federal, states and local governments must implement Abuja declaration of setting aside 15 percent annual budget to health finances in the country to save more women from avoidable deaths due to childbirth complications.
According to her, “We are not happy that after several calls on the federal and state governments to earmark 15 percent of their annual budget to the health sector of the economy, they are still struggling between six and seven percent as against the Abuja declaration of 15 percent.
“It is shameful that we still lose 814 women in every 100,000 livebirths at national level and its even higher in some states. Even smaller countries like Swaziland have started 15 percent implementation of the Abuja declaration of 2014 despite having smaller size and economy. We have to double efforts in terms of financial and political will because action is the key.
“Issue of maternal mortality is social, political and economy. We need to add human face to our policies. We have a record second to India. It is a big shame.
“As citizens, we should continue to hold government to account. People should be sensitised to get the right information that can equip them to ask their political representatives relevant questions. It is not good for any woman to die because she wants to give life. We want Nigeria to reduce its maternal deaths from 814 to 70 from there, we can beginning to talk about reducing it to zero.