With the increasing maternal deaths being recorded in the country, a human right advocate has urged governments at all levels to stop discriminatory policies that hinder women from accessing maternal health care thereby resulting in preventable deaths. To this end, both federal and state governments have been called upon to eliminate barriers that women face including high ante natal and delivery fees, the requirement for preliminary authorisation for ante natal care, and the sighting of health facilities in locations that is far from communities, difficulties in getting public transport for easy access to delivery venues, among others.
Executive Director of Women Advocates Research and Documentation Centre (WARDC), Abiola Akiyode-Afolabi who disclosed this said due to high user fees charged by many public and private hospitals, pregnant women risk being detained in healthcare facilities if they are unable to pay. From a maternal mortality ratio of 545 per 100,000 live birth (lb) in 2012, it rose to 576 per 100,000 live birth lb, according to the 2013 National Demographic Health Survey (NDHS) “This practice (high fee) leads women to avoid care if they are unable to afford it, or to endanger themselves by leaving the hospital before treatment has ended to avoid the hospital fees,” she said.
it is a common practice for many poor rural and urban pregnant women to forego ante natal care completely because of inability to pay required fee. Similarly, Akiyode- Afolabi said the practice of compulsory spousal blood donation continues to be a great impediment for women to access maternal health care. Although the Nigerian policy on blood donation requires that all donations be voluntary, women who attempt to access maternal healthcare services at many public or government hospitals are often required to bring their husbands to donate blood, she noted.
According to her, while patients may sometimes opt out of this blood donation requirement by paying a fee, this option is not always made known and has a discriminatory impact on the poor who may prefer to pay—but be unable to afford—a fee in lieu of blood donation. Highlighting the specific impact of compulsory blood donation which is practiced in Lagos State, the human right advocate said compulsory spousal blood donation can have multiple negative consequences on pregnant women who are unable or unwilling to compel their husbands to donate blood, including husbands’ refusal to permit their wives to access antenatal, intrapartum, and postnatal services and women’s exposure to domestic violence if they attempt to compel their husbands to donate blood.
“The blood-donation requirement also disadvantages pregnant women who are unmarried, including those who may have become pregnant due to sexual violence, or whose husbands become ill, abandon them, or pass away during the course of the pregnancy. “The discriminatory impact of the fee on poor and single women includes diminished access to reproductive health services, inferior care, and worse health outcomes.”
Furthermore, tax certificates are also requested in some states as a precondition for access to maternal care, said Akiyode-Afolabi. While calling for government intervention to end these practices, she said the death of women while giving birth is discriminatory. “Women have right to life while bringing forth life,. However, while suggesting intervention to reduce maternal deaths, the human right advocate said framework for recommended change must be approached holistically and not merely as a technical intervention.
According to Akiyode- Afolabi, adopting a right based intervention should involve using a framework that is nondiscriminatory and equitable, one that will empower the women, make the accountable, sustainable, participatory and amenable to monitoring. Similarly, she said the policies should allow for a gender perspective in public policies addressing women’s health needs. “It should take into context culturally accepted means of provision of pregnancy related services which encourages rather than discourages women from visiting clinics.
Source: New Telegraph
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