The health authorities could do more in curbing these unnecessary deaths
An estimated 313,700 infants died as stillborns across the country in 2015, making Nigeria second to India, with some 592,100 stillbirths, according to a new study.
The report further noted that Nigeria’s deplorable ranking for children dying before 28 weeks of pregnancy has remained the same since 2000, with only a 1.3 deaths reduction annually. In addition, the grim report showed that 42 stillbirths are recorded on the average out of 1,000 live births in Nigeria, as against two per 1,000 births in Finland and Singapore and 2.2 per 1,000 births in Denmark and Norway.
It is indeed worrying that out of about 2.6 million third trimester stillbirths recorded annually worldwide, an estimated 1.8 million stillbirths occur in 10 countries and four of them are in Africa – Nigeria, Democratic Republic of the Congo, Ethiopia and Tanzania. What should further worry the health authorities in our country is that two-thirds of the stillbirths happen in rural areas, where skilled birth attendants, in particular midwives and physicians, are not always available for essential care during pregnancies, childbirth and for obstetric emergencies, including caesarean sections.
The report is very useful for the relevant authorities because it shows very clearly that there is a link between poverty and stillbirths, especially considering that they happen mostly in low-income countries and in the rural areas. But the report has also attributed the huge number of stillborn infants in these countries to five main causes including childbirth complications, maternal infections in pregnancy, maternal disorders, especially pre-eclampsia and diabetes, fetal growth restriction and congenital abnormalities.
We believe that this report should spur action on the part of the health authorities in the country. As things stand, many rural communities across the country lack cottage hospitals and medical facilities that will address these challenges. Where they exist, there is shortage of manpower, besides obsolete medical equipment and related services that more or less worsen the situation. For instance, many a time, pregnant women have died in the process of commuting from their homes to a medical facility. Recently, a woman in Enugu State gave birth to a baby inside a tricycle, popularly known as ‘Keke NAPEP’.
Were it not for the intervention of some passers-by at that critical hour, the woman perhaps would have ended having a stillborn infant. And that is if she was lucky to be alive.
It is very much evident that the Universal Health Coverage (UHC) has failed abysmally to tackle the challenge of stillbirths and other hiccups associated with pregnant women and infants. We put the blame on the harvest of deaths largely on the state governments across the land and the lack of attention by many of them to primary health care systems at the grassroots. It is even worse that most of them have rendered prostrate the local government administration in their states, leaving health care delivery at that level comatose.
The solution therefore goes beyond mere formulation of policies by the government in Abuja. There should be a framework where states and local governments are held accountable for maternal child health care services.
Similarly, the National Primary Health Care Development Agency (NPHCDA) should be strengthened in such a manner that will enable it collaborate with the states more effectively. There is also a need to go beyond rhetoric and promises to actionable plans to address all the existing gaps in the primary health sector. We must end the agony and tears of mothers who carry pregnancies for nine months only for their babies to be dead on delivery.
