Adopting Primary Health Care Approach In Stemming Maternal, Perinatal Death At The Grassroots - THE DAILY CRUCIBLE



Thursday, March 10, 2022

Adopting Primary Health Care Approach In Stemming Maternal, Perinatal Death At The Grassroots

The Daily Crucible | Thursday, March 10, 2022

By Lateef Akintunde

One of the  prayers for pregnant women in Western Nigeria is -  "Agbohun lya a gbohun Omo." Meaning, the pregnant women shall  successfully deliver their babies without hitch. This emphasised the high value the society attached to the wellbeing of both the mother and their babies during birth.

 To ensure a resounding success at the grassroots level, the core principles of stablishing Primary Health Centre (PHC) as the basic structural unit of the public health must be established to embolden  public trust in its capacity to provide accessible, affordable, quality and available health care services to the  people particularly those at the Local government areas  of the state.

One key advantage about Primary Health Centre is that, it is an health care intervention across both low and middle earners in Nigeria. More so,  it is very close to the people  with the aim of ensuring their wellbeing specially to stem  Maternal and Perinatal Death (M&PD) among pregnant women which occur  during the birth of a child and records reveal that, it has  led to death of a lot of women, especially in developing countries.

Reports have it that, some pregnant women in Sub- Sahara Africa still believe that any death that occurs during child labour or after birth is purely spiritual attack. No wonder some women during pregnancy fail to utilise and tap from embeded values in Primary Health Centre visit  the native herbal care shops "alagbo Omo" for their antenatal to fortify them against untowards spiritual manipulations and  this  potends grave consequences for some of the ignorant women when crisis arises.

 According to the view of World Health Organisation (WHO), maternal death is the death of a woman during pregnancy or within 42 days after delivery, while perinatal death is the death of an infant after birth and it has no spiritual colouration but mainly  complications due to some antenatal negligence among other health challenges facing the ignorant women.

As a matter of fact, it was disclosed that, perinatal period begins at 22 completed weeks, precisely 154 days of gestation and ends seven completed days after birth

As a result of nonchalant attitude to maternal care of some women, many of them have been rendered childless and many children have become  motherless.
A report from WHO, revealed that about  303,000 women died of complications during pregnancy and child birth in 2015, mainly as a result of lack of access to quality health care at health centre before during and after child birth

Investigation revealed that some factors have also been pinned down as some of the challenges leading to increase in rates of maternal and perinatal death in Nigeria in spite the existence of Primary health Centre at the Local Areas and some of the factors include obesity, severe infection during pregnancy, high blood pressure, unsafe abortion, domestic violence, late registration for antenatal and unhygienic conditions.

Researchers have disclosed that of all the listed factors, late registration for antenatal has been considered to be the most prevalent and responsible factor for increased maternal and perinatal death in some developing countries. Records showed that most pregnant women in the region, do not register for antenatal care and treatment until when they are about  to  deliver their babies.  Reasons for this nonchalant was due to lack of confidence in efficient service delivery at Primary health Centre, making it almost impossible  to correct any complications and anomaly at this stage

Though It is worrisome that Nigeria still ranks second globally in the number of maternal death according to WHO report in 2010. As  most maternal death review in Nigeria are isolated research based reports from a single health facility. For example present administration in Ogun state was determined to stem the growing ratio of perinatal death through a constant study of causes and contributory factors of maternal mortality in the state and was done through a periodic state -  wide maternal and perinatal death surveillance and responses MPDSR review.

This exercise revealed the ratio and average  cause of maternal death which include, Haemorrhage,  pre- eclampsia and eclampsia account for it respectively

The reported challenge being faced in the past such as, inadequate equipment, lack of ambulances for transportation, and delay in referral services, poor percent of women have antenatal care while significant proportion were referred from Traditional Birth and Mission houses.

Kudos to the proactive measures put in place by the present administration of Governor Dapo Abiodun across the the primary health care centres in the state. Apart from aggressive renovation of all health care facilities  embarked upon by the present administration, reports have it that, health care centres are being equipped with necessary medical facilities among other needed equipment  to boost their capacity as efficient public health care centres at the grassroots level of the state. 

As a matter of fact, the present administration led by Prince Dapo Abiodun has  rehabilitated about 236 primary health care centres in every wards of the state and general hospitals across three senatorial districts as well as tertiary health  facilities were equipped to tackle M&PD across the 20 Local Governments Areas of the State.

In order to effectively fight the scourge, the Abiodun government increase the fleet of the State Emergency Ambulance Service from five(5) inherited from the last administration to 30 to ensure 24 hour prompt and improved medicare services to patients. It also purchased and distributed  22 Tricycle Ambulances to all primary Health Centres across the state to prevent incident of maternal death due  transport delay In the hinterland. A laudable step at ensuring public wellness  which had hitherto being a challenge at the grassroots area in the past.

 The State Government has also trained about 1,433 Health Workers and Community leaders on Basic Basic Health Care Provision Fund (BHCPF ) for the Ward Deployment Committees (WDCs)in each of the 236 ward in the State. All these steps are to curtail the maternal and perinatal death.
Also, the disbursement of Funds to 196 Primary Health Care Centres across the 20 LGAs for the implementation of Basic Health Care Provision Fund (BHCPF) activities in Ogun State. This has really helped to boost activities of primary health care centre in no small measure.

The relentless effort at improving health condition of the people particularly children, attracted the National Deposit Insurance Corporation (NDIC) to partner with the state to inaugurate Paediatric Unit at General Hospital, Ayetoro, Head Quarters of Yewa North to complement all the aforementioned interventions by the state government to curtailed maternal and perinatal death at the council area 

The wellbeing of his constituents are also paramount to the Federal Lawmaker representing Yewa North/Imeko-Afon Federal Constituency, Hon Olaifa Jimoh Aremu,who donated an Ambulance Service Van to General Hospital, Ayetoro to ensure 24hour prompt and improve medicare services to patients for further health attention

Another area the present administration has improved service delivery at health centre  was through  training and retaining of midwives, Traditional Birth Attendants (TBA) and provision of a 24hours Emergency Obstetrics Centre, among others, in other to reduce maternal and perinatal death 

In furtherance to stemming the increasing  ratio of maternal perinatal death, government has priorities MPDSR as a feasible measure in pinning the scourge  and with plan to institutionalise it as part of key strategy to reducing death during pregnancy and child birth in the state.

There is no gain saying the fact that, Government huge investment at improving service delivery at Primary Health Centres across the state particularly at Yewa North Local Government Area of the state has begun to yield positive result with the record of a successful delivery of quadruplets through well trained  and renumerated nurses at Primary Health Centre, Oja Odan. This success has brought to the fore, the core values in government's determination to renovate, re-equip, scale up the  primary health centers in Ogun State.

The Chairman, Yewa North Local Government, Hon Gabriel Ogunyomi rejoiced with  the family of Mr Taiwo and Mrs Mary Odunfa over the successful delivery of the first quadruplets, where the female is weighing 2.0kg, and the three males, two weighing 1.7kg each  while the third weighing 1.8kg, at the Local Government Primary Health Centre, Oja-Odan, Ketu. He commended the matron, Mrs.Olaiju Oluwaseun for a job well done and professionalism the centre  deployed in carrying out a hitch free delivery of the  quadruplets

Findings showed that Yewa North Local Government Area presently has 21 Primary Health Centres (PHCs) scattered across the council experiencing a touch of one  renovation or a face lifting so as to meet up with the  global  standard ditto other LGs . The singular story of a successful delivery of the quadruplets at the LG primary health centre  has further  increased patronage of pregnant women for antenatal care and increased people's confidence in efficient service delivery of the Health Centre.

Considering the aggressive intervention of the present administration at improving  the health sector and wellbeing of the people carried out comprehensive renovation of all hospitals and Primary  health Centres across the state and provided key health facilities which have  boosted health care delivery particularly across the 20 Local Government Areas of the  state. 

As a matter of fact, the interventions have seriously changed the erroneous concept people have against primary Health centres. Today primary health centres  have scaled up even to stem maternal mortality and child morbidity rate at the grassroots just as both the mother and quadruplets were saved, it indicated that people can actually enjoy dividends of democracy at health centres  through  the on going renovation, retraining programme for nurses among others  as the facilities will further promote service delivery. The good renumeration and other benefit approved for health workers also  motivated them to be committed in the  discharge of their duties 

Although it is a fact that, one thousand of women die annually from complications during pregnancy, child bitrth or postpartum period. It is a problem in public health in the  society but with the on going efforts of the present administration to improve the sector, experts believe that  collaborative support from all stakeholders, apecially the Non Governmental Organisations (NGOs) amongst other in the area of advocacy and publicity awareness will go along way at stemming the scourge.

Mr. Lateef Akintunde is a Zonal Information Officer, Yelwa North Local Government Area of Ogun State

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