Prioritizing maternal healthcare in the public sector

Annually, 59,000 maternal fatalities occur in Nigeria. Women in Nigeria are 500 times more likely than women in advanced countries to experience issues during childbirth. Daily Trust on Sunday reports. A large number of pregnant women in Nigeria do not have access to adequate healthcare. This is either due to lack of resources in their neighbourhood […]

Annually, 59,000 maternal fatalities occur in Nigeria. Women in Nigeria are 500 times more likely than women in advanced countries to experience issues during childbirth. Daily Trust on Sunday reports.

A large number of pregnant women in Nigeria do not have access to adequate healthcare. This is either due to lack of resources in their neighbourhood or because the women cannot afford healthcare. Also, many pregnant women in Nigeria avoid seeking medical help because they believe the services will be of poor quality.

Data from the United Nation (UN) shows that 303,000 women die every year during child delivery or due to pregnancy-related problems. This translates to approximately 830 women dying every day, or one every two minutes. Sub-Saharan Africa accounts for almost two-thirds of all pregnancy-related deaths, leaving Nigeria and India to account for one-third of all deaths worldwide.

According to the United Nations Economic Commission for Africa, Nigeria accounts for one in every seven maternal deaths worldwide. In Nigeria, more than 50,000 women die each year. Approximately 95 per cent of deaths during delivery are avoidable.

Furthermore, the patriarchal society and female oppression in the country can prevent a pregnant woman from receiving proper care. In some regions, many pregnant women’s healthcare decisions are influenced by cultural factors, lack of education and poverty.

A research by Beatrice Wuraola Ope which sought to address the challenges of maternal care in Nigeria noted that several women in south-western Nigeria believe that giving birth in a non-institutional setting is preferable than giving birth in a modern facility because traditional birth attendants are more concerned and compassionate than qualified birth attendants. 

The research showed a clear distinction between actual and perceived quality of care provided, explaining that even if modern health facilities in that region have enough health experts with internationally recognized good practice, maternal deaths may still be on the rise because women’s perceptions of ‘quality’ influence health service utilization. 

Similarly, Puddah, which is female seclusion is also widespread in Northern Nigeria, where women are isolated and encouraged to give birth at home. Allowing an outsider to assist with delivery is seen as disrespectful by many in these contexts.

In an interview with some women who had patronised the public healthcare system during their pregnancies, it was concluded that one thing that made maternal care exhausting in the public sector was the poor state of facilities and also the lack of disregard for human life.

Mrs Joyce Egwu, a mother of three, stated that after what she had experienced in the public healthcare system after giving birth to her first child, she often advised other pregnant women to seek care in the private hospitals if they could afford it.

“Imagine being pregnant, a period everyone knows that a woman gets easily irritated or annoyed by everything and the hospital isn’t clean. Most times, the nurses speak with an attitude like they are doing you a favour instead of their jobs.

“I remember a time when the hospital pharmacy was out of a particular medication I needed and when I asked the lady pharmacist when I could come back for it, she said to me if I like I should not go and look for it in another pharmacy. So, how do you trust people who are constantly rude and display disregard of life to deliver your baby without complications? God forbid should something happen, they don’t seem like the type of people who would be remorseful,” she added.

After narrating her experience, Mrs Egwu noted that she was shocked by the attitude the pharmacist had displayed towards her. She vowed only to have communication with her obstetrician and be getting her supply of drugs outside.

Another lady Margaret Effa who spoke to Daily Trust on Sunday said that her concern wasn’t with the doctors and nurses as she had a good relationship with the people who had attended to her during her pregnancy. 

However, she complained about the poor state of facilities being used at the hospital. She described the hospital where she gave birth as unkept and disorganised. She recalled that often times they wouldn’t be able to find her records but because she was a familiar face, they would still attend to her.

“Sometimes you can’t blame the doctors and nurses for steering up an attitude when you speak them. These are people who are underpaid and sometimes don’t even get paid for a while, yet they have to attend to people in full capacity.

“The healthcare centre is located in the rural area so most times there’s no electricity. You’d see ladies having their ante-natal classes outside or in rooms that are stuffy and uncomfortable. The pharmacy too isn’t stocked with most drugs prescribed by the doctor,” she added.

Mrs Margaret Effa, who is also a mother three, mentioned that it was only her last child that she had in a hospital. Her first two children were delivered by traditional birth attendants.

As she narrated her experience, she explained that; “the only reason why I even went to the hospital was because the lady who had assisted with the delivery of my two children had fallen ill and I didn’t want to use any other person because it is better to do these things with people you trust.”

She also explained that “With the traditional method, the women who surround you during the delivery process know how to console and massage the body in a way that the process is less painful. They are mothers and had once given birth so they just know what to do.

“I also believe that the herbs given to you after the delivery process work faster than the medication at the hospital because it’s made up of natural ingredients that benefits the body in so many other ways.

Dr. Paul Adejo, who is an obstetrician and has worked both in the public and private sector noted that it would not be possible for healthcare professionals to give their best with the quality of services being provided in the public sector. 

“I wouldn’t want to go into details but they were so many times as a doctor at the healthcare centre I worked at, I had put in my personal finances just to make sure that my patients were comfortable.”

Dr Adejo also explained that the perception of healthcare services is what will encourage other women who do not want to try proper institutional methods such as hospitals, fertility clinics etc.

“It’s not as if the doctors and nurses don’t know how to go about their jobs but it takes more than passion to keep going on this job. Maternal casualties can be avoided if the parties responsible are ready to prioritise healthcare and make sure that the standard quality of care is given to the women who visit the hospital.

“The only difference between the public and private sector is the state-of-the-art facilities being used to treat patients and also the fact that you have to see the value for the money you’re paying. So, if the public sector can try to adopt the quality of service given at the private hospitals, pregnant women will be opportune to experience a safe and sound pregnancy period.”