Experts react to Nigeria’s high maternal mortality rate

Medical experts have described as worrisome the recent figure released by international agencies which put Nigeria’s maternal mortality rate at 58,000 in 2015.

This makes Nigeria the country with the second highest maternal death rate in the world.

The News Agency of Nigeria reports that a joint report by the World Health Organisation, WHO, United Nation Population Fund, UNFPA, and the United Nations Children Fund, UNICEF, published the statistics.

The report was, however, presented by Olusola Odujinrin at the 2017 Annual Faculty Day Lecture by the Faculty of Public Health and Community Medicine, National Postgraduate Medical College of Nigeria.

The conference with the theme, “Transition in Global Health Paradigms: What Hope for Nigerian Women and Children?’’ was held at the Lagos State University Teaching Hospital, LASUTH, Ikeja.

In an interview with NAN, the guest lecturer, Mr. Odujinrin, a community health expert, said Nigeria had not done well in the provision and maintenance of Primary Health Facilities, PHF.

“Our country is off the track in meeting all Millennium Development Goals (MDGs). We are on the back row because we lack healthcare infrastructure which necessitated the high mortality rate.

“Our first goal is to eradicate extreme poverty and hunger according to the World Bank’s projection for sub-Saharan Africa has not been met. Nigeria and Democratic Republic of Congo has fared badly.

“At present, the report that says Nigeria contributes about 15 per cent of the annual global death, this is alarming and we must act fast on it because it is no favourable.

“Albeit scary as the report may, however, seem to be, we can still address these challenges if we have the political will to do just that,’’ she said.

Read more here

News credit: PremiumTimesNG

Epidurals Do Not Prolong Labor

Many obstetricians resist giving epidural anesthesia during the late stage of delivery because they believe it lengthens the duration of labor. But a clinical trial by Chinese researchers has found that it does not.

The study, in Obstetrics & Gynecology, randomized 400 women in labor to receive either a standard epidural anesthetic or a saline solution in an identical container. Neither the patients nor the health care providers knew who was receiving which.

The average time from full dilation of the cervix to delivery was 51 minutes in the saline group and 52 minutes in the women who got the anesthetic, a difference of no clinical significance.

The number of cesarean sections, the number of forceps deliveries and the number of episiotomies were almost identical in the two groups. Seventeen of the obstetricians in the saline group stopped the infusion to speed labor, compared with 21 in the epidural group, again an insignificant statistical difference.

The only difference between groups was that the women who received the anesthetic expressed greater satisfaction with their pain control.

“Turning off the anesthesia won’t help,” said the senior author, Dr. Philip E. Hess, an associate professor of anesthesia at Harvard. “If you decide you want an epidural for pain relief, you should not be concerned that it’s going to prevent a vaginal delivery or cause any negative effect on labor.”

News credit: The NewYork Times

In Nigeria, wrong perceptions and ignorance fueling malaria in pregnancy

MATERNAL malaria episode is a  common occurrence in pregnancy and one of the concerns of pregnant women in Nigeria is just how best they can prevent or treat  malaria. According to guidelines provided by the World Health Organisation, WHO, a pregnant woman should obtain Intermittent Preventive Treatment of Malaria, IPTp, in the form of Sulphadoxine-Pyrimethamine (SP) to  reduce  maternal and foetal anaemia, prevent placental parasitaemia, low birth weight, and neonatal mortality.

All pregnant women are also expected to recieve iron and folic acid supplementation as a part of routine antenatal care. However, growing misconceptions about  IPTp in pregnancy persist among women known to have attended antenatal care clinics, even as public health experts say the treatment therapy is safe for mothers and their unborn babies.

Intermittent preventive treatment with an antimalarial drug during pregnancy such as sulphadoxine-pyrimethamine (SP) is a cost-effective means of preventing malaria in pregnancy; unfortunately, the uptake has remained low as findings show that only a minority of pregnant women are receiving IPTp as recommended by national guidelines. 

According to the 2015 Malaria Indicator Survey, MIS, only 19 per cent of pregnant women in Nigeria received three doses of IPTp. Studies identified wrong perceptions as number one reason why Nigeria could not meet the 80 percent target by the Nigeria government and the World Health organisation, WHO in 2015. Read more here

News credit :Vanguard

FOR ALL MOTHERS: Bridging the Quality and Equity Gaps in Maternal Health Care

While we have seen global maternal deaths drop by 44% since 1990, women are still dying from preventable causes during pregnancy and childbirth – and not just in low and middle-income countries that lack resources. Even in high-income countries, there are women who face a much higher risk of death, or grave injury because they are poor, migrants, refugees, minorities or from indigenous populations.

In Canada, indigenous women are twice as likely as members of the general population to die in the weeks before or after delivering a baby. The indigenous infant mortality rate is also two to four times higher than the general population.

MSD for Mothers and MSD Canada Inc. recently teamed up to launch a very exciting program in Toronto to address this disparity in maternal and child health. Called "Kind Faces, Sharing Places," the Toronto project is a unique community-hospital-university-private sector partnership, led by indigenous health professionals, researchers and community leaders. It focuses on the patient, and on providing culturally-sensitive, individualized, wraparound support.

"The hope is that we will be able to demonstrate something that is sustainable, and that other levels of government in the country, including the federal government, will decide to pick it up and run with it," says Ani Armenian, Corporate Communications Manager for MSD in Canada who was instrumental to getting this project going. Read more here

News credit: MSDformothers

International Day of the Girl

"We cannot all succeed when half of us are held back."  ― Malala Yousafzai

We celebrate today the 11th of October 2017 as the International Day of the Girl. 

Kenya maternity fee waiver is great - but there are still gaps in the policy

About 21 pregnant women die every day in Kenya due to complications from childbirth. That’s equivalent to two 10-seater commuter micro minibuses, known as matatus, crashing every day with the loss of all the passengers on board. 

Pregnant women in Kenya die because they either do not receive appropriate care during pregnancy or are unable to deliver with the help of skilled health attendants.

The World Health Organisation recommends four antenatal visits and skilled care during and immediately after delivery. It also recommends emergency obstetric care in cases of complications as key to reducing maternal and neonatal deaths.  But the costs for antenatal care and skilled delivery are simply too high for many poor women in Kenya. Based on data collected before the maternity subsidy policy was introduced the costs associated with a normal pregnancy and delivery was more than 20% of the country’s gross national income of USD$1,380 per capita.

The intention of the maternity fee waiver, implemented in 2013, was to remove out-of-pocket fees for skilled delivery in public health facilities across the country. This would enable thousands of pregnant women delivering at home to access proper services. The direct payments for normal and c-section deliveries was replaced by a national government budgetary allocation to reimburse health facilities for deliveries provided. 

The effect of the new policy was immediate. There was a 22% increase in skilled deliveries in facilities between 2013 and 2015. 

What the policy hasn’t done is address the entrenched inequity between rich and poor women. In fact... read more here

News credit: TheConversation