In this report, Sunday Ehigiator writes that the second edition of the Nigerian Health Watch, NHW, ‘Celebrating Womanhood Art Gala’ recently held in Abuja with the theme, ‘Elevating Women’s Voices for Quality Maternal Healthcare‘, was focused on using art to draw gainer attention for quality maternal healthcare in Nigeria
Over time, art has been used to record history, shape culture, cultivate imagination, and encourage individual and social transformation. This is strongly tied to the power of art to captivate the mind and graphically control it to better understand reality.
This is the advantage art brings on board when using it to promote maternal healthcare for women.
Maternal Mortality in Nigeria
According to the World Health Organization (WHO), the Maternal Mortality Rate (MMR) in Nigeria is 814 (per 100,000 live births). The lifetime risk of a Nigerian woman dying during pregnancy, childbirth, postpartum or post-abortion is 1 in 22 women; this is in contrast to the lifetime risk in developed countries estimated at 1 in 4900.
According to MSD for Mothers, “A woman’s perception of the care she receives is an integral part of her clinical experience and therefore, an important consideration in improving the quality of maternity care. Maternity care that focuses on women’s needs and treats women respectfully is likely to lead to greater satisfaction as well as better and more equitable health outcomes.”
Current evidence suggests that the high maternal and neonatal mortality rate in Nigeria is linked to the three forms of maternal delay proposed by Thaddeus and Marine.
These barriers include delay in the decision to seek maternal health care, delay in locating and arriving at a medical facility, and delay in receiving skilled pregnancy care when the woman gets to the health facility.
Despite efforts targeted at addressing maternal deaths across national and sub-national levels, the maternal mortality ratio has remained high in Nigeria in the last two decades, with the country currently accounting for about 20 per cent of global maternal deaths.
While improving the overall quality of healthcare is crucial to addressing the high maternal deaths, some country-specific issues need to be explored.
To address the challenges associated with the three delays which prevent women from receiving adequate timely maternal health care as earlier stated, there is a need to improve access to Skilled Birth Attendance (SBA) especially through better quality Primary Health Care (PHC), improve quality of care provided within tertiary health facilities, while also making access to quality healthcare affordable, accessible and available.
Additionally, the WHO associated the high prevalence of maternal death in Nigeria with inequalities in access to health services as women in resource-poor settings are least likely to receive adequate, timely and affordable health services by skilled personnel compared to their counterparts in more developed countries.
Needless to say that awareness of MMR in the country and how it can be better addressed, precedes the listed solutions, hence the reason why NHW decides to draw the public’s awareness to the need for quality maternal healthcare for women, using the ‘Womanhood Art Gala’.
The Womanhood Art Gala
The Nigeria Health Watch Womanhood Art Gala was organised as part of activities to commemorate International Women’s Month in March 2023.
The theme acknowledges that women’s perspectives, insights, needs and experiences are frequently overlooked in decision-making, policy design and implementation.
The art gala was aimed at advocating for maternal health programmes and services that incorporate and centre women’s experiences and perspectives to improve the quality of maternal care.
Nigeria Health Watch held its first #HealthMeetsArt, Celebrating Womanhood Art Gala in 2021, where it used creative art to raise awareness and motivate stakeholders to take action on maternal health and other gender-related issues.
The gala allowed art lovers and interested stakeholders from around the world to interact with the artwork while also considering the need to improve maternal healthcare in Nigeria.
The art gala was organised with support from the National Gallery of Art (NGA) and the Female Artists Association of Nigeria (FEAAN) curated art pieces from selected female artists and showcased same at the event.
Elevating Women’s Voices
Speaking at the event, The Managing Director of Nigeria Health Watch, Vivianne Ihekweazu, said women’s voices were important because ultimately a woman knew her needs and the experiences she had had.
She noted that women’s perspectives and experiences before, during and after childbirth provided critical insights on how to strengthen maternity care and design systems that worked for all women.
According to her, “The experiences a woman has been close to, and anything about maternal care is a journey. It is a nine-month journey the woman goes through. Throughout those nine months, there are many issues the woman may face.
“And at every step of her journey when she accesses healthcare in the home or community, listening to her voice and her needs can be very important because that is the only way to address them.”
Ihekweazu added that art was used to elevate women’s voices for maternal health because it can be used to express different issues,
“Traditionally, when we talk about maternal health or healthcare, we sit in conferences and meetings, but with art, it is a physical expression. So, to a woman, it means many things, and there are many things we can experience from that single piece.
“According to SDGs’ target for 2030, we shouldn’t have more than 70 women dying from childbirth. But currently, according to NDHS, it is 512.”
Government and CSO Role
Also speaking, the First Lady of Kebbi State and Founder of Medicaid Cancer Foundation (MCF), Dr Zainab Shinkafi-Bagudu, said interventions from government, partners and Civil Society Organisations (CSOs) had helped to improve maternal health indices in Kebbi State.
She said that the state leveraged the existence of community development committees to influence decisions and social behaviour, noting that this had made a huge difference in the maternal indices in the state.
According to her, “We have a lot of maternal health issues in Nigeria but through interventions, we are not doing so badly, we are improving some of our indices.
“We are using community development programmes with partners to bring change for women. The maternal health clinics offer an improved opportunity to get cervical cancer screening. The outcomes we are seeing are enormous. Leveraging this can impact our cervical control programme.”
Similarly, the Director of Public Health, Federal Ministry of Health (FMoH), Dr Ngozi Azodoh, said, “Women’s voices are important. I believe that women are powerful; we just need to remind them.
“We must remind mothers that they are so powerful; they can change the world. When we have the opportunity, we must create opportunities for other women to speak up, and take them to their rightful position. At the FMoH, we mentor young women.
“As a mother and wife, your platform is endless. Women are the neck that turns the head. As sisters, we stand in the gap all the time. Let us remind ourselves how powerful we are and can be.”
The Power of Voice
Also speaking, the Resident Representative of the United Nations Population Fund (UNFPA) in Nigeria, Ms Ulla Elisabeth Mueller, said,
“The power of what you are seeing today is that of voices. I hope that the power of the arts and voices can be seen. Today will be a reminder of how many women die giving birth. I hope that we will bear that in mind and lend our voices to save our sisters, friends, mothers etc.”
The Country Director of PLAN International Nigeria, Dr Charles Usie, noted that “We want to celebrate womanhood in a very special way. In the office, our first assignment is to ensure that our lives reflect women’s empowerment.
“For us is a connection that influences our everyday lives. Women’s issues are not a good thing to talk about but the right thing. We believe the issues women go through should be a thing of priority. Women should earn more in the allowance we pay for food contingencies.
“I believe in a world where women will earn more than men and have more days for maternity leave.”
MSD for Mothers Commitment
Also speaking, Nigeria Director, MSD for Mothers, Iyadunni Olubode, said, “We’ve committed to ending preventable maternal deaths in Nigeria.
“This is not only because of the country’s high burden of maternal mortality but also because we are optimistic about the tremendous potential of Nigeria’s local private health sector, which serves more than 60 per cent of the population, to help solve the problem and sustain gains in women’s health for years to come.”
She said formal channels to integrate women’s perspectives and preferences would fortify and sustain efforts to improve quality throughout the continuum of maternity care.
“To every woman receiving care, your opinion counts. What you have to say matters; you must use your voice.”
The White Ribbon Alliance
The White Ribbon Alliance enumerated five reasons why women’s voices matter when it comes to reproductive and maternal healthcare.
Providing more insight on the alliance, the Director, Advocacy and Programs, at White Ribbon Alliance, Kristy Kade, said, “At White Ribbon Alliance, we push for women’s perspectives to be included in the design of new health programs and policies and the strengthening of existing services.
“Here are the top five reasons White Ribbon Alliance believes women’s and girls’ voices can transform healthcare for the better.
“First, when women and girls have a voice, progress accelerates. Nobody knows the challenges or the solutions better than the people using the services meant for them, so involving them from the outset is a no-brainer.
“Secondly, quality means different things to different people. In a community without running water, the top priority for women might be that all clinics are equipped with clean water and proper sanitation and hygiene. In another mired in the ongoing conflict, it may be a safe place to give birth and care for an infant.
“Thirdly, the global health community has made tremendous progress when it comes to women’s and girls’ health, but we are starting to see that progress stall, even slide backwards in some countries. The missing piece is hearing from women and girls themselves. Now is the time to accelerate our efforts; to do that we must put women at the centre.
“Fourthly, if we are to create truly sustainable, effective reproductive and maternal healthcare programs and policies for women and girls, they must be grounded in what matters most to those we are creating programs and policies for, until that happens, policies will not be enforced and services will go unused.
“And lastly, when women receive quality healthcare, they tell their sisters, daughters, friends and neighbours. Quality health services are born from involving those they are meant for. It’s not enough to encourage women and girls to seek care from trained midwives, health clinics or hospitals, the care they receive must meet their needs.”
We must remind mothers that they are so powerful; they can change the world. When we have the opportunity, we must create opportunities for other women to speak up, and take them to their rightful position. At the FMoH, we mentor young women