Infant Mortality In Nigeria and Need For Sustainable Interventions By Afolabi Gambari

The 45-year-old sprawling University of Calabar Teaching Hospital complex is in dire need of a face-lift, except that this seems the concern of a first-time visitor that kept thinking of why the complex should be refurbished, even if for the sake of attraction.

But the non-stop activity at the sick baby unit belied the somewhat depleting structure. Staff were enthusiastic and dutiful, just as there was electricity as well as running water – the key ingredients needed to make the health care facility worth its status. The Deputy Director in charge of the unit, Mrs. Esther Esenwenren Onoh, exuded the noticed enthusiasm. She said: “Babies are getting treated and discharged. In the last two months, between eight and ten babies were brought in here.”

Onoh’s excitement at the low traffic was palpable. Months before, the unit was a like a baby market with many babies brought in from around the state needing life-saving interventions. Not any more, thanks to improved services motivated by government’s partnership with UNICEF which aimed at reduction in infant mortality.

Despite all the foregoing, however, Onoh said there are still some challenges needing to be surmounted, chief among which is finance: “Getting all the required materials to get this unit functioning perfectly, especially on the side of the parents procuring antibiotic drugs, sometimes poses a great challenge. There is also need for more incubators to augment the ones available at the moment, in addition to non-stationed oxygen cylinders, while it won’t be a bad idea to have more nurses employed.”

The social system of Nigeria makes the challenge of finance stressed by Onoh gripping, especially with regard to mothers getting the desired treatment for their sick babies. The case of 32-year-old teacher, Mrs. Ekana Samphill, is typical. Early in November, she brought in her twin babies delivered prematurely and each weighing 0.8kg upon their admission.

They also needed to be treated with antibiotics. Inadequate finance, worsened by the fact that her husband is also a teacher on low wage, weighed her down. Unfortunately, she lost one of the twins in the process but the surviving child has got the required treatment to stay alive and healthy. But she had bills totaling N320,000 to settle before which she would be discharged, forcing her to call on well-meaning Nigerians to come to her rescue.

Many other mothers spread across Cross River State would be so circumstanced and would require empathetic people to get reprieve.

Situated inside the Mary Slessor General Hospital in Calabar is an Oxygen Gas Plant donated by the UNICEF to provide oxygen for the needy new-born. The solar-powered plant produces 300 liters of oxygen per minute under the supervision of experts and, according to Dr. Kenneth Takim, Medical Superintendent/Manager at the hospital, the facility, the biggest in the state, has helped to reduce child mortality in quantum, especially within the last four years.

At the School Health Services Clinic in Ekpo Abasi, Calabar South, one of the Primary Healthcare Centers in the state, the need for expansion to cater for the needs of babies could not but be noticed. Officer in Charge of the facility, Mrs. Bassey Oyama listed a plethora of challenges that include inadequate staff and inadequate training for the staff on the ground.

Unlike the Ekpo Abasi clinic, the Primary Healthcare Center at Ikot Offiong Ambai in Akpabuyo Local Government Area of the state is expansive.

But with the staff strength at 15, it gets overstretched especially on Thursdays when the facility receives between 30 and 40 babies who are in need of treatment. Safe for the cooling freezer for vaccines that is solar-powered, the entire facility is not serviced with regular electricity supply, making service provision cumbersome.

Traditional birth attendants are a common feature in Cross River State, although there is nothing to suggest yet that it is a phenomenon. Dr. Vivian Out, Director General of Cross River State Primary Health Development Agency, admitted to being aware of the trend in her address at the two-day Media Dialogue on new sick born and zero dose organised by UNICEF and the Federal Ministry of Information and National Orientation’s Child Rights Information Bureau (CRIB) on December 4 and 5 in Calabar.

She said: “We appreciate the fact that the traditional birth attendants are patronised by a lot of women in the state, which is as a result of the culture and tradition of the people. But we have since developed a strategy to engage them in series of meetings aimed at educating them on the need for safety of the new born babies.

We have a collaborative engagement with them such that in situations where they are overwhelmed, they can make referrals to the primary health care centers or the general hospitals as the cases may demand.

We also give incentives to expectant mothers to patronise standard facilities for their babies’ delivery because at the end of the day, it is the well-being of mothers and babies that matter.”

According to a UNICEF data, 7,100,000 babies were born in Nigeria in 2015, approximately 19,500 every day. The data also indicates that Nigeria’s neonatal mortality rate (NMR) is 34 deaths per 1,000 live births.

This, perhaps, informed the remark by Dr. Martin Dohlsten, Health Manager, UNICEF, Abuja in his presentation at the media dialogue where he advocated what he called mentality shift from survival of mother and child at birth to opportunities for both to thrive afterwards. Dohlsten also sought answers for why expectant mothers would shun standard health facilities, stressing that adequate ante-natal care is key to saving the child from infections, asphyxia and immaturity while calling on particularly the government and other stakeholders to engage in well-coordinated interventions towards achieving this vision for Nigeria.

In their presentations, both Mrs. Aderonke Akinola-Akinwole, SBC Specialist. UNICEF Lagos Office and Dr. Olusoji Akinleye, Health Specialist, UNICEF Enugu Office, identified barriers to interventions on child mortality and advocated measures at breaking the barriers.

They also agreed that the media have an onerous role to play in bringing all the stakeholders together to form a united front in fighting the scourge that threatens to decimate the future of Nigeria.

Akinola-Akinwole specifically advocated a home-grown antidote to the scourge, saying: “UNICEF will not be in Nigeria forever, so it is expedient on us all as Nigerians to find a lasting solution to these challenges in our own way.”

Views expressed by contributors are strictly personal and not of TheCable.

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