Maternal, Neo-natal & Child Health

According to World Health Organisation (WHO) and the World Bank despite some progress made during the last few years, maternal mortality  rate  in Nigeria is still as high as 821 per 100,000 while that of Niger State is 130/100,000, under 5 maternal mortality of 103/100,000 live births and Infant mortality rate is 260/100,000 live births. In Niger State, 1 in every 95 women die during pregnancy and childbirth which translates to an annual estimate of 1,934 deaths from pregnancy-related complications. Majority of these deaths occur in rural areas which are in hard to reach communities due to the terrain of the state.

The commonest causes of maternal death across all local government areas in the State is Post-Partum Haemorrhage (PPH) and Eclampsia while birth Asphyxia and neonatal sepsis contribute to the largest causes of neonatal mortality in the State.

In order to build on existing government structure and to ensure that interventions are based on evidence, the foundation carried out a rapid assessment of maternal, new born and child health services in Niger State in August 2015. The assessment was undertaken in six LGAs spread across the three senatorial districts of the State. Data were collected from representative households from women group using focus group discussions. In depth interviews were conducted with women of reproductive age 15 – 49 and with men ages 15 – 59 in all the sample LGAs. Twenty-four secondary and primary health facilities were assessed for quality of maternal, new born, child health and family planning services. 

The findings show that only 50% of women of child bearing age received family and antenatal care from skilled healthcare providers across the State at primary and secondary health facilities. Although most births in the surveyed sites occur in health facilities, some still take place at home especially in zones A and C where facility-based deliveries are below sixty percent. Regarding post-natal care, this service is rarely provided in secondary health facilities (below 10%) and not offered at all in primary health centres that provide delivery services.

To further verify the urgency for this project, Raise Foundation equipped its MNCH project team with the Niger State RMNCAH+N Scorecard 2018 Q2. This is a cross-section of data on Reproductive, Maternal, Neonatal, Child, Adolescent Health & Nutrition recorded in the second quarter of 2018. The scorecard shows baseline indicators on MNCH situation in all 25 LGAs of the state.

This qualitative and quantitative assessment through patient’s analysis and data collation; the deduction shows that Mashegu LGA has 9% health facility deliveries and 2% birth registration. Suleja LGA has 26% health facility deliveries and 27% birth registration and so on. This result is quite poor for an urban city which has a secondary healthcare facility.

The scorecard informed the foundations’ decision on identified gaps at the primary healthcare facilities and guided the project interventions in the selected LGAs.

OUR ACTIVITIES

Provision of Community Based Emergency Transport Schemes

Delay in accessing and receiving appropriate care is a major predisposing factor to maternal and newborn deaths. The community-based emergency transport scheme fills a crucial gap in the referral chain by transporting expecting mothers to health facilities promptly and efficiently. It addresses one of the three delays associated with maternal mortality and morbidity i.e.  the delay in getting to a health facility. The emergency transportation plan includes the use of Tricycle ambulances which can maneuver the rural terrain in the state.

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A support referral system is in place to link the tricycle ambulances and the Primary Healthcare facility to assist the communities’ quick access for maternal and new-born services especially during pregnancy and delivery.

Training of Healthcare Personnel and Volunteers Involvement

Capacity building for health workers at Primary healthcare level to offer effective MNCH services. The project is involved in training of Project monitoring and evaluation staff on data collation, analysis and dissemination. These personnel undertake continuous professional development quarterly. Development of training modules and practical sessions to ascertain the level of technical know-how. The volunteers work at the community level with the PHCs and influential women and men who would form support groups to sensitize and mobilize on MNCH issues and act as agents of change in the community. This is complemented by behavior change communication through mass media campaigns and targeted messages in the local dialects.

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The volunteers visit households to build awareness and engage women in forming primary groups to address maternal and newborn health concerns. These volunteers have become a new cadre of grassroots leaders, who are responsible for increasing communication and networking between the communities and health facilities.

Distribution of delivery kits (Mama Kits)

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A preventive dose for PPH which is Misoprostol tablet is included in the kit with leaflets showing diagrammatic illustration of how to administer the medication in different ethnic languages. Chlorhexidine is also included in the kits for application on new-born umbilical cord.

OUR ACHIEVEMENTS

• Over 20,000 thousand women making at least four antenatal care visits (20,736)
• Over 230 Women been provided with Emergency Transport
• Forty-Five (45) Health personnel trained
• Over 8,000 thousand births assisted by skilled personnel (8,163)
• Over 8,000 Mama Kits distributed at point of delivery to expectant mothers
• Over 8,000 newborns and mothers have received professional care within 24 hours of delivery (8,163)
• Over 10,000 thousand children under the age of one year fully immunized against vaccine-preventable diseases (11,994)