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Nigeria’s Delegates at Global Women Deliver Conference By Dr. Aminu Magashi
From 17th to 20th October 2007 , Leaders ranging from United Nation System , International Non Governmental Organisations , Bilateral Donor Organisations , International Private Foundations , Heads of Health Ministries and Academia from many countries , MPs and Policy Makers interacted actively at Excel Centre , London to discuss issues around addressing the worrisome high Maternal Death across the globe .
The Lancet Paper of that week captured the essence of the Global Women Deliver Conference brilliantly in its cover page “Since the human race began, women have delivered for society. It is time now for the world to deliver for women.” According to many reports , more than half a million women die each year due to complications during pregnancy and child birth , most of which could be prevented with appropriate maternal health services and care . Nigeria and India are accounting for one third of that calamity yearly.
The Conference had observed that 20 years ago “The global health community came together to highlight the most striking inequity in public health ……. High Fertility , inadequate and inaccessible health services and women’s low status meant that women in the poorest regions of the world were 500 times more likely to die from pregnancy – related complications ( one in 20 risk ) than women in northern Europe ( one in 10,000 risk ) .” At that time the Global Safe Motherhood Initiative was launched to generate political will, identify effective interventions and mobilise resources that would address such injustice.
In some regions especially in middle income countries in Latin America and Northern Africa, the Maternal Mortality has declined. However many countries are still by far lagging behind and with that , attainment of reducing Maternal Death by 75 % by 2015 is still a Herculean task.
I felt thrilled by attending the conference in a city that hosted me very well for a year for my Masters Degree Course not too long ago and more importantly travelled with many senior colleagues from Nigeria and throughout the journey had wonderful conversations around the issue of Nigeria’s worrisome maternal mortality ratio, the worst after India. This article is dedicated to Nigeria’s delegates at the conference and of course in line with what we were doing, not doing and what might be the areas to look upon for effective interventions.
In that conference from Nigeria where all those who call the shots in the area of Sexual/Reproductive Health Interventions in the country . The Minster of Health was represented by a senior director, Country Leaders of MacArthur and Packard Foundations and Pathfinder International as well as the Presidential adviser on achieving Millennium Development Goals ( MDGs ) , so also the Chair of MDG Committee in the Federal House of Representatives had graced the conference . Leaders of many National NGOs working around Safe Motherhood, few commissioners from some states and professional groups such as Society of Gynaecologists and Obstetricians made their presence.
In one of my many informal discussions with Hajiya Bilkisu Yusif at the conference, chair of Advocacy Nigeria , she lamented that our local Media were not represented . They supposed to report the events and engage policy makers on the need to invest in Maternal Health Services. So also our 774 Local Governments were not visible, if at all some were in attendance. Majority of all maternal deaths happen in communities where Primary Health Care Services were almost not existing .
A lot of funding is coming to Nigeria through many International Private Foundations (MacArthur and Packard and Bill Gate e/t/c ), Bilateral Organisations like USAID and DFID and United Nations System to address Maternal Health . In that conference MacArthur Foundation with Pathfinder International have launched a good initiative worthy of commendation to the tune of 11 Million Dollars to expand the use of an innovative new tool – The Anti Shock Garment- along with other simple technologies to help reduce maternal deaths and morbidity due to Post Partum Haemorrhage in India and Nigeria.
Postpartum and Antepartum Haemorrhages together with Eclampia and Obstructed Labour are accounting for the majority of all maternal death in Nigeria. With these problems and delay in decision making at community level , delay in transporting women to hospitals equipped to provide emergency services and delay of care at the health centres , Nigerian women will continue to suffer and die everyday due to many preventable problems of pregnancy and child birth .
Development partners are doing their best putting funding in providing services, awareness creation, capacity building and leadership training to advocates /activists . The huge funding gap which I strongly believe should be of paramount importance is how to engage Policy Makers across the three tiers of government innovatively to put resources in addressing Maternal and other Health Problems . No matter the amount of money and projects Donor Governments and Development Partners put in Nigeria, it will only make some impact and die gradually and cannot be sustained unless leaders are empowered to put resources where there is need.
The Lancet ( Vol 370 , October 13, 2007 , 1307 ) according to Pius Okong Profile; Saving Mothers’ Lives in Uganda and Worldwide “The Biggest Challenge to those working in Maternal Health is capturing the commitment of political leaders …… the situation cannot improve until Maternal Health is established on the political agenda of developing countries….”
I agree with Dr Okong assertion about the need to put Women’s Health among the top priority issues on our Political agenda. In Nigeria , we spend a lot of time and resources at Federal and State Governments and putting little funding to LGAs . However , majority of all Maternal Death occur at communities where Primary Health Services have almost collapsed . The 20th Anniversary of Safe Motherhood Initiative should be a time to look back and make a critical review of all Sexual and/or Reproductive Health Interventions and evaluate why Nigeria’s Maternal Mortality Ratio is not improving over the years.
There’s so much financial resources at the Local Government levels, but are not been utilise very well to reach the women in need of Maternal Health Services. It is time new projects emerge to innovatively engage Policy Makers at LGA Levels through advocacy and empowerment as well as provide capacity building and community mobilisation that will meaningfully lead to communities demanding for services from their leaders in the area of meeting the unmet need of Contraceptive Services, Emergency Obstetric and Ante Natal Cares, Regular Training and Supervision of Health Workers and community participation to ensure quality and equity and efficiency in the delivery of services .
Dr Magashi is the Executive Director of Community Health and Research Initiative, Kano , Nigeria . He can be reached at GAmagashi@gmail.com or healthinteractive@hotmail.com |