Much ado about SURE-P, maternal and child health

The SURE-P MCH Project is supposed to focus on increasing access to maternal and child health services through the continuum of care for pregnant women and their newbornThe convener of the project, Barrister Halima Alfa said that in 2012, the government allocated N16.1 billion out of which they used N3.8bn and rolled over the rest. […]

The SURE-P MCH Project is supposed to focus on increasing access to maternal and child health services through the continuum of care for pregnant women and their newborn
The convener of the project, Barrister Halima Alfa said that in 2012, the government allocated N16.1 billion out of which they used N3.8bn and rolled over the rest.
Her words, “In 2013, it was N15.9bn, while in 2014, we were given N12.1 billion, but presently we have no allocation for 2015, we are waiting for the government or National Assembly to appropriate for us, you know the project is supposed to end this year.”
Ugly picture of maternal and child health
The Minister of Health, Dr Khaliru Alhassan, speaking on the project said that Nigeria consists of 2% of the world population, but when it comes to the issue of maternal mortality, its account for almost 10% of the burden globally.
“A woman’s chance of dying from pregnancy and childbirth in Nigeria is 1 in 13 (compared to 1 in 5000 in developed countries), with only about 40% of deliveries attended to by skilled birth attendants (Integrated Maternal & Child Health Strategy, FMOH),” he said.
The most recent figures from the National Demographic and Health Survey estimated Nigeria’s overall maternal mortality ratio at 565/100,000 live births. There is however, a high degree of variation across the country, with the highest maternal mortality ratio (1549/100,000) found in the North East and the lowest (165/100,000) in the South West (NDHS 2013). Most of these maternal and child deaths occur in rural communities hence the SURE P MCH is focusing on delivering services at primary health care facilities in rural communities across the 36 states and FCT.
Intervention put in place
The Executive Director of National Primary Health Care Development Agency (NPHCDA), Dr Ado Muhammed, said that to address the issue in 2009, the federal government introduced the midwives service scheme, also added the SURE-P MHCH intervention two years later to consolidate the gains made with the MSS team.
Meanwhile the chairman of SURE- P General (RTD) Martin Luther Agwai revealed that the programmes when infused was able to recruite into the system over 12,000 front line workers to provide skilled attendants during delivery.
According to the retired general, about 2500 health facilities were renovated and rehabilitated, while 2000 bore holes across all PHC nationwide were sunk,  midwifery kits, mama kits were provided and  health workers trained.  
“SURE-P health programme is currently implemented in 1,000 PHC facilities and 250 referral hospitals which serve as referral centres and sites across the 36 states and FCT. As at August last year, 1.2m women have received antenatal care and 200,000 babies have been delivered at these SURE-P supported facilities.
“We have zero tolerance for maternal mortality, no woman should die while bringing a child into the world, because pregnancy is a thing of joy,” he ssaid.
Another intervention is the robust referral system to provide readily available transportation from healthcare centre to referral centre.
The SURE-P boss noted that the project acquired 100 ambulances to reduce transportation challenges for women in pregnancy and children who require referral.
The NPHCDA boss added that the national ambulance service would reduce 60% of deaths caused by the fact that that there is no effective referral system.
His words, “The national ambulance service is the key driver, even though there are other services being provided, like the emergency transport service by the National Union of Road Transport Workers,” he added.
Conditional Cash Transfer/ MSS
This programme was launched to provide regular cash payments to poor households to encourage pregnant women access care at health facilities.
However some women told Daily Trust that they have not been paid since the programme was launched in their location, a claim the project director SURE-P MCH, Dr Ugo Okoli denies saying they have not defaulted in their payment as that will defeat the aim for which the scheme was established.
Her words,“It is a pity you people hear such news. I think the best thing is when we are doing a payout, we will just call you to the place. We just did one in December in Gwagwalada. We have paid out a total of N69m to women across the country in 18 states”.
The women earn N1000 to N5000. We are doing another payout in the next two weeks, but that will be in the new states where we started,  states like Abia, kogi, Sokoto, Taraba. After that we will go back to the old states. I don’t know why women will say [they don’t get paid,” he said.
MSS
Midwives under the MSS Midwives Service Scheme (MSS) also complained of non-payment of salaries, some even held a protest to call on government to address their issues.
But the chairman SURE-P said that the midwives recruited under the SURE-P are not being owed any money, but explained that the midwives are supposed to get some support from states and some local government and maybe they were not getting that.
Halima Alfa said, “We give them 40,000, as midwives, state is supposed to give them 20,000 and the local government is supposed to give them 10,000, making 70,000.  But some states are unable to meet up, but we have not defaulted.

Achievements
Dr Ugo Okoli said that a lot has been achieved and many lives touched and saved, saying, “1000 primary health care facilities renovated across the 36 states while 12,110 workers have been recruited and deployed to work in states, these are 3158 midwives,  Community Health Extension Workers, 3123 and Village Health Workers, 5829.
“We also supplied 680,000 mama kits,  midwifery kits  2000, outreach kits 1000 and village health worker kits 3000, we renovated 500 primary health care facilities, 625 boreholes installed and 145 units of midwives accommodation built across the 36 states and FCT.
“Meanwhile the total number of women beneficiaries from the conditional cash transfer is 49,708 with a cash paid out to date to these women to a tune of N69,000,000.00.”