• Most still face hurdles to safe delivery
By Onche Odeh
It was a regular Ante Natal Clinic Day (ANC) at Orisunbare Primary Health Centre. The waiting hall of the clinic, which wore a decent look apparently from a face-lift it has received a few months earlier from one of the international health support agencies, was filled with pregnant women and a few other mothers who had visited for their ANCs and other issues, as the health centre also entertains people with basic health conditions too.
Some of the women in the crowd were carrying their first, second, and fourth or more pregnancies.
They, however, had one common reason for being there. Someone had referred almost each of them to the centre, which is considered cheap.
It is, of course cheap, as confirmed by some of the patrons in separate interviews with Daily Independent.
Buky Rufai, is carrying her second pregnancy, which is in the second trimester. She was visiting the Orunsibare PHC for the ANC for the first time.
She had been referred by her friend to give the PHC a trial, as she used a private Hospital in Shasha area, within the same vicinity for the ANC and delivery of her first child.
Speaking on this in an interview with Daily Independent, she said, “For each Antenatal, I had to pay N1,000 and I paid N25,000 for the delivery.”
This is, in no way, comparable in cost to the free ANC registration, N800 token for laboratory test and the N2,000 fee for delivery at the PHC.
As cheap as it looks, paying has been identified as a deterrent factor for many women. This is a direct consequence of the widespread poverty, as most families in the Akowonjo axis are low income earners, with majority of them being petty traders.
Mrs. Ruth Omolodu, who is not new to the PHC said, “We pay N800 for lab test, and small amount of money for drugs.”
When ask if this small amount of money meant anything to her, she said, “Of course. You know what that can do for as a trader in the market,” adding, “You know the price of food has also gone up,” in an expression that suggests that most of the patrons of PHC in low-income settlements across Lagos are also struggling to feed well.
A particular concern is how the Orisunbare PHC could cater for the inherent Antenatal and delivery needs of a population of over 40,000 people.
At the Akowonjo PHC, which is one of the model health centres of Lagos, an ambulance was conspicuously stationed, and the high tempo of activities is obvious.
At about 1 pm when Daily Independent visited, the PHC had seen over 100 patients, of which about 90 per cent are pregnant women.
There, it was obvious that the facility is strained. This was alluded to by Chief Rasheed Akinmade, the Vice Chairman of Akowonjo Local Government Ward Health Committee (WHC), a committee driven initiative created to bridge the needs of the health facilities, and at the same time promote access to the PHCs.
“Problem is that the PHC does not have enough space to accommodate the large number of women that come here for ANC and other medical attentions.
“Imagine heavily pregnant women being made to sit on very hard benches. Imagine them combining the pains they are going through with additional pains from the environment.”
Chichi Nkire, a development consultant and member of the Lagos State Civil Society Partnership (LACSOP), who has worked with some of the PHCs in Lagos speaks of the challenges they face that could put the lives of many pregnant women in danger in an interview with Daily Independent.
She said, “A lot has been done to ensure that there are adequate facilities in Lagos hospitals and PHCs for safe deliveries and pregnancy management. But some challenges still abound, especially at the local PHC.”
Elaborating on some of these issues, Nkire said, “The issues include those concerning labour. It is common knowledge that most deliveries occur at night. But most of the PHCs barely have electricity supplies. I have worked in PHCs where the nurses are forced to deliver women of babies with candle lights. This makes things difficult for them and this may lead to loss of life, or other complication.”
She also noted that movement to safety for pregnant women who are in labour and those faced with complications is usually a big deal.
Although the Lagos State Government has an ambulance system that helps on some occasions, Nkire said this help is highly limited, as the state has a high number of cases to deal with per time. She said, “The ambulance system is another challenge. They are not well circulated. Most ambulances are at the General Hospital, and where you have clusters, it is usually parked in one, meaning if that one is in use, any other case deserving to be moved to another hospital on referral would be catered for by the patient. That can be challenging,” she said.
According to her, the ambulances could be rotated, just as they could be operated by more than one driver to ensure a more effective service.
Nkire who identified lack of political will on the part of the LG chairmen as another impediment to effective maternal health care service in Lagos PHCs, noted that partnerships with Millennium Development Goals (MDGs) programmes could help alleviate the situation.
Medical Officer In Charge of Akowonjo LG, Dr. Kayode Odufuwa, who acknowledged the challenges in Lagos PHCs, however, noted that attempts are being made to address them.
“Most of the PHCs have alternative sources of power, just as the services are almost for free, except in some cases. NYSC doctors are also being drafted to some of them that did not have doctors, and the result have been increase in the number of deliveries and ANC attendance in the facilities,” he said.
Odufuwa also noted that the affordability of the services at the PHC has helped the personnel to teach many pregnant women how to ascertain danger by looking out for signs like spotting and bleeding, abdominal cramps, and sudden weakness, among.
Record from the family health division of the Federal Ministry of Health disclosed that about 5.3 million children are born yearly in Nigeria. However, it has also emerged that, out of every 100,000 live births recorded in Nigeria, 800 of the women involved would have died.
This is comparable to another study by the Nigerian Urban Reproductive Health Initiative (NURHI), which puts Nigeria’s current maternal mortality ratio at 576 per 100,000 live births. In May, the World Health Organisation’s (WHO) reported that Nigeria lost about 40,000 women due to childbirth in 2013, making Nigeria one of the most dangerous places for women to live.
The creativity of the WHC members has, however, been impressive, as they are not resting.
“We are approaching the Baales, the Obas, well meaning people and even the banks to help in which ever form so that we can have better PHCs,” Akinmade said.
Source : Independent