Despite of the new platforms launched by the Federal Government to tackle the burden of maternal mortality, experts in public health insist that Nigeria may continue to be a hot bed for maternal deaths on account of nearly non-existent primary healthcare in the country.
Faisal Shuaib, Executive Director, National Primary Health Care Development Agency (NPHCDA), has decried the alarming statistics and called for prompt action.
“Every day in Nigeria, approximately 145 women die from preventable causes related to pregnancy and childbirth. This is equivalent to having one Boeing 737-300 series aeroplane, fully loaded with 145 women crashing every single day in Nigeria, and killing everyone on board”, Shuaib said.
Recently, the Nigerian government launched the Nigeria Reproductive, Maternal, Newborn, Child, Adolescent and Elderly Health Plus Nutrition (RMNCAEH+N) platform. The platform seeks to improve the well-being of women, children, adolescents and elderly in Nigeria.
Government also introduced the National Emergency Medical Ambulance system, NEMSAS, to respond to medical emergencies, to reduce lives lost in emergencies by 50 percent including emergencies around child birth.
The minister of health, Osagie Ehanire, while launching the platform lamented that Nigeria had the worst burden of maternal deaths, with a ratio of 512 per 100,000 live births and 67 out of every 1,000 live birth in Nigeria die at infancy.
While there are several medical and non-medical factors responsible for maternal mortality, experts say the most underlying factor has been inability to access the minimum level of care or reaching the the hospital and not attended to.
Aural Musa, Executive Director, Civil Society Legislative Advocacy Centre (CISLAC), said the dire lack of functional Primary Health Centres across the country was the leading factor giving rise to deaths of Nigerian women and children, because they cannot access the most basic care they deserve.
According to Musa, Primary Health Care should be the first contact at levels of care, but a lack of functional centres results in overburden of Secondary and Tertiary health care facilities with basic ailments that PHC was established to addressed.
“The burden exacerbates the existing high patient-to-doctor ratio. It also amplifies delays in accessing minimum level of care for maternal and child health”, Muaa said.
Available statistics from trends in Maternal Mortality show that 23 percent of global maternal deaths occur in Nigeria.
Adaobi Onyechi, a public health analyst, says though all the plans rolled out by government are good, what is urgently required is concerted efforts and attention to the establishment of functional primary health centres, which according to her are non existent.
“There has been so much talk about the revamping of these facilities in every ward of the country but I don’t see any progress being made to that regards. If there was a primary health centre in every local government area at the very least, it makes it much easier for women to access health services and this will improve significantly the indices on maternal care”, she states.
The ambulance services proposed by the federal government may be out of reach to women in rural communities being that it is being designed to run like an uber service, and will likely excavate the burden of out pf pocket payment, she notes.
She further stresses that improving access to care is not enough, ensuring availability of quality care and medicines before, during and after child birth is key, and urges government to expedite actions in identifying and addressing the gaps fuelling maternal mortality.
In January 2017, federal government pledged to revitalize 10,000 PHCS across the country. President Muhammadu Buhari said at the time that the aim was to ensure quality basic health care services were delivered to the majority of Nigerians irrespective of their location in the country.
The federal government says 4,000 of PHCs have so far have been revitalised, but the minister of health admitted that what had been done so far was not good enough and not up to the standard of an ideal PHC. He said government would redesign and remodel the centres with state of the art facilities.
Despite being described as the bedrock of health care, PHCs are yet to receive adequate funding as the Basic Health Care Provision Fund (BHCPF), is yet to be implemented. In September 2019, the federal government disbursed N6.5 billion to 15 states and FCT, but findings revealed that none of the states are yet to access the fund and the money has not reached any PHC in the beneficiary states.
