Poor access to healthcare takes toll on women, children

Pregnancy is a normal process for women but many of them go through it with apprehension because of the complications associated with child birth, said to be the leading cause of death and disability among women of reproductive age in many developing countries. Kaduna State has been recording a high rate of maternal deaths. As […]

Pregnancy is a normal process for women but many of them go through it with apprehension because of the complications associated with child birth, said to be the leading cause of death and disability among women of reproductive age in many developing countries.

Kaduna State has been recording a high rate of maternal deaths. As shown by the National Bureau of Statistics 2012 survey, maternal mortality ratio in the state is 1025/100,000. Governor Nasir El-Rufai confirmed the figure in December 2015 when he said Kaduna records over 103,000 maternal deaths annually and also loses 95 babies out of every 1,000 births, attributing the situation to lack of access to ante-natal care and medical facilities.

The trend in Kaduna, like many other states in northern Nigeria, is that majority of women give birth at home and do not seek the services of healthcare professionals or approach facilities until apparent complications set in. This is further compounded by the lack of health facilities in some communities as well as poor roads that make it difficult to quickly get to where such facilities are available.

Kesebo in Chikun Local Government Area is inhabited by predominantly farmers. In spite of the many people living in this village, there is no single health facility as the people travel several kilometers to access health care.

An elderly woman in the village who gave her name as Mary said before now, they went to Maraban Rido which is more than 15 kilometers away to access health care but now they go to the next village to patronize a hospital at Kakunmi.

 “A lot of women deliver at home but once we notice any form of complication, we find a way to move them to the hospital. Because of the distance, some have lost their lives while on their way to the hospital, so also children,” she said.

Deborah Musa, a 28-year-old mother of five said she delivered only two children in the hospital while others were delivered at home with the help of older women in the community.

 “We prefer to deliver at home because it takes over an hour to trek to the hospital at Kakunmi because now, there is a government hospital in Kakunmi but getting there is difficult for us because of the distance,” she added as she urged the state government to build a primary healthcare centre in the community.

Similarly, Kabobo village, a Hausa and Fulani dominated community in Igabi LGA has  existed for about 200 years according to the village head, Abdullahi Kabobo, without a health facility, electricity and water, among others. “The lack of health facility is of greater concern because our women don’t go for ante-natal care. The closest health facility is about 17 kilometers from this village,” he said.

“We take our sick children and wives to Maraba or Rigachikum for treatment. Although, there are women who despite the challenge still go for ante-natal, majority prefer to deliver their babies at home because of the rigors of travelling far to seek health care,” he added.

Lariya U. Kabobo, a pregnant mother of six confessed that she does not go for ante-natal care because of the distance, saying she delivered most of her children at home.

“We don’t even have commercial motorcycles operating here which makes it more difficult to go to hospital. We have no choice than to resort to traditional herbs while the older women among us help take deliveries.

“In fact, my fifth child was born by the riverside on my way to hospital, even though labour came with complications.”

85-year-old Halimatu Alhassan said she had been taking delivery for more than 20 years in the community.

“I was not trained but I have been doing the job for more than 20 years without difficulty. We are not used to modern medicine,” she said while appealing to the state government to site a health facility in the village.

Poverty is another cause of women and child mortality in such remote areas because in most cases the people cannot afford health care.

Our reporter also gathered that some women lose their lives or babies due to refusal to go for caesarean section (CS) even when it is very necessary to do so.

Mr. Sefunmi Blessing narrated how he lost his long awaited first baby.

 “When my wife was due to deliver, my mum insisted she should be taken to the church for prayers and so that she can deliver with the supervision of women trained to take delivery. After many hours of labour, there was no progress and my wife was already tired while the baby was not coming out. Then, we were asked to go to hospital, so she was rushed to the hospital where she went for ante-natal care, but she was not accepted because her situation had already worsened.

“So, we rushed her to a nearby private hospital where she had surgery even though the baby was already dead. I regret all my actions because I was not firm as a man to insist on taking my wife to hospital in time particularly as she was giving birth for the first time.” he said.

Oluwabukola Ogunjimi narrated her ordeal at the General Hospital, Kakuri in Kaduna where she was allegedly abandoned for hours which she said apparently led to the death of her baby.

“I went to the hospital on a Friday morning in November last year while I was in labour. I actually went there because we were told that public hospitals are better now. When I got to the hospital, I was admitted, a nurse called a doctor from OGPD. After the doctor attended to me and saw that I may not be able to give birth on my own, he suggested I may have to undergo CS, which I consented to. At about 11pm, the doctor told the nurse he was going on temporary break.

 “He never came back. The next morning, I went to meet a nurse and asked if my fetus was still moving. I pleaded with her and she got another doctor from OGPD who eventually prepared me for theatre and I was operated upon around 1pm on Saturday. I lost the baby within those hours. I was left without a doctor. It was at that point I observed that apart from the general poor environment, the hospital is also poorly staffed. You can imagine only a nurse on duty in that section throughout the night in such a big hospital. At a time, she became so tired because she alone took about eight deliveries before morning.”

 “Also, throughout the night, there was no power supply while the nurse used torchlight to carry out her life-saving tasks. I also observed that in the morning, you see many nurses, a ew in the afternoon, most of whom disappear by evening,” she narrated.

The present administration in Kaduna is currently renovating and upgrading 255 public health centres in all political wards in the state. The Commissioner for Health and Human Services, Dr. Paul Manya Dogo, said the upgrade and renovation had progressed, though slowly.

According to him, 102 have been completed, 62 are between 50 and 99 percent completion while 91 are below 50 percent completion.

He listed the general hospitals receiving intervention to include those in Ikara, Hunkuyi, Kaura, Gwantu, zonkwa, Kagarko, Maigana, Hajiya Gambo Sawaba, Yusuf Dantsoho Memorial Hospital, Sabon Tasha, Rigasa, Kawo, and hospitals in Kujama, Kwoi, Fadan kagoma and Turunku, among others.

He noted that government had deployed over 1,200 newly recruited health workers to hospitals across the state.

He disclosed that the state government had disbursed N100 million as first tranche under the Saving One Million Lives Initiative.

The Executive Secretary of Kaduna State PHC Agency, Dr. Hadiza S. Balarabe, during an activit to mark the Safe Motherhood Day in Kaduna last year noted that the most common direct causes of death among women for all reported cases were hemorrhage, obstructed labour, sepsis, eclampsia, anemia and unsafe abortion.

According to her, the maternal mortality ratio in Nigeria is 576 deaths per 100, 000 live births, which she said represents about one woman dying in every 10 minutes.

The founder of Wellbeing Foundation Africa, Mrs. Toyin Saraki, also recently said, “Around 20,000 babies will be born in Nigeria today, however, we will also lose 2,300 under – five year olds and 145 women of child-bearing age. Nigeria’s growth rate of 3.2 percent annually means that our nation will, according to the USAID, reach a population of 440 million people by 2040.

“More than 80 percent of newborn deaths is due to prematurity, asphyxia, complications during birth or infections such as pneumonia and sepsis. These deaths can be prevented.”

Saraki, who is also the global goodwill ambassador of the International Confederation of Midwives, notes that the death of women during childbirth and that of newborns can be prevented if Nigeria has more well-trained midwives.