Tuesday, 4 November 2008

Nigeria- Off track in reaching MDG 4 & 5

The United Nations national economist, Dr Ayodele Odusola, recently at the United Nations information center, said that Nigeria is one of the countries worse affected by maternal and infant mortality and morbidity. By definition, an infant is child below the age of one year.

He affirmed that Nigeria is yet to make appreciable progress towards achieving the Millennium Goals 4 and 5. Odusola stated that contrary to the Infant Mortality Rate (IMR) of 91 out of 1000 live births recorded in 1990,the reference year for the MDGs, statistics has shown that the value worsened to 110 per 1000 live births in 2005. If the target for the IMR reduction were to be reached by 2015, the country would need to reduce the rate to less than 28 per 1000. It seems unlikely that this target would be achieved, which may further compound the problems relating to the reduction of under-five mortality.

Dr. Odusola stated that under-five mortality rate is another problem that calls for urgent intervention. According to the national average, one out of five children dies before it reaches the age of five. In rural areas it is even higher, with under-five mortality rates up to 25%.
This difference is attributed to neonatal rates, the probability of dying within the first month of life, which is higher in rural areas. This is due to unequal access to health facilities since urban residents are expected to have better access than rural residents.

The major challenges facing the country in its efforts to reduce child mortality include

Poverty, which manifests itself in various ways, including the fact that poor families can not afford appropriate treatment and medical supply at health facilities, especially when it involves referral cases requiring movement from one particular location to the other.

Poor access to health facilities, more pronounced in the rural areas as a result of insufficient health personnel, lack of adequate health care services and distance to the primary health care centers.

The problem of HIV/AIDS posing a threat to under five mortality as many women of childbearing age have the probability of transmitting HIV to their newborn babies. Furthermore, children who become orphans in their early years are at high risk of not reaching their fifth year, even if they are not HIV positive themselves.

He lamented the decline in the proportion of children immunized against measles saying the proportion slows down from 46% in 1990 to 31.4% in 2003 and then rose to 50% in 2004.

According to him, the available data on maternal mortality shows that the rate of deaths among mothers in pregnancy and childbirth remains at abysmally high level with 800 deaths out of 100, 000 live births in 2004 compared to the global target of less than 75.

“The proportion of births attended by trained health personnel worsened from 45% in 1990 to 36.3% in 2003 but improved to 44% in 2005 as against a target of not less than 60% by 2015” Odusola stated during his speech at the UNIC.
The number and timing of antenatal care visits can be a salient factor in preventing adverse pregnancy outcomes, but only about 47% of mothers made at least four antenatal care visits.

According to National Population Census 2000 , only about 37 % of the births were delivered in health facilities. It should be noted that lack of care is most life-threatening during childbirth and the days immediately after delivery, since these are the days when sudden complications ate most likely to arise.

Meanwhile, he urged both state and local governments to give more attention to primary health care services while also stating that Nigeria can only achieve MDG 4 and 5 if more attention is devoted to effective management of resources and improved allocation of resources.

Furtermore, he advocated for policy efforts aimed at promoting reforms in major health sectors. In addition, the National Health Insurance Scheme, Integrated Child Survival Intervention Programmes, and Expanded Programme on immunization should be fully implemented.

-Adesanmi Ayodele & Sofia Krauss

Northern-based journalists embedded in the “warfront”

Kaduna, October 2008. Statistics on maternal, infant and child mortality show the situation in the north is far worse than in the southern parts of Nigeria. The maternal mortality rate in the north east (1549 in 100.000 life births) and the north west (1025 in 100.000) is more than five times as high as in the south west (165 in 100.000) . Hence, it is ever more necessary to raise public awareness on the grim condition of maternal health, the poor situation of many health facilities and the lack of accessibility to appropriate health care across Nigeria.

After the success of the first batch of Immersion Program Fellows, which reached its goal to educate a large number of journalists about maternal, newborn and child health issues, the project has been scaled up to train a new bunch of northern journalists. The approach looks at maternal mortality as a battlefield, in the same way war-reporters are embedded in the warfront, health reporters can be trained to be health experts in order to handle the complicated issues of health knowledgeably.

And who could fulfill this challenging task better than the media?

Seventeen journalists from all over the North were invited to a two-days orientation in the historical setting of Arewa House, Kaduna, and given the opportunity to be tutored by experts on health issues thereby increasing their reporting skills to create stories that directly affect the reader. Unfortunately, two of them had to be expelled due to lack of commitment. The first day was dedicated to information gathering, whereas the second day focused on the translation of the mere information into a grasping story.

The invited presenters, amongst them Dr. Oladapo Shittu from the Department of Obstetrics & Gynecology; Iyeme Efem, a health expert who spoke about Vaginal Fistulae; Augusta Akparanta-Emenogu, media specialist with ActionAID, Professor Emmanuel Otolorin from Access Project, Ms. Chinwe Onumonu from Pathfinder International and many other distinguished health professionals delivered informative presentations and never hesitated to engage themselves afterwards in discussions with the journalists. The participants had the opportunity to interview the experts and get exclusives voices for their health broadcasts.
It was pointed out, that the Millennium Development Goals 4 & 5, which focus on maternal and child health, are still out of reach and could only be advanced by huge improvements of the health sector. Participants advocated for the abolition of user fees for pregnant women and children under five; increased number of skilled birth attendants; improved access to health services especially in rural areas; implementation of a national health insurance .

It was noted that one player, be it the government or anybody else, can never reach these targets on its own. What Nigeria needs is a multi-sectoral partnership between a government which is committed to health policy, professional organizations keeping track of the spending of funds, an active civil society demanding their rights to access high-quality health care and last, but not least an investigative media environment, passing on information to every household and as a watchdog to the government of its promise

Budget tracking to ensure that funds allocated to health reach the communities is one more essential aspect of critical journalism.
The aim of this workshop was to train the journalists to live up to the desired change towards establishing a critical and investigative media environment, which can translate medical information and especially medical vocabulary into a language comprehensible to the lay audience. As Iyeme Efem put it in words, stressing the responsibility of the media :

“A responsible media person first learns about the issues, then highlights the issues and thereby generates dialogue between health providers and “consumers”, maintains the issues on the front burner and advocates for the voiceless and marginalized.”

Journalism is not only about reporting daily news, there must be a commitment to follow up with policy makers and continuously reminding them of the unsolved problems.

Only after the issue is resolved, the journalist’s job is done.