Toyin Saraki
8 July 2008
opinion
Lagos — As the world and developing countries like Nigeria strive to attain the ideals of the Millennium Development Goals and MDG 5 in particular, there is an urgent need to reconsider our collective tendency to restrict the issue of maternal mortality to just the reproductive health of women.
The capacity of women to get reproductive health is key to their survival in the ante-natal and post natal period, but we need to look at various other health issues to which women are not only disposed but which affect their chances for healthy livelihood in the post partum period.
I have spoken in favour of the proper counselling of girls on their reproductive potentials, the need for skilled ante-natal attention, as well as efficient post delivery management of both mother and child.
But I am aware that so many other facts that we currently do not pay so much attention to, portend as much danger to women during and after pregnancy as any of the issues immediately attached to reproductive health.
When Nigeria marked the National Safe Motherhood Day recently, one of the issues I pointed out was that we must all work together, as NGOs, government agencies and funding bodies to help build a health system that makes women feel welcome and safe.
It is unfortunate that in the 21st Century, Nigeria cannot routinely quantify the health problems of its people. The compilation of verifiable information on mortality rates and other health indices has not been standardised in the country.
Forecasting health trends and health needs should involve the full complement of the health sector, especially as more people now mouth the importance of improved maternal and infant health, healthcare and health service delivery in sure determination for Nigeria to meet the 2015 deadline set for a 75 per cent reduction in maternal deaths.
As we move towards tackling these challenges, advocacy and research for policy formation and reform must be mindful of the fact that the issue of maternal health goes far beyond reproductive health alone.
The issue of maternal health actually begins with the conception of the girl child in the mother's womb. The health of the baby within the mother, the circumstances and events of her birth, her early infancy, childhood, adolescence, early adulthood, her experiences as regards nutrition, childcare, education, physical, mental, intellectual and emotional development; all have vital and interdependent roles to play in what we term maternal health.
We can all play a role in facilitating policy change if everyone becomes aware of this fact. It is important that we move away from public relations that merely creates goodwill for ourselves to public relations that really saves lives.
Gender-responsive budgeting technically refers to the tracking of government budgets so that adequate resources are devolved equitably, even if not equally, to issues relating to women and children as well as men. It also goes to help hold government responsible for their promises to commit to issues of gender equity and equality in the areas of provision of health and social service.
This is good. I believe that while holding the government accountable for their commitments to gender equality and the empowerment of women is important, we need to also get women in positions of political power to pay more attention to issues that affect women QUOTE.
Whether we realise it or not, those issues eventually affect us all. We cannot expect that the government, which is largely dominated by men, would honestly assess where policies need adjustments and where resources need to address gender inequalities.
Even if they found this to be so, the tendency is that they would not do what is necessary to rectify the situation if they are neither encouraged nor pressured to do so, particularly in our environment where we are still struggling with accepting the reality of the woman's importance to our collective growth as a nation.
Again on maternal health, we must adopt holistic measures. It is estimated for example that 450 million adult women in developing countries are stunted, a direct result of malnutrition in early life.
The discovery of high blood pressure, cancer, heart conditions and other non-communicable diseases in women are classic examples of areas where we need more action if we truly must reduce the rate of maternal death.
Knowledge has increased on the causes and effects of high blood pressure in women and the dangers this has during pregnancy. Although many pregnant women with high blood pressure have healthy babies without serious problems, high blood pressure can be dangerous for both the mother and the foetus.
Women with pre-existing, or chronic high blood pressure are more likely to have complications during pregnancy than those with normal BP.
Important for the continued health of the mother and of paramount importance to the health of the baby is the issue of breast-feeding. This simple, affordable, universally available infant survival strategy calls for the increased support and understanding of the men.
Women can and need to be encouraged and motivated towards breast-feeding as early in childhood as possible. We need to get back to a mindset where the option of giving babies any other form of infant feeding is almost never considered except in the most extreme of cases.
Mothers positive for the human immunodeficiency virus (HIV) add other new concerns and certainly a lot of trained technical support is needed to ensure that both mother and child get the best in terms of care and support that is available.
This is dependent on relevant timely, accurate information getting to the families and communities in a manner that is sensitive to the cultural norms, mores and values of that community. One size does not always fit all.
Cancer, particularly breast and cervical cancer, also require more work than has ever been contemplated in Nigeria. It is said to occur in one of every three thousand pregnancies, an indication that hundreds of thousands of Nigerian women are exposed to this dangerous ailment every year.
The prevalence of cervical cancer according to the Ibadan cancer registry is reportedly 24 women in 100,000; an estimate thought to be grossly under-reported seeing as this assesses only the women who actually get to the hospital.
This is still too many lives lost, considering that this is a mere fraction of the numbers of women whose health is affected, thereby reducing their ability to care for their families and children.
Delays in the diagnosis of breast or cervical cancer invariably means the outcome is more likely to be fatal. The importance of raising awareness of conducting breast self-examination cannot be over-emphasised.
There also needs to be more opportunities created for women to visit the health centre for wellness check-ups that do not always have financial implications.
Early diagnosis allows for a lot more treatment and care options to be made available to women at affordable cost to government and society. Above all, its saves lives that would ordinarily be lost to the lack of accurate, scientific, timely information.
A country desirous of the attainment of the MDGs can not afford to continue applying pain-killers to treat pain as the symptom while the underlying killer disease is ravaging her people.
To tackle maternal mortality from the roots is to take it from the beginning which is the quality of upbringing and education we give our girls and the quality of health information we make available to our women.
And this is not just when they are pregnant but even when they are not even yet at the stage of contemplating pregnancy.
Saving Lives will create wealth through health!
- Saraki is the wife of Kwara State Governor
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