5 February 2013

Nigeria: Yes We Can On Maternal and Child Health


An ardent follower of my weekly health column and of course everything that I do with respect to development work recently sent me an email and it reads "Aminu, don't you ever get tired, angry and discourage with respect to your sustained advocacy especially on Maternal and Child Health?

Your energy never ceases to amaze me despite the glaringly picture that the Nigerian government and many states in Nigeria aren't serious and not investing in the health sector as they should and please when do you really get time to read and write all those inspiring and well focused weekly articles?"

My answer to him is simple, if he and many others join the struggle, then we can achieve it collectively and celebrate the improvement in the Maternal and Child Health Services in our country. I was quick to remind him and others that it is our responsibilities to continue to ask questions and hold our government accountable on all the pledges and promises made in the past and we shouldn't relent in our effort simply because we aren't seeing much progress. The change we expect to see will come slowly but we have to be resilient, patient and committed to the course of our women and children.

I reminded him that Nigeria committed to achieving the goal of a contraceptive prevalence rate of 36% by 2018, which I have written extensively as a pledge difficulty to achieve. If that is done, it will enhance maternal and child survival, thereby contributing to the government of Nigeria's initiative to save one million lives by 2015. In addition to Nigeria's current annual commitment of US $3 million for the procurement of reproductive health commodities, Nigeria commits to provide an additional US $8.35 million annually over the next four years.

This increases Nigeria's total commitment for the next four years from US $12 million to US $45.4 million, an increase of almost 300%. According to such pledge the federal government will work with the state and local governments to secure complementary budgets for family planning and reproductive health service delivery. Nigeria's commitments include training frontline health workers to deliver a range of contraceptives and action to improve equity and access to family planning for the poorest. The government of Nigeria will partner with the private sector, civil society, traditional and religious institutions and development partners.

The fundamental questions are; is Nigerian government on track to implement what was promised? Who or which agency is tracking and reporting on such commitments? Are we ready and willing to ask our government the hard questions of what are the yearly targets and what has being achieved so far?

Every woman, every child

Let's also observe another commitment that we have made on Every Woman, every Child initiative of the United Nation which aims to save the lives of 16 million women and children by 2015. It is an unprecedented global movement that mobilises and intensifies international and national action by governments, multilaterals, the private sector and civil society to address the major health challenges facing women and children around the world. The effort puts into action the Global Strategy for Women's and Children's Health, which presents a roadmap on how to enhance financing, strengthen policy and improve service on the ground for the most vulnerable women and children. As a nation, we have endorsed the Global Strategy for Women's and Children's Health, and committ to fully funding our health program at $31.63 per capita through increasing budgetary allocation to as much as 15% from an average of 5% by the Federal, States and Local Government Areas by 2015. This will include financing from the proposed 2% of the Consolidated Federal Revenue Capital to be provided in the National Health Bill targeted at pro-poor women's and children's health services. The bill is yet to be passed as it always suffers political tussle between legislature and executive arm of government and is difficult to see how our commitment will be realised without having the bill pass into law.

At the just concluded 2013 Global Maternal Health Conference in Arusha, Tanzania, what we all do in our little ways and collectively was summarized beautifully as follows;

1. "We thank and we appreciate because we know the sacrifices and risks of women through the ages are the reasons we are here today. We know that maternal mortality was extremely high until recently.

2. We regret and we apologize and we cannot expect forgiveness. Women had to give up their lives when we did not have the means to prevent their deaths in pregnancy and childbirth. And yet, when we do have the means, we still leave them to die. We should plead guilty when we see that 800 women still die every day. An inconvenient truth is that they die because societies have yet to make the decision that their lives can be saved.

3. We promise we will eradicate maternal mortality, and yes, we can, for several reasons: Between 1990 and 2010, maternal deaths had dropped by 50%, but there still remains work to be done.

Yes We Can on Maternal and Child Health

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