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Health Interactive with
Dr Aminu Magashi UNICEF and
Maternal/Child Health At one of the UNICEF Planned Project of Action ( PPA ) meetings in the past, an official of the agency who was also among the presenters in that meeting summarized the role of UNICEF to me during a break session. He mentioned amongst others that, UNICEF is like a butter or cheese in a container and the entire world's children are trying to get their share and spread it on their bread for consumption. From that beautiful example, one is bound to deduce that UNICEF cannot cater and solve the entire problems of the world children even if the agency wishes to do so, it is an appetizer, a moral booster and a stimulator and a helping hand to address the needs of children. Those who are responsible and expected to shoulder the needs of the children are the governments in other words, the member states of the United Nation. I totally agreed with that analogy and of course it is the responsibility of government, in our own nation, federal, states and local governments to lead the process of protection, survival, development and participation of Nigerian children towards sustainable development. However, one cannot talk about children needs without involving women due to the inter connectivity in their plight and mutual co-existence. My understanding of UNICEF involvement is to do with provision of capacity building , social mobilization as well as advocacy and at times service delivery, these strategies are part and parcel of the Master Plan of Operation between UNICEF and Federal Government of 2002-2007 country programme goal, overall objectives, strategy and beneficiaries. From 2002 to date, UNICEF Nigeria has being engaged and working with stakeholders in the development of women-children friendly services certification process, it commences by drafting a guideline for assessing hospitals whether such establishments are women and children friendly or not. After which , stakeholders are called upon periodically for zonal meetings to be abreast about the draft and of the assessment and later on certification, which is to say ‘Hospital A is a women-children friendly center while hospital B is not women-children friendly center. In the last two years, as part of the new country programme, a lot of time has been wasted in the process which also translates in to waste of resource and funds to finance meetings and accommodate government officials and some selected stakeholders all in the name of understanding a draft and how to use it. If that formula in addressing maternal and child health is not a window dressing and decoration and a wild goose chase, then nothing can best describe that mis-priority. Let
us digress a bit and look at those yard sticks that make a place
women-children friendly center. In a news report tagged 1000
children die daily in Nigeria-UNICEF published in Daily Trust of
Tuesday, 19th October, 2004, the representative of UNICEF
Country Representative in person of Ms Barbara Reynolds reportedly
mentioned that the National Demography and Health Survey of 2003
indicates that the under five mortality rate has jumped to 217 per 1000
live birth while the UNDP Human Development Report indicates that the
maternal mortality rate has increase to 800 per 100,000 live birth. In
some states, I have to add that the rate is about 2000 per 100,000 and
that figure if it is not the worst globally, certainly it will be close
to that. The programme is the launching of the women-children friendly
services in Other
goals are to improve delivery of care and services to newborn, growth
monitoring, immunization and integrated management of child hood
illnesses and prompt referral. The women-children friendly services
launched include national standards and criteria, health facility
assessment, testing guidelines, facility designation process and
supervision, monitoring and evaluation system. To
add another guideline if allowed, is to say that there is the need to
put boldly on the notice board out side any hospital that ‘ This
center is women-children friendly establishment and if those that were
found to be unsatisfactory based
on the criteria, should carry a negative message. From the time the formula is introduced in 2002, it took the agency and its government collaborators 2 years to launch it and it will take probably another 2 years of hard labour to complete the assessment, certification and conveying another series of meetings to plan the way forward to improve our bastardized public hospitals which are mere consulting units and mortuaries. When someone visits public hospitals, one is left with no doubt that our public institutions are in total shambles that need total overhauling. A pediatric emergency unit that is designed to respond to emergency problems is devoid of resuscitative facilities, such as Suction machine , oxygen gas cylinder with the gas inside and anti convulsive drugs , if a child is rushed which is the routine not the exception , a doctor or a nurse can only make a spirited referral to either private clinic or tertiary health institution if such exists in that environment , at times before the child is rushed out, the health worker will be called to certify his/her death. One will come across an entire pediatrics ward being filled up with malnourished children who are being fed through naso-gastric tube or intravenous infusion and receiving treatment as a result of numerous complications attributed to Malnutrition. Even the UNICEF prepared oral rehydration solution (ORS) is no longer available and free, one needs to purchase it in a chemist. On visiting maternity section, a lot them do not have basic equipments and facilities for timely obstetric procedures, in some places, not even a hand globe is found, not to talk of emergency drugs and infusions. In some places, beds dedicated to labour and delivery are inadequate which warrant women queuing up for delivery or at worst deliver on the floor. In some states, a complete ward is dedicated to Eclampsia alone, a problem that is highly preventable. When I mentioned that, UNICEF is to provide advocacy and capacity building , I dispassionately mean that the agency should use its meager resources to engage government at various tiers so that resources and fund towards maternal and child health services are provided through provision of facilities, drugs and investing in human resources towards health for all and more importantly to ensure policy reforms . That approach is far better than accommodating the same policy makers and government officials and civil society in luxurious hotels for days using the meager resources meant for children , all in the name of teaching them how to assess and certify hospitals on whether they are women-children friendly centers or not . Dr Magashi Is the
Executive Director, Community Health and Research Initiative, |