At 17, Ahmed still wears diapers and is unable to communicate properly. He is suffering from Cerebral Palsy, CP, a disorder of movement and posture due to a permanent but non-progressive insult to a developing brain. It manifests as a delayed developmental milestone. At birth, he had his umbilical cord wrapped around his neck and though, doctors detached the cord, he suffered brain damage caused by a lack of oxygen (asphyxia) before the cord was cut.
Words cannot explain the emotional pain Ahmed and his parents undergo daily. Part of the pain was caused by the inability of his mother, Hauwa, to receive the minimum of four Antenatal Care, ANC, visits as recommended by the World Health Organisation, WHO. When she was pregnant, she shunned the ANC.
Medical reports say ANC visits include tetanus toxoid vaccination, screening and treatment for infections, and identification of warning signs during pregnancy. Pregnant women are also tested for various diseases, if positive; they receive help and guidance to avoid transmission to their babies.
Antenatal visits
But Hauwa never received such services as she is among numerous Nigerian women who have the perception that ANC is a waste of money and time. In Nigeria, commencement of the ANC within the first three months is often regarded as too early. Many women who claim to have registered early do that at about five months while majority hardly attend up to four antenatal visits before they put to bed.
Senior Lecturer/ Consultant Paediatric Endocrinologist, Department of Paediatrics and Child Health, Obafemi Awolowo University Teaching Hospital, OAUTH, Osun-State, Dr. Jerome Elusiyan, defined Antenatal care as the care that a pregnant woman receives with the aim of making her pregnancy safe and in which she is prepared for an uneventful labour and also for a good pregnancy outcome.
"It involves health education and counseling and identification of mothers with high risk of jeopardy to her and the baby so that adequate preparation could be made to prevent them." Sadly, many pregnant women have maintained a deaf ear to these medically proven facts.
Statistics have shown that country-specific information suggests between 5 and 10 per cent of all children in Africa grow up with disabilities. The leading causes of disability - in addition to genetic disorders and complications during birth -- include poliomyelitis, measles, meningitis and cerebral malaria, as well as inadequate prenatal and neonatal health care services and inadequate diet leading to stunting.
But experts say early prenatal care could reduce the risk of such disabilities in children. Elusiyan in a chat with Good Health Weekly, hinted that birth complications such as asphyxia, a condition in which the newborn fails to initiate and sustain spontaneous respiration after one minute of birth, could be prevented by proper antenatal care. "Babies who develop birth asphyxia could die or develop neurological sequelae like cerebral palsy, mental retardation, learning disabilities and seizure disorders."
Contrary to belief that registration for antenatal should be made around the first 14 weeks, Elusiyan, advised that a woman should register as soon as she suspects she is pregnant.
UNICEF's Child Survival Development, CSD, Manager, Enugu, Dr. Oluwatosin Kuti, noted that early commencement of prenatal care would reduce risk of disabilities in children as well as the over 6000 million people that live with disabilities globally.
Kuti at a recent UNICEF Media review of the State of the World's Children 2013 which focuses on children with disabilities noted in a lecture entitled; "Health and Disabilities", said the prevalence of physical and health disabilities ranges from 10 per cent - orthopaedic impairments, about 85 percent - other health impairments (3rd largest category) and about .04 percent - traumatic brain injury.
Causes of health disabilities that could be averted through early prenatal care are numerous, but CP, one of the most common disabling conditions affecting children can resolve in up to 50 per cent of children diagnosed prior to two years of age.
Spina Bifida which also causes disabilities in children could be prevented when mother gets Folic acid before getting pregnant and during early days of pregnancy.
However, while early prenatal care is being promoted to reduce risk of disabilities, UNICEF 2013 State of World's Report on Children with Disabilities is calling for the inclusion of Ahmed and other unfortunate children who are currently living with disabilities and have continue to be the most excluded among all groups of children to be included in health, education and justice. The Report notes that the deprivations faced by children and adolescents with disabilities are violations of their rights.
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