Washington, DC — One in five Nigerian children will die before reaching his or her fifth birthday, according to Save the Children. Their mothers are also suffering - the country accounted for 14 percent of maternal deaths worldwide in 2010, according to the United Nations.
But one governor says he is determined to reverse the tide on maternal and infant mortality with a new program that offers free health care to mothers and children under five. Ondo State Governor Olusegun Mimiko launched the Abiye (safe motherhood) initiative in 2009. Its success - through the deployment of roving paramedics, opening new hospitals and slashing medical costs - has garnered acclaim from international organizations such as the World Bank.
At a media roundtable in Washington DC on Thursday, AllAfrica's Kyle Pienaar and Lauren Everitt caught up with Mimiko to learn why the governor chose to focus on maternal health, the challenges he faced along the way and his plans to meet Millennium Development Goals 4 and 5.
You said that Nigeria accounts for an estimated 14 percent of maternal deaths worldwide. Why are conditions so bad for pregnant women in Nigeria?
It's a combination of many factors. It's lack of planning, lack of emphasis on the right priorities. The population is also a factor - we're 160 million. Where I come from, Ondo State, there are four million people. But leadership is also part of it. It's an issue of priorities, mainstreaming the right things.
But one thing that the MGDs have done for us is mainstream all of these critical areas like maternal health and infant health. You can see more resources are going into these areas. I'm sure that in the coming years we'll have better outcomes.
Do you think your state will reach Millennium Development Goals 4 and 5, which would mean reducing child mortality by 67 percent and maternal mortality by 75 percent by 2015?
We're part of the larger Nigerian society, but as a state we will get there. But there is no question about the fact that at a national level we still need more efforts to be able to reach those development goals.
Why did you decide to focus on maternal and child mortality during your governorship?
I knew if you want to develop society, especially a typically African society like our own, that we must mainstream the empowerment of women.
One area where women are most vulnerable, as a result of the limitations we have in terms of infrastructure, in terms of personnel, in terms of attitude, is in pregnancy. We targeted pregnancy and safe motherhood, believing that once you can remove that problem from women you also release them to be more economically active.
One of the reasons that women go on and on procreating is it's believed that if you have few children you will automatically lose some of them and so you want to have many. Once a child's survival chances improve, and the mother's survival chances improve, then you free the woman to be more actively economically engaged. This is why we say our expenditure in this direction is actually an investment in the socioeconomic development of our state.
How did the federal government respond to your efforts on improving health care for women and children?
The federal government is not hostile. As a matter of fact, some of the programs of the federal government, like the health insurance scheme, we're trying to key into this. We have benefited a lot to an extent from that program.
There is the subsidiary reinvestment program: the money they accrue as the savings from the removal of subsidies they are partly reinvesting into safe motherhood. We also key in it. We hope to be able to scale up the type of collaboration that is possible between us and the federal government and that is what we will be doing in the coming months.
What challenges did you face in getting community buy-in for the new program?
Initially there was some skepticism - over the years people have developed some distrust for public facilities. But when I came in as governor, I came in with a lot of social capital, having served on the State House Commission as secretary of government, I was credible.
People believed me and I leveraged on that. People would say, 'Let's give it a chance - if the governor says it will work, then it will work.' The social capital, credibility factor helped a lot initially.
Do you incorporate family planning into your work?
Family planning was initially incorporated only to the extent that the heath rangers, these are paramedics that go around to visit pregnant women at home, explain it to women. Part of the education and sensitization they give is about family planning, child spacing and other methods of family planning.
But on a larger scale, we have methodically built family planning practices into every stage of our work. We believe that if we can space the children and people have fewer pregnancies, ultimately it will increase the quality of life for children because there will be more resources at home to take care of these children.
Family planning is an integral part of all of this. So we are looking forward to partnering with Pathfinder, they have given us the nod that they really want to partner with us to be able to scale up the family planning practices that's part of our program.
How would you define success for your program?
Success is having good results that are sustainable.
Any last thoughts you'd like to leave people with concerning the program?
In Nigeria, where I come from, there are a lot of stereotypes out here.
There are a lot of good things happening if we look deep enough. I believe that we need the cooperation of the international community, especially the international press, to fight some of these stereotypes.
We have security challenges, such as Boko Haram. But it's not the end of the world. The U.S. had their challenge with 9-11 and they are getting that behind them, and what happened in the public school Sandy Hook (in December with the shooting deaths of 20 children and six adults). So we want to defeat these stereotypes about Nigeria, that it's all negative, negative, negative. A lot of good things are happening in Nigeria. We think that the international press, if you look deep enough, we can move away from this stereotype and towards what is actually going on there.
Yes, we are not there yet, but things are looking up.