• Sunday, February 25, 2024
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Bridging gaps for transforming maternal mental health in Nigeria

Mental health is a universal human right

In Nigeria, the experience of pregnancy often comes with heightened anxiety and inadequate support for many women, who frequently turn to their faith in God as a primary coping mechanism. Recognizing this challenge, the Nigeria Health Watch conducted an investigation in May 2019, delving into the causes of maternal deaths and examining the mental health of pregnant women in the country.

One significant source of anxiety among pregnant women is the fear of labour and the increased risk of mortality during childbirth, further intensified by prevalent reports of maternal deaths in their communities in the dailies. These reports highlighted a lack of emotional and practical support from spouses, indicating a substantial gap in addressing women’s mental health and emotional experiences during antenatal and postnatal care.

Mental health problems during pregnancy, such as anxiety disorders, are significant issues in Nigeria. They can lead to poor physical health, persistent high-risk behaviours, an increased likelihood of obstetric complications, and reduced engagement with antenatal or postnatal care. The indirect consequences, including suicide, contribute significantly to maternal mortality.

To address these challenges, we advocate for a comprehensive perinatal care program in Nigeria, incorporating routine perinatal psychosocial screening and early antenatal and postnatal mental health assessments. Women with mental health problems should receive counselling and appropriate treatments during pregnancy.

To address these challenges, we advocate for a comprehensive perinatal care program in Nigeria, incorporating routine perinatal psychosocial screening and early antenatal and postnatal mental health assessments. Women with mental health problems should receive counselling and appropriate treatments during pregnancy. Moreover, there is a pressing need for improved and sustainable maternal mental health care delivery across all healthcare facilities in the country.

Patient-centred maternal care is crucial, and health workers must recognise and address the psychological aspects of pregnancy. Despite the prevalence of mental health challenges in Nigeria, access to mental health care remains limited. Authorities should enhance access through innovative community-based approaches, such as integrating mental health screening into existing maternal health programmes targeting both pregnant women and their male partners.

Involving male partners in integrated mental health services is essential, as their understanding of the psychological dynamics of pregnancy can provide significant support. Additionally, exploring the effectiveness of church-based programmes that utilise prayer sessions for early antenatal care and integrate health interventions through baby shower activities and receptions could yield positive outcomes.

Religious houses, often implicated in health-seeking behaviours, could be valuable partners in strengthening the psychological experiences of pregnant women. We emphasise the role of the government in driving change through policy improvements, curriculum enhancements for health workers, and adequate funding at all levels. The goal is to create a patient-centred approach to maternal care that complements behavioural changes at the grassroots level.

Addressing maternal mental health challenges requires a multifaceted approach that not only recognises the prevalence of these issues but also works toward tangible solutions. The anxiety experienced by pregnant women is not merely a personal struggle but a societal concern that necessitates collective efforts for lasting change. By bridging the existing gaps in maternal mental health care, Nigeria has the potential to ensure healthier outcomes for both mothers and their newborns, fostering a stronger and more resilient society.

Lead 1:

A rumbling, and A new beginning in the House of God

By Femi Olugbile

(an excerpt from a forthcoming book)

Q: In his sermons, he admonished the congregation to stop giving their children English names at baptism, and to be proud of their native names. He even once told him, Coker, that he thought palm wine should be served for holy communion instead of the expensive imported wine.

Lagos. Sunday, October 13th, 1901.

The mild October breeze blew in from the lagoon nearby, but the air seemed to swirl into a hot ferment inside the hallowed portals of the St Paul’s Breadfruit Church on the Marina. The pews were thickly packed with the congregation. Everybody seemed to have come in early, today, long before the morning service was due to commence.

J.K.Coker, the People’s Warden, had arrived much earlier than everybody else, as was his wont. His home, Rose Cottage, was only a short distance away. He paced about the enclosed space now, holding conversation with different members in a hushed voice. His handsome face was creased with worry lines.

Even at this late hour, he still prayed for a miracle.

Since the day in Abeokuta when, under the ministration of his father in the Lord ‘Holy’ Johnson, he had given his life to Jesus Christ, he had not felt his soul so troubled. He had spent much of the past night on his knees in his bedroom.

‘Holy’ Johnson was a man of great conviction, and daunting intellect, a Sierra Leonean slavery returnee who had gone into the priesthood and settled back into Yorubaland. His faith often left the faint of heart cowering before him and submitting to his point of view. In his tenure as the Vicar at Breadfruit, he had drawn in new converts in numbers that had not been known before. He was, in every sense, a warrior for Christ. But he also had certain ideas which sometimes frightened even his most ardent followers. He wanted Christianity to be domesticated and made culturally relevant in Africa, as, according to him, had been done in other places. He abhorred the sense of racial superiority shown by some white clergy to their African counterparts. He resented the humiliation that had been meted out to Bishop Ajayi Crowther in his old age.

Sometimes when he talked about how some white missionaries such as Rev Townsend openly advocated against putting Africans in positions of responsibility, his eyes dimmed in fury. In his sermons, he admonished the congregation to stop giving their children English names at baptism, and to be proud of their native names. He even once told him, Coker, that he thought palm wine should be served for holy communion instead of the expensive imported wine.

Breadfruit Church, as everyone knew, was located at the site of a big breadfruit tree where, many years past, slaves were tethered, preparatory to their embarkation on European slave-ships moored nearby at the Lagos port.

Coker pulled out his pocket watch and checked the time. It was approaching nine o’clock.

Perhaps one last try, he thought.

He beckoned to his friend Oguntolu. A few others got up from their seats and followed him as he walked with grim determination towards the vestry.

They passed Bishop Johnson where he sat. His eyes were closed in prayer. His demeanour bespoke angst.

He had come today, under instruction, to preach his last sermon, and say goodbye, knowing his time was up in the Church, and a successor had been appointed.

Bishop Herbert Tugwell was sitting in the great chair, in the vestry. His face wore a flushed, angry look.

Coker cleared his throat, as he stood before the white priest.

‘You need to reconsider, Sir. The Mission in England must acknowledge the strength of feeling out there’ He pointed towards the congregation.

Tugwell rose to his full height.

‘Canonical authority is sacrosanct. Anyone who does not wish to submit to authority may leave Breadfruit.’

There was nothing more to be said.

Coker turned on his heels. He was not quite sure where he was going.

The others followed him.

By the door, he divested himself of his warden ‘s robe and retrieved his agbada and cap.

As he reached the street outside, he could tell from the noise that most of the congregation were trooping out after him.

Instinctively he headed in the direction of Rose Cottage.

A song came to his mind, and he began to sing it:

Onward Christian soldiers

Marching as to war…

His singing voice was not good, but the song was immediately taken up behind him.

…With the cross of Jesus

Going on before…

They were making a journey of no return, like the slaves who had been tethered to the Breadfruit tree. But he knew in his soul that this was a journey to a new life. The African had to own his Christianity and be respected for it. White, black, and yellow men were children of the same God.

It was a spectacle such as had never been seen before, hundreds of worshippers in their Sunday finery, trooping through the streets of Lagos. Along the way, some people joined in, swelling their numbers further.

Rose Cottage had an ample compound that bespoke the wealth God had given him at a relatively young age, growing kola nuts and cotton in Ipaja.

Oguntolu led a service of sorts on that day, and everyone in the congregation sang and danced with gusto.

They would come again to worship at Rose Cottage the next Sunday. This time, there were canopies, and Oguntolu was ready with his first sermon, taking his text from Songs of Solomon Chapter 1, Verse 5.

‘Look not upon me because I am black…they made me the keeper of the Vineyard, but my own vineyard have I not kept…’

Within a few weeks, the congregation would put together money to build a temporary bamboo church on Balogun Street.

On the day the new Church was dedicated. Jacob Sylvanus Williams, a lay reader who would later become the first Primate of the African Church, officiated. He named the new Church ‘Bethel’. His words were evocative.

‘This day, we lay the foundation of the Church for the black race’.

The date was 22nd December 1901, three days to Christmas.