By Asmau Ahmad with agency report
The Nigeria’s Minister of Health, Dr Osagie Ehanire, says the lack of access to healthcare is the main factor contributing to high maternal, infant and under five mortalities in the country.
He said this during the News Agency of Nigeria (NAN) ministerial forum in Abuja.
The latest United Nations Children’s Fund (UNICEF) report titled “Situation of Women and Children in Nigeria” states that the country records 576 maternal mortality per 100,000 live births, while approximately 262,000 babies die at birth every year.
Also, infant mortality currently stands at 69 per 1,000 live births, while under-five deaths is 128 per 1,000 live births, with more than 64 per cent of the deaths due to pneumonia, malaria and diarrhea.
Ehanire, who said that the figure is embarrassing, added that the Federal Government is working toward extending healthcare to areas that lack services.
He added that “it is embarrassing when you go to conferences and see that your country has some of the worst indices and that’s one of the reasons why this administration is looking at extending healthcare to areas where we have problems.
“The area where you see this maternal mortality mostly is the rural areas where they have zero access to healthcare and where you will see that in spite of preaching inclusion, many people are actually excluded from the health service delivery.
“That’s why we are pressing for expanded primary healthcare. If you examine the causes of this high maternal mortality and also the infant mortality and the under-five mortality, you find that most of it is due to lack of access.
“There is no hospital there. Most of the women who deliver do so without skilled birth attendants, but once you have skilled birth attendants, maternal mortality reduces drastically.”
According to him, once Primary Healthcare Centres (PHCs) are functional with one in every ward, they should also be manned by experienced midwives.
He also said that the Federal Government was working with state governments to ensure staff complement every PHC because the states and local governments are responsible for all the personnel at the PHCs as they were the custodians of PHCs.
“If you have enough nurses and midwives, you will be able to offer service at all times. We are now pressing for PHCs that are open round the clock not only by day time, the dispensary can open by day but the PHCs will now be open round the clock.
“The new model that we have set up will have a staff quarters,’ solar power independent of grid electricity, water supply and be able to offer community service day or night so anybody who is ready to deliver will not have a long way to go.
“So, that is a very important part of reducing maternal and infant mortality. The other part of it is financial access. There is no point when they get there, they don’t have money and then they are ignored.
“So, that’s where health insurance comes in and then the Basic Health Care Provision Fund assures that even somebody who goes to the PHC in an emergency without any money in his pocket will still receive attention because the provider will be assured of payment.
“So, you have physical access, and then you also have financial access. Now, it is just to improve the quality of the healthcare.
“We have enough nurses and enough supply chain of medicines and digital technology that allows a nurse in a rural PHC to contact the doctor at the local government headquarters or a specialist at the teaching hospital to give advice on what to do if they have complications.”
Ehanire explained that such intervention would ensure access to an experienced doctor at all times, as currently, it may not be possible to have a doctor in every PHC.
On emergencies, the minister said there were people who even though they deliver safely at home, they suffer complications.
He said some may bleed severely, while some others may have obstructed labour and cannot deliver and wait till the next day to get to a capable treatment centre, which would be dangerous.
He, however, added that the National Emergency Medical Service and Ambulance Services (NEMSAS) was created to address such emergencies.
“You will just dial 112 and the ambulance with paramedics will come to wherever the patient lives, administer first aid and move to the nearest capable treatment centre where the problem will be solved.
“These are the measures that will reduce maternal mortality and under-five mortality. As far as the under-five mortality is concerned, the three main killers for children are diarrhoea, malaria and pneumonia.
“If a child has acute pneumonia or acute diarrhoea and you don’t take care of that child quickly, there is high risk so we can’t wait for two days or three days. So, if they get to a medical centre or a PHC early enough, an experienced nurse can take care of that problem,” Ehanire said.