Reducing Maternal, Child Mortality, through Health Workers’ Empowerment

21 Feb 2013

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Child Mortality

No doubt, maternal mortality is high in Nigeria, but an international private organisation, PATHS2 said all hands are on deck to checkmate the ugly trend through the empowerment of health workers, Steve Dada writes

Without any reliable medical record, the health care workers believe that 75 per cent of maternal deaths in Nigeria occur in the rural communities where pregnant women do not have adequate information about what they need to do when they are pregnant.

Also in the rural communities, there are no reliable health care institutions to cater for women during child delivery, as most fairly equipped hospitals are concentrated in the urban areas, making the pregnant women to rely on the Traditional Birth Attendants (TBA), who do not possess the necessary skills to carry out save child delivery, particularly when there are complications.

The referrer system in the health sector has broken down, thus complicating the situation for most pregnant women during delivery. At a recent training of doctors in Lagos State on the use of latest Ultrasound machine organised by Partnership for Transforming Health System 11 (PATHS2), a programme funded by the government of the United Kingdom (UK), a Chief Consultant Gynaecology to the State government, Dr. Godwin Akhabhoa in an interview with THISDAY explained that, there are various reasons why pregnant women die during childbirth.

According to him, “most pregnant women in the rural communities do not have access to adequate medical services capable of taking care of them when complications set in and besides the health care centres are far from where such women reside, therefore making such women get to the nearest hospital always too late, especially with difficult transportation service in Nigeria.”

Akhabhoa emphasised that even when such women get to the hospital, the delay usually experienced before they are attended to could cause deaths, noting that some of the materials needed to rescue pregnant women may not be readily available.

Talking about the importance of the ultrasound machines, Akhabhoa, who claimed to be a super -user of the machine said that every gynaecologist who knows the importance must make use of such machine to do a successful child delivery. He said most of the methods employed in the past to care for pregnant women are now obsolete, stressing that what will normally take some weeks to discover pregnancy can now be detected in a minute with the use of ultrasound.

He said for instance, ultrasound will indicate whether the baby in the womb is well positioned or not, or whether the baby is in the uterus or outside the womb, which is the case of ectopic pregnancy, which could therefore guide the doctor on what to do about the pregnancy and will also tell the doctor whether the baby is growing or not.

He said it can be the case of the placenta covering the lower part of the womb, which requires medical intervention before delivery, stressing that in such a case if the placenta has dropped to the lower part of the womb and not detected before delivery, the head of the baby will burst the placenta before coming out, which in most cases leads to internal haemorrhage (excessive bleeding) in which a woman can bleed to death.

According to him, if it’s discovered that the placenta has dropped to the lower part of the womb through the use of ultrasound scanner, it’s better to perform a surgery on such woman to bring out the baby instead of normal delivery.

The medical expert who is a member of Society for Gynaecology and Obstetrics of Nigeria (SOGON) said an ultrasound is a must for every hospital for successful ante-natal services aimed at reducing maternal mortality situation of Nigeria. “The society has put a policy in place to regularly visit hospitals in the rural communities where they give free lectures to the women on what they need to know and do when they are pregnant. Also the group is implementing a programme that will ensure that when a pregnant woman dies during child delivery, the cause is known,” he said.

PATHS2 National Programme Manager represented by Lagos State Team Leader, Dr. Bisi Tugbobo explained that the training is part of efforts of PATHS2 to reduce avoidable deaths of women and babies and improve health care delivery by empowering medical doctors in secondary health facilities across its focal States with ultrasound application skills.

According to her, PATHS2 has supported its focal States of Jigawa, Lagos, Kano, Enugu and Kaduna with drugs and medical equipment, with donation of ultrasound to health facilities that provide comprehensive emergency obstetrics services just as training is being provided to build the capacity of health workers to use the equipment effectively in their health facilities.

“With the use of the ultrasound machines, the doctors can make better decisions on how to deliver babies, confirm multiple pregnancies, abnormalities in babies, wellbeing of mother and baby among others,” she stated.

Tugbobo noted that the skill gained by the doctors will improve quality of health care service delivery as well as hopefully lead to a greater patient satisfaction in the services provided by the benefiting health facilities and stressed that PATHS2 is committed to reducing maternal and infant mortality rate assuring that it will continue to support Nigeria to actualise its health related Millennium Development Goals (MDGs).The training is aimed at reducing maternal and child mortality, by providing workers with skills and knowledge to effectively manage obstetric conditions that can be fatal to mothers and their babies. Since inception, a total of 80 doctors selected from PATHS2 Focal States were trained at a capacity workshop at the Lagos State University Teaching Hospital (LASUTH) by a team of clinical application specialists.

PATHS2 she noted is a six-year health systems strengthening project aimed at improving the financing, planning and delivery of sustainable, replaceable, pro-poor services for common health problems in Nigeria. “It is working to improve health system in Nigeria by enhancing the skills of health care workers.

“It also improves facility infrastructure, galvanising communities to participate in making decisions for health services and improving access to quality healthcare delivery, by providing services to improve maternal, newborn and child health.

“For the past four years, the project has been successfully responding to health challenges, making ground-breaking progress in governance and enabling health system reforms and the implementation of a technically-sound, responsive service delivery strategy,” she said.

The leader of the team, Dr. Susan Wanjau of the Philips Healthcare in Nairobi, Kenya described the ultrasound machines provided by PATHS2 to the facilities as the new ClearVUE 550 models, which is one of the best in its range. ‘’The versatile ClearVue 550 ultrasound with active array technology offers image quality designed to enhance diagnostic confidence, delivering diagnostic images with quality, speed and precision,’’ she explained.

‘’It is very sad that we are losing our mothers unnecessarily, but the machine will reduce the rate of mortality in the rural communities. Education for the health workers is important so that they also can go and educate the rural women on the importance of scanning. It is important to do scanning at least two times before delivery,’’ she advised.

Tags: Wellbeing, Featured, Child Mortality

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