It was a thing of a joy on Thursday 14th June 2012 as civil societies, health professional bodies and the media interacted about the need to have a national platform for dialogue and advocacy to ensure accountability in maternal and newborn health in Nigeria.
The meeting took place at the conference hall of Valencia Hotel in Abuja and prominent at the meeting were Hajiya Bilkisu Yusuf (Advocacy Nigeria), Auwal Rafsanjani (CISLAC), Professor Ladipo (Association for Reproductive and Family Health) , Dr Fred Achem (Society of Obstetrician and Gynaecologists), Dr Husain Abdu ( Action Aid Nigeria), Dr Farouk Jega ( Pathfinder International), Barrister Abiola (Women Advocates ‘Research and Documentation Centre), Dr Nkem (HERFON) and Dr Wilson (Women’s Health and Action Research Centre), to mention but few.
Nigerian Government and Maternal and Newborn Health
It is important to recognise government efforts and policies to address maternal and newborn health like I observed in my paper. In the face of these staggering statistics, the Nigerian government has prioritized maternal health since the change in government in 1999. However, despite an increased prioritization of maternal health both in public statements and on paper, this commitment has yet to yield significant impact on the ground.
A number of critical barriers impeding progress are;
1. Funding: Low levels of funding for maternal health constrain implementation
2. Inadequate commodities at the facility level such as Magnesium Sulphate, Oxytocin, Misoprostol and antibiotics
3. National data on maternal health in Nigeria are weak, making it difficult to assess the situation of maternal health in the country.
Nigerian Government has taken some steps to redress the situation;
1. National Strategic Health Development Plan (NSHDP) (2010- 2015).This is the guiding document for health interventions, and includes a costed framework for action, as well as an Essential Package of Care for reproductive, maternal and infant health.
2. Integrated Maternal, Newborn, and Child Health Strategy (IMNCH Strategy). It was adopted in 2007 with assistance from UNICEF, and aims to take an integrated approach across all levels of government and across the continuum of care for women and children, from pregnancy through early childhood. Essential Childhood Medicines Scale-up Plan
3. Midwives Service Scheme. Although the policy environment is generally not supportive of specific investments in maternal health commodities, the Midwives Service Scheme (MSS) serves as one example of a national policy that reflects a relatively high level of harmonization among tiers of government, including clear roles and responsibilities for federal, state and local authorities.
4. National Health Bill (Pending). Perhaps the most promising policy development in recent years would have been the proposed national health bill that would transfer a substantial amount of funds from the country’s oil revenues to improve health services.
Some useful questions asked were
1. What is the level of implementation of these policies?
2. What is the impact of these policies and programmes across Nigeria?
3. How much do we know about them?
4. Who monitors and ensure accountability?
On behalf of all of us Nigeria’s Government has made some commitment based on United Nation’s Secretary General’s Strategy on women’s and children’s health that was launched in 2010. Nigeria has committed itself to fully funding its 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.
Others were;
1. Integration of services for maternal, newborn and child Health, HIV/AIDS, Tuberculosis and Malaria
2. Strengthening Health Management Information Systems
3. Improved Midwives Service Scheme
4. 2% of consolidated crude oil revenue allocated to health sector
Some pertinent questions based on the above commitment are;
1. Are we aware of these commitments?
2. Is Nigeria on track to fulfil these commitments?
3. Who monitors the implementation of these commitments and ensure accountability?
In conclusion, a critical mass of voices is needed in Nigeria through an organised national platform for dialogue and information sharing on accountability, use of score cards to monitor key indicators of government performance and produce an annual shadow report on ‘State of the Nation in Maternal and Newborn Health’. Culled from the Daily Trust -Dr Aminu Magashi.
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