To achieve the Sustainable Development Goal target of ensuring that no child dies from preventable deaths by 2030, there must be strong political will. ODIRI UCHENUNU-IBEH of Leadership Newspaper writes.
In recent time, deaths of newborns and children in Nigeria are unacceptably high as about one million child deaths are reported annually, a third of which is among newborns.
According to the NDHS 2008 report, child deaths in Nigeria mostly occur in rural localities of highly populated states. States like Kano, Jigawa, Bauchi, Katsina, Zamfara, Sokoto, Kebbi, Niger, Lagos and Oyo contribute about half of the absolute number of children dying before their fifth birthdays.
For instance, the Multiple Indicators Cluster Survey (2016/2017) conducted by the National Bureau of Statistic (NBS) with support from the United Nations Children’s Fund (UNICEF), revealed that neonatal mortality in Oyo state is 42 per cent, which is higher than the national average of 39 per cent.
As to why children are dying in the state, investigation by LEADERSHIP revealed that the state has 33 Local Government Areas (LGAs) and 351 wards. A total of 538 Primary Healthcare Centers (PHCs), 109 health clinics and 45 health posts, yet only 270 PHCs are functional.There are 22 doctors, 248 nurses/midwives, 166 Community Health Officers, 922 Community Health Extension Workers and 747 health assistants.
Despite the limited number of health workers in the state, there is an unequal distribution of nurses/midwives in LGA health facilities as 45 per cent of the nurses/midwives are in three LGAs and overwhelming majority of them are in urban LGAs.
Except in two LGAs, all others have 10 or less number of LGA employed doctors and no single LGA doctors in Egbeda, Ona Ara, and Ogo Oluwa In Oyo state.
Implementation of AAI In Oyo State
With Oyo state contributing immensely to under five deaths in Nigeria, UNICEF, National Orientation Agency (NOA) and other stakeholders recently introduced the Accelerated Action for Impact (AAI) programme as a game changer to fast track reduction of preventable child deaths in Oyo state.
According to Health specialist, UNICEF, Akure, Dr. Adebola Hassan, who spoke with LEADERSHIP at a two day media dialogue on improving health outcomes for children in Oyo state, the AAI is all about granulating the data so as to know where the problem lies, addressing the problem by bringing on board all the relevant stakeholders and then track progress through the dashboard.
Hassan said in Oyo State, UNICEF while working with relevant stakeholders, identified that
Ibadan North East, Saki West and Ibarapa North LGAs have the highest burden of new born deaths and the reason is not far fetched.
She said, “Ibadan North East that supposed to be an urban area, has a lot of slums. Ibarapa North and Saki West have a lot of hard to reach areas, whereby one can spend hours to reach communities within the LGA, due to poor access road.
“These limitations have however deprived health workers from going to those three LGAs and the few health workers that are posted there are not monitored, leading to poor quality of health services.
“The people living in the three LGAs, however resolved to patronizing TBAs for healthcare services and the result is the high burden of newborn deaths recorded in the state annually.”
To tackle the issue, the health specialist said UNICEF with other stakeholders focused on the three LGAs to bring down the prevalence rate of newborn deaths and reducing the number of non-immunized children by introducing the AAI programme.
The deputy programme director, NOA, Oyo state, Mr. Moshood Olaleye said the partnership with UNICEF, has brought about frequent community dialogue on immunization, Exclusive Breast Feeding (EBF) and neo-natal deaths.
Olaleye said Community Development Agents (CDAs) were formed to promote immunization, EBF and elimination of Neo-natal deaths and there have been distribution of materials as sensitization and mobilization tools for the promotion of immunization, EBF and neo-natal deaths.
“Distribution of UNICEF/NOA support checklist as tool for tracking of compliance of community households with immunization, EBF, promoting elimination of neo-natal and other best practices was done.
“The scope covered by the partnership are Ibadan North East, Saki West and Ibarapa North of which the target audience were CDA volunteers, TBAs and Officers In-Charge of Health Facilities (OICHFS),” he added.
Prior to the partnership, Olaleye said members of the three communities complained of what they described as the hostile attitude of health workers; some women gave fear of adverse reaction as reason for non completion of immunization for their children and several women confessed delivery their babies at home because of alleged extortion at health facilities and poor attitude of health workers.
“With the AAI intervention, there have been awareness at the grassroots level on immunization, EBF and practices promoting elimination of deaths of under one month old and effective synergy entrenched between CDAs, TBAs and OICHFs as nursing mothers and pregnant women are now promptly referred by TBAs to approved health facilities for immunization and other child health services.
Testimonial By Pregnant Women
At a field trip to Iwo Road PHC which is an AAI site, sponsored by UNICEF, some of the pregnant women who spoke with LEADERSHIP applauded the health workers for giving them the best in terms of antenatal care, immunization services and adequate information on EBF.
Mrs Ada Okeke who is seven months pregnant, said CDAs in her community educated her on the need to go to the public health facility for antenal care.
“When I came to Iwo Road PHC for the first time, I was given the needed attention by the nurse who attended to me. At five months, she gave me Tetanus/Diphtheria injection and some drugs,” she added.
For Mrs Abiodun Omolomo, who is eight months pregnant, she got to know about the PHC from a group of women who go from house to house to preach about delivery at the public healthcare facilities, immunization, EBF and feeding their children with the proper diet.
Through the AAI programme, Okeke, Omolomo and other pregnant women are aware of the importance of antenatal care, giving birth through skilled birth attendants, immunization for their children, EBF and the need to give their children proper diet.
However, they pleaded with the new government in the state to establish more health facilities in all the LGAs within the state and equipped them with the necessary equipments and qualified doctors/nurses.
Healthcare agenda for Oyo state new government
To ensure that no child dies from preventable deaths in the state, pregnant women, community leaders and healthcare providers who spoke with LEADERSHIP have urged the new government in the state to establish more health facilities in rural communities and employ adequate and competent health workers.
While applauding UNICEF, NOA and other stakeholders for reducing newborn deaths in the state through AAI programme, they however called on the government to sustain the progress made by ensuring that community leaders are involved in the recruitment of immunization Ad-how staff and also such personnel be recruited from the communities they are to work.
“Periodic refresher trainings should be given to health workers in order to improve and sustain their knowledge, skills and competent in providing efficient immunization and other child health services and CBAs should be given periodic trainings and their activities monitored,” they added.
Meanwhile, the commissioner for health, Oyo state, Dr. Azeez Adeduntan, in an exclusive interview with LEADERSHIP, revealed that part of the Oyo state government plans for the fiscal year 2019 budget, was to open more PHC centers, assuring that the people who don’t have PHC in their wards are accommodated in the 2019 budget.
Adeduntan said, “Establishing PHCs in all the wards is our number one plan. The federal government has reserved the one per cent consolidated revenue fund and one of the criteria to accessing that fund is building one PHC per ward. Presently we have met that criteria but because we want to take healthcare services to the doorstep of every community in the state, we intend to build more PHCs within the community.”
In terms of the unequal distribution of health workers at the various public health facilities, the commissioner said few weeks ago, the State Primary Health Care Board (SPHCB) conducted interviews for all cadres of health workers and in few weeks to come, they will be deployed to all those PHCs that have inadequate health workers.
“The Oyo state government cherish the well being of the people, hence the reason we have gone the extra mile to ensuring that we prioritize the health needs of our people. We recently launched the health insurance scheme in that no matter the financial status or religion of our people, they can have uninterrupted access to quality healthcare services,” he added.
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