Thursday, 8 June 2017

Maternal Health: Group Urges Women To Utilise PHC Centres.

The need for women, especially the pregnant ones to take full charge of their lives through ensuring the use of healthcare centres to prevent high rate of maternal mortality has become one of growing concern.

The issue was the major high point recently, when Mamaye/Evidence 4Action, a non-governmental organisation in collaboration with Lagos State Ministry Health organised an advocacy campaign in Amuwo Odofin and Ori Ade Local Council Development Areas (LCDAs).

The goal was to sensitise women and educate them on how to avoid maternal and infant deaths.

Stressing on how timely the sensitisation programme is to the people of the community, Dr. Orebiyi Olatunji Sunday, medical officer of health of Amuwo Odofin Local government, said that one of the things that is quite obvious in Amuwo Odofin is that maternal mortality is 525 per 100, 000 women.

“So it’s very high and it’s the same thing with Lagos state, so we need to reduce the maternal mortality. We can only get that done when we enlighten the community on what maternal mortality is all about.

“We want this to start with family planning –   content of family planning. We have different types of family planning, it is very important. Then they should go to a health centre to register when they are pregnant -within six weeks of the pregnancy; it is very important.”

Bemoaning the cause of maternal mortality in the area he said: “Most of the pregnant mothers often remain at home till when they are about to deliver, it is then they want to rush out. Some of them often develop many complications, including haemorrhage and you cannot use water to replace blood. “Some developed High Blood Pressure (HBP) and this has a lot of implications on them as well as the baby. Another thing is when the baby stop moving, if there is no sign, then something is happening to the baby. It might be that baby has died inside the womb without anybody knowing it. Those are the things that led to this awareness creation today. It is not a one day thing, it is continuous,” Sunday reiterated.

According to different stakeholders from Amuwo Odofin, many of the maternal and child deaths are recorded in traditional birth attendants’ places.

“We are also using this same forum to sensitise our traditional birth attendants (TBAs) because they are many in our local government. We are here to sensitise them on how to prevent maternal mortality because most of the deaths in their facilities are not being recorded. We want to enlighten them and also train them to know what to do. Some of them don’t know at what point that they have to refer their patients and they keep them until when they are almost lifeless. That’s one of the things we want to sensitise them,” Dr. Sunday said.

Also commenting on the choice of Amuwo Odofin for their campaign, Fola Richie-Adewusi, Advocacy Campaign Lead, Mamaye/Evidence4Action, Nigeria said from the scorecard of Lagos State, Amuwo Odofin and Badagry showed low performance and that informed while the group has chosen to take the campaign to the two communities.

“We felt it will be nice to meet with the community people, sensitise them on the need for the women to go for antenatal care; to deliver in the hospital and to also mobilise people to donate blood, because shortage of blood is also a challenge.

“Lagos State government has a robust programme but you know it’s one thing for the facilities to be provided it’s another thing for the people to utilise those facilities so those are the challenges. So the focus of this is to sensitise people that facilities have been built, let them utilise the facility. Trained healthcare providers are there, drugs are there, they can utilise the facilities instead of going to TBAs.

“Most times, deaths that are recorded are recorded because they are referred late to the health facility. So if the pregnant women go for antenatal care on time especially before 20 weeks with other tests that would be conducted, the professional healthcare provider will be able to know if there are danger signs that need to be referred beyond the primary health care. So that’s what this is all about.

Also, health education officer, Amuwo Odofin local government, Olawole Abiola, also described the programme as a laudable one while he was optimistic that it will go a long way in changing the record of high maternal deaths in the area. “Because most of these deaths are traceable to TBAs, we are educating them to patronise our health centres at least that will reduce the trend,” Abiola said.

However, head, Donor Organisation Unit, Lagos State Blood Transmission Service, (LSBTS) Olayinka Sijuade, said the programme is timely in an environment where awareness must be emphasised on the importance of donating blood voluntarily.

Stating the benefits of donating ones blood she said: “In fact they are actually doing themselves a great deal of help. Average Nigerians don’t go for medical check-ups, so it’s very good opportunity for them to get checked while they think they want to save the life of someone they are indirectly saving their own life. Quite a number of people who have visited our stand today were unable to donate and they were amazed. Some of them have a very high blood pressure and another with very low haemoglobin level and ordinarily, these people will keep moving, but they are not safe until when they get to the extreme when they will actually need a blood transfusion which might actually be too late. So I want to believe it is a timely intervention programme and I want to give kudos to Lagos State government and the organizers,” she commended.

Federal Government Approves Central Coordination.

The Federal Executive Council (FEC) today approved a memoranda from the Federal Ministry of Health seeking for approval of central coordination, placement, posting and funding of all Medical and Dental graduates to Medical and Dental Council of Nigeria (MDCN) accredited Housemanship and Internship training centres.

A statement signed by Mrs. Boade Akinola, Director, Media and Public Relations, for the  Minister of Health, Prof. Isaac Adewole, quoting the Minister said that this is to address the enormous challenges fresh graduates face in securing placement for the one year mandatory programmes.

Over the years due to constraints in the funding of the Housemanship and Internship training in Nigeria, a large number of fresh Medical and Dental graduates have not been able to undertake and complete the training within the allotted time limit thereby preventing them from becoming fully registered Medical and Dental Practitioners ready for services within and outside Nigeria.

The Housemanship and Internship training is the last basic training hub of all fresh Medical and Dental graduates from Nigeria and Foreign Institutions.

These graduates are required by law to complete their uninterrupted 12 calendar months rotational Housemanship and Internship training and obtain a certificate of experience from any of the MDCN accredited training institutions.
On completion of the training, they are eligible to be placed on the full Medical and Dental register as provided in the Medical and Practitioners act Cap M8LFN 2004, Section 18 which will enable them to practice as Medical and Dental Practitioners.

With the approval from the Federal Executive Council, the Federal Ministry of Health will work with the Federal Ministry of Budget and National Planning and Federal Ministry of Finance to implement this laudable programme to be domiciled in Medical and Dental Council of Nigeria (MDCN).

This would clear the large backlog of fresh Medical and Dental graduates that have been unable to undergo the training due to absence of central coordination, poor funding, and inability to pay salaries and allowances among others.

Mothers Receive Cash Gifts For Giving Birth To Triplets, Quintuplets

IVF: Mothers Receive Cash Gifts For Giving Birth To Triplets, Quintuplets
·      FAAI, Nordica Fete Children
That age is not a barrier to child bearing cannot be disputed.  This fact was confirmed recently, when Mrs. Folashade Akiode was honoured during the Nordica Bon Bon family fiesta held to mark this year’s International Children’s Day for breaking all medical rules of menopause and having her set of triplets seven years ago, at  57.

Mrs. Akiode who retired from the Lagos State Civil Service as Director of Service, but now doing her own business was married for 18 years before she had In Vitro Fertilization (IVF) at Nordica fertility Clinic, delivering a set of triplet.

Making the presentation of N50,000 to Mrs. Akiode, Dr Abayomi Ajayi, Managing Director, Nordica Fertility nationwide told journalists that the event which held in Lagos, was organised by Fertility Awareness Advocacy Initiative (FAAI) with collaboration from Nordica Fertility to celebrate children born through IVF.

Dr Ajayi also said that the main objective of NORDICA is to complete families, noting that age is not a barrier to achieving pregnancy through IVF.

The Fertility expert explained that Nordica also tries as much as possible to limit the age at which people can have IVF to avoid abuse of technology, recalling that the oldest mother in the world is a 70-year-old.”

For Mrs. Akiode, the gyneacologists explained, “She delivered her children at 57. She actually had triplet, a boy and wo girls, but the boy died during the neonatal period.”

“Age has never been a barrier but the thing that we have technology doesn’t mean we use it anyhow and so what we try to do is to limit the age at which you can have IVF.”

On the major challenge of fertility experts following the recession, Dr Ajayi said that power supply poses a challenge as fertility treatment industry are dependent on generators to do business. However, he acknowledged that there’s a limit to which fertility treatment centres can increase price.

He however called on the federal government for intervention and to help see that there are no quacks in the system, so that people who pay for the service can get value for their money, saying that when there are quacks those who think IVF is expensive will start patronising them.

Another family of Olayemi Sofunlayo who had six children through IVF were also awarded N100,000 for emerging the largest family from Nordica Fertility Centre during the occasion.

“Well, that was the largest children in the family from Nordica. They had the six children from Nordica, that’s why we chose to recognise them, they had them two times.” Dr Ajayi said.

While telling her story, the visibly excited Mrs. Akiode said that accessing IVF was not so expensive for her since she was working and even training other people.

Commenting, Engineer Oladipo Soetan, treasurer of FAAl, said, “We are the support group to Nordica facility. We have an association that comes to create awareness among people who are looking for babies. There are many families out there whose families are not completed, we have passed through Nordica. In view of this we came together to form an association to create awareness to the general public to know that IVF babies are normal babies. Many people run from IVF, thinking that IVF children are not normal and we are here to say that IVF babies are normal babies, very intelligent with high IQ. As parents we are spreading the gospel for people should do IVF if they have challenges with fertility.

“l have one boy, Emmanuel, after 19 years of fruitless marriage, at that time my wife was close to 50 before we had him. Actually if you see him he looks like me. We are like identical brothers. By July he will be nine.”


Mrs. Tola Ajayi, Clinic Manager, Nordica Fertility Centre, said that the Nordica Bon Bon family fiesta was organised to create awareness about IVF, adding, “the only unique thing about the goals of the party is that it will address that issue of difficulty for parents to identify with IVF, to say, ‘We did IVF.’

“That’s the issue and it took some efforts for us to be able to get them to come for the party.”

PSN Hails Federal Government's 40% Order Preference To Local Goods Procurement

Pharmacists under the aegis of Pharmaceutical Society of Nigeria(PSN) have commended the Federal Government on the recent Executive Order on support for local content in public procurement.

Acting President, Prof. Yemi Osinbajo had on May 18, 2017, signed the Executive Order, which mandated all Ministries, Departments and Agencies (MDAs) of government to give preference to local goods and services in their procurement activities.

The order also directed that made-in-Nigeria products should be given preference in the procurement of relevant items as it stipulated that 40 per cent of spending by the MDAs must be expended on locally manufactured goods and services.

A statement jointly signed by Pharm. Ahmed Yakasai, PSN President and Pharm Gbolagade Iyiola, PSN National Secretary, which was made available to Independent, noted that the federal government deserves commendation for deeming it fit to include locally manufactured medicines in the Executive Order as specified in its Section 4F of the order.

This move will surely give a boost to pharmaceutical industry in Nigeria by guaranteeing adequate medicines supply for our local needs as well as export that will earn foreign currency for the economy, the statement added.

PSN urged the players in the pharmaceutical companies to exploit this window of opportunity with all seriousness.

“Doing this will place the pharmaceutical industry on a pedestal where it will be able to contribute its own quota to the growth of the economy by providing employment opportunities to the teeming Nigerian youths.”

However, PSN urged government to operate this policy thrust with sincerity of purpose by ensuring that companies are paid promptly by MDAs after they make supplies to them.
Recently, government parastatals had been frustrating transactions between them and private players with huge burden of debts for supplies coupled with bureaucracy and corruption endemic in the system when payments are to be made, it noted.

PSN further called for a boost in the operating environments for the pharmaceutical industry.

According to the body of pharmacists, the operating environments need to be made more conducive with improvement in infrastructure, cheap loan facilities and a regime of tax holidays as we have been canvassing all along.

The group also pledged her continued commitment towards the realisation of sustainable access to affordable and quality medicines to Nigerians.


Minus Funding, FG’ll Be Paying Lip Service To Fistula Intervention –Efem

Chief Iyeme Efem, a Fellow of Institute of Social Works (FSOW) and professional in Social Works is at the vanguard of global efforts to eliminate Obstetric Fistula. Fellow of Institute of development Administration (FDA) and the Country Project Manager, United States Agency for International Development (USAID) and Fistula Care plus Project, in a recent interview with CHIOMA UMEHA to commemorate International Day to end Obstetric Fistula spoke on prevention, treatment and management of the condition. Excerpts:

What is obstetric fistula?

Obstetric Fistula is a hole, or abnormal opening in the birth canal that results in chronic leakage of urine or faeces. Theme for this year is “hope, healing, and dignity for all.”

This captures the essence of repairing of obstetric fistula. Firstly, people need to understand that women with fistula are stigmatised and marginalised within the society. They have lost respect and they are either begging on the streets or hidden at home, depending on the part of the country they live. The USAID Fistula Care plus Project offers them hope that their condition is not hopeless and they can have succour. It provides the opportunity for them to experience healing, not only for the fistula through repairs, but also for their emotions. Lastly, it restores their dignity as women and makes them stand tall and proud again. However, the theme of this year’s International Day to end Obstetric Fistula aptly reflects the reversal of their fortunes through the services the US government offers.

The theme actually reflects this very well. It holds a real hope for the eventual elimination of fistula globally, as well as a clarion call for all to come together to eliminate this scourge.

Mention causes obstetric fistula?

The primary cause of obstetric fistula is “prolonged obstructed labour” usually as a result of the disproportionate cranio-pelvic relationship, when the head of the baby is too big to pass through the birth canal. During this time, the soft tissues of the pelvis are compressed between the baby’s head and the mother’s pelvic bones. The lack of blood flow causes tissue to die, creating a hole between the mother’s vagina and bladder or between the vagina and rectum, or both, resulting in leakage.

Left with chronic leaking, women with obstetric fistula are often abandoned or neglected by their husbands and family members. And they are most often unable to work, due to their condition and ostracised by their communities. Women who develop obstetric fistula usually have a stillbirth, so they must also deal with the loss of a baby. Women with fistula are often among the most impoverished and vulnerable members of society.

There are other types of fistula, based on the cause. Iatrogenic fistula could occur during a cesarean section, when the bladder is accidentally cut, resulting in a hole or abnormal opening through which urine leaks. Traumatic fistula occurs following several physical impacts on the female genitalia, including rape, forceful insertion of sharp objects into the female private parts as experienced during war/conflicts and also during Female Genital Cutting (FGM).

What do you think the public should know about Obstetric Fistula?

It is not the fault of the woman. Many communities have myths that the woman causes this to herself. The only crime here is that she probably had a baby, whose head is bigger than her birth canal. How is that her fault?

It is not because she refused to marry someone, with whom she had previous agreement and went on to marry someone else. This is not true. Obstetric fistula is also not due to witchcraft. It is not anyone in the community trying to bewitch her for whatever reason.

Obstetric fistula can be repaired. Once repaired, the patient can get back her life and dignity. The repairs are free, thanks to the Support of USAID Nigeria. You can contact any Fistula Centre in the country and the patient will receive help. Public should ensure they have all pregnant women visit hospitals for antenatal care, as well as deliver under the care of a trained health-care provider.

Mention signs, symptoms and treatment of Obstetric Fistula?

These include constant leaking of urine or faeces from the birth canal, though it is important to immediately go to a Fistula centre to do check-up and confirmation, as other conditions might mimic such symptoms. The patient should go directly to a centre near her to see the hospital staff and she will be examined and repaired, if it turns out that it is Obstetric Fistula.

 Is Obstetric Fistula preventable? How?

By ensuring that people are aware of the causes and that all births are planned, as well as ensuring that all pregnant women go for the full completion of antenatal care. Pregnant women should deliver in a hospital under trained healthcare provider.

A lot has to be done by all to ensure that this scourge is eliminated. The Fistula Care plus Project is funded by the US Government to support repairs and rehabilitation of women with fistula. It also supports prevention through various approaches. So, we should individually ask ourselves what we can, and should do to ensure this scourge is eliminated. There is need for adequate awareness and education about Obstetric Fistula.

State governments should support USAID, because most of the repairs of the women with fistula happen at the state level. Several state governments have made it a point of duty to support the repairs in their states. But, many more states have not seen this as an issue. The state governments should do more to support Fistula activities in their states, as no state in this country is free from it.

The Federal Government through the Federal Ministry of Health has done well by setting up a Fistula Desk to coordinate fistula activities nationally. Unfortunately, the desk has not been funded since 2009, when the first budget line was created. Without such funding, the government will be paying lip service to fistula intervention at coordinating level.

The Federal Government has also done well by setting up national centres at the geo-political zones. This is great. Each of those centres has budgets, but as usual, their budgets are not released. So, we end up with facilities that have no consumables to conduct repairs. They depend on USAID to fund consumables for their repairs. This is not fair to the women and the facility staff, who really want to work, but lack the funds. If you look at their budget on the website, you will see that they are well funded, but releasing the funds for the activities is a major challenge.

I would, therefore, appeal to the Federal Government to do its best to release funds, so these facilities can cater for the women with fistula. At this rate, depending on USAID alone will not clear the backlog of the 200, 000 women living with fistula in Nigeria, and the 12, 000 new cases occurring annually. For the rest of the country, all hands need to be on deck. Our traditional rulers, religious leaders, community leaders, school officials and various associations in the country need to educate themselves and their wards on the challenge of fistula and how to prevent it. Let’s adopt the slogan “Help one help all,” as we join hands to end fistula in Nigeria.

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