Midwifing Millennium Dev Goals 4, 5
The national tragedy The Executive Director of NPHCDA, Dr Muhammad Ali Pate has described maternal and newborn deaths in Nigeria as national tragedy, stressing that “every Nigerian life lost is a loss to our dear nation’s human capital.” Speaking during the orientation of the midwives, Pate announced that 2,488 midwives had been deployed to 652 […]
The national tragedy
The Executive Director of NPHCDA, Dr Muhammad Ali Pate has described maternal and newborn deaths in Nigeria as national tragedy, stressing that “every Nigerian life lost is a loss to our dear nation’s human capital.”
Speaking during the orientation of the midwives, Pate announced that 2,488 midwives had been deployed to 652 primary health care facilities linked to 163 General Hospitals in all the 36 states and the FCT.
According to him, loss of lives of mothers and infants could be linked to: delay to recognise there is a problem, and that health care must be sought often due to lack of access to right information; delay due to lack of means to access health care which could be physical and financial access; and delay due to non availability of needed service and skilled manpower to provide the services.
He said two out of three deaths happen at the primary health care and community level and can be minimised through effective primary health care system. Based on this, according to the director, MSS is an important entry point for delivering better maternal and newborn health outcomes as well as revitalising the primary health care system.
He said under the scheme, the agency would reinvigorate the Ward/Community Development Committees and build capacity within diverse community stakeholders.
Philosophy behind the MSS
Medical experts have come to the conclusion that generally, mothers, newborn babies and children in Nigeria are threatened by human resource shortage of midwives at the primary healthcare level. Many traditional birth attendants cannot handle many maternal and child related problems.
As a result, in every 10 minutes, a woman out of five million pregnant women dies on account of complications of pregnancy. And out of 11,000 children born daily, 2,300 die. Available reports show that even though the South-east has good performance, North-west Nigeria has the poorest performance in maternal and child care as the place is not properly covered by antenatal and postnatal care. Northern states generally have high rate of maternal mortality. The South-west and South-south have what is called moderate rates.
This has necessitated the birth of the MSS. The MDGs office takes the initiative and is paying for the scheme hoping that Goals four and five of the millennium declarations which focus on reducing infant and child deaths and improving maternal health will be met by 2015. It is believed that the scheme will provide skilled personnel to attend to maternal and child healthcare needs in rural Nigeria.
Limitations of the birth attendants
The ubiquitous and much-talked about traditional birth attendants are far behind the new trends in the orthodox medicine. Many who patronise them might be at risk because they (traditional birth attendants) can do little or nothing in situations of maternal crisis. For instance, they cannot help in instances of Haemorrhage, obstructed labour, sepsis (infection), eclampsia (convulsion in labour) and complications of septic abortion. For this reason of limited skills, government hopes to make midwives more easily available to the people.
Objectives
The scheme fashioned along the National Youth Service Corps (NYSC) scheme style is to increase the proportion of pregnant women receiving antenatal care from 60 percent to 80 percent by 2015; reduce neonatal mortality from 48 percent 1,000 live births to 18 by 2015.
Who are the personnel?
The scheme has mobilised unemployed and retired midwives for national service. They are deployed to health facilities in rural communities.
What are the midwives expected to do?
They are trained to offer emergency obstetric and neonatal care services at the various primary health facilities where they are posted.
The midwives are to identify pregnant women and ensure they have access to antenatal services; provide family planning information; initiate and sustain breastfeeding; participate in national programmes on immunisation; monitor infant and child health and prevent malaria; provide health education—pre-pregnant advice, antenatal care and danger signs of pregnancy and postnatal care; manage complications from miscarriage and unsafe abortions; give tetanus toxoid, IPT and routine drugs to pregnant women; make appropriate referrals; provide HIV counselling and testing; manage common childhood illnesses; mentor community resource persons on midwifery skills; ensure eligible children in the community are immunised; work with PHC team to ensure that equipment, drugs and consumables are well managed; document required information and provide statutory reports.
How does it work?
The scheme is for one year and renewable thereafter. According to the National Coordinator of the Midwives Service Scheme, Dr Mohammed Abdullahi, it is the intention of government to make the scheme last for many years. He said states would be made to carry on with the scheme if the federal government eventually withdraws.