Eliminating maternal, neonatal & tetanus deaths

The idea of seeking care to stay healthy at health facilities is far from their minds because of a combination of factors deeply rooted in either their traditional or religious belief.Some of these women like Esther (not real name) who lives in Otukpo town in Benue State had not been to the hospital in all […]

The idea of seeking care to stay healthy at health facilities is far from their minds because of a combination of factors deeply rooted in either their traditional or religious belief.
Some of these women like Esther (not real name) who lives in Otukpo town in Benue State had not been to the hospital in all of her three pregnancies despite the availability of some health facilities around her domain.
Esther simply thinks that she cannot afford the cost of antenatal care, besides she had been tutored by her mother that a strong woman could deliver at home without necessarily needing help with the right traditional practices in place.
“So I need not attend antenatal care or subject my infants to the same. I know the right traditional practice to help myself and my newborn which are far better than any orthodox medicine.
I have had three kids at home and they are fine,” she said.
While Esther might be fortunate, other women in her shoes aren’t, as complication from pregnancies related illnesses have claimed both lives of mother and child.
Apart from people like Esther, there are pregnant women who would want to access health facility but the distance between their locality and the hospitals are quite far so they have to depend on the services of a traditional health attendant which in some instances know little about safe delivery practices to prevent mother and child from tetanus or other diseases.
Although, tetanus is not the only cause of high maternal and infant morbidity, it is responsible for a lot of pregnancy related deaths which are said to be preventable if the mothers had accessed pre and post natal care.
These session is meant to teach mothers proper handling of births, early detection and management of the disease by skilled medical practitioners.
Experts have said that tetanus is a preventable disease but often fatal as it is caused by Clostridium tetani (bacteria) which enters the body through an open wound or puncture that affects the central nervous system to provoke painful muscular contractions.
According to Dr. Emmanuel.I. Odu, Director of Community Health Services at the National Primary Health Care Development Agency (NPHCDA),  tetanus is a common cause of neonatal and maternal deaths but can be controlled with vaccine through immunization which is a cost-effective strategy.
The medical practitioner noted that the disease strikes rapidly, killing newborns soon after as a result of unhygienic birthing practices such as cutting the umbilical cord with unsterilized instrument or treating same with contaminated dressing.
The mothers, Dr. Odu added are not left out as they can be infected with the disease during unsafe or unsanitary delivery, making the disease known as the “silent killer” because so many of these women and newborns die at home unreported.
To this end, media practitioners drawn from 12 states of the federation have mapped out strategies that would contribute to the elimination of Maternal and Neonatal Tetanus (MNT) deaths in the country.
The journalists who comprised of both electronic and print media had converged in Lokoja, the Kogi State capital on a one-day workshop organised by the National Social Mobilisation Working Group (NSMWG) with members from NPHCDA and development partners for the 2014 non-polio supplemental immunisation activities.
Participants observed the need to reduce tetanus deaths among children and other vulnerable group  estimated by the World Health Organisation (WHO) kills one newborn in every nine minutes of an hour in a day.
In fact, global record had showed at the end of the 1980s that neonatal tetanus was considered a major public health problem. However, the disease is said to be largely invisible because most of the deaths occur at home before the baby reaches two weeks of age, so neither the birth nor the death is reported.
This is despite global progress campaigns conducted in high risk areas in 52 countries where 118 million Women of Reproductive Age (WRA) were vaccinated in most inaccessible locations yet close to 100 million WRA in 24 countries are still at risk of tetanus and Nigeria accounts for two third (2/3) of the women in the remaining countries that are still MNTE high risk.
Interestingly, the global mandate had Nigeria as a signatory to the 1989 World Health Assembly in Resolution to  eliminate MNT by 1995, a goal defined as less than one case of neonatal tetanus per 1000 live births at the district of every local government level.
This is believed to be possible through immunisation and hygienic birth practices that protects mother and newborn from tetanus especially as the vaccine had been available for decades.
However women don’t access routine antenatal care and deny themselves the privilege of five doses of Tetanus Toxoid Immunisation (TT) to confer lifetime protection against the disease.
WHO in its 1998 estimation stated that about 787, 000 newborn children die of neonatal tetanus and that Nigeria which is yet to eliminate the disease, which is a global burden.
Media personnel at the workshop believed that if they support the strategies outlined by the NPHCDA and its partners, the lives of no less than 62 percent of Nigerian women who deliver at unskilled health facilities would be saved.
Such strategies as outlined in a lecture entitled, “The role of the media in the 2014 campaign” by UNICEF’s Margaret Adaba Soyemi include sensitisation of the public to focus on administering the three doses of TT to women of child bearing age which provides at least ten years of protection (to cover child bearing years).
“Once the mother is protected, she will pass on the immunity to her child who will be protected for the first months of life, thereafter the child should be immunised regularly to boost immunity.    
 “If people don’t understand, it will lead to loss of confidence in vaccines. The media can be both cause or the solution to crisis situation,” she said.