By Chioma Umeha
Lagos – At 15, Olayinka still wears diapers and
has difficulty in communicating properly. She is suffering from Cerebral palsy
(CP) a group of non-progressive disorders of movement and posture caused by
abnormal development of, or damage to, motor control centres of the brain.
“I don’t know how it started. But, I watched my
baby and noticed that she behaves somehow. Every time, she will be throwing up
saliva, bending and shaking her head somehow. When she could not sit down even
at eight months I became worried,” these were the words of Adeline Gbaja, 20,
housewife.
Asked when she attended antenatal care when she
was pregnant, Adeline, appearing distraught, told Independent: “I registered for
antenatal care. Yes, I think registered after five months of my pregnancy. I
went to my hospital when I had complains. But, I didn’t have complains. I was
surprised when the doctor at General Hospital, Ikeja told me that I was
supposed to register ANC before 20 weeks and antenatal regularly. According to
him, this could have helped to detect this kind of problem early and avoid it.”
Cerebral palsy is caused by abnormal development
or damage to the parts of the brain that control movement, balance, and posture.
It manifests as a delayed developmental milestones, including, sitting, walking
and standing.
Studies show that the problems often occur during
pregnancy; however, they may also occur during childbirth, or shortly after
birth. Though the cause is unknown, experts agree that CP is partly preventable
through immunization of the mother and efforts to prevent head injuries in
children such as through improved safety.
Words cannot explain the trauma which Adeline is
passing through with her family in managing their daughter, Yinka who is now
living with CP.
The story of Opeyemi Osun, 28, Secretary, appears
different. She said: “I used to register for antenatal care at least when my
pregnancy has reached five months. The time has not reached. This is not my
first time. When I gave birth to my first baby in 2010, my pregnancy has passed
five months before I registered for ANC. Everything went well, my baby used to
come fast; they don’t waste time when I enter labour. My second and third baby,
in fact it is the same thing, I registered for antenatal care, and I didn’t
have any problem.
Though, Opeyemi was lucky, Amarachi Ndima, 22,
trader, was not.
She said: “My first baby died in the womb. I had
still birth and the doctor told me that my baby would not have died if I
registered early and was regular at ANC. This one is my second baby, I didn’t
waste time, I have registered at General Hospital, Igando, Alimosho Local
Government Area (LGA). ” Opeyemi told Independent.
The World Health Organisation (WHO) recommends
that all women giving birth and their newborn babies should be protected
against tetanus.
United Nations (UN) health body further recommends
minimum of four Antenatal Care (ANC) visits for every pregnant woman. According
to WHO, the first ANC visit should be as soon as a woman knows she is pregnant;
the second visit is to take place between 20 and 28 weeks, while the third
visit should be between 34 and 36 weeks.
However, the fourth visit should take place before
expected date of delivery or when the pregnant woman feels she needs to consult
health worker.
Provision of antenatal care (ANC) is included in
the pillars of maternal health care promoted as effective answers to neonatal,
infant and maternal mortality. For instance, the Amarachi could have avoided
still birth in her first pregnancy.
Early antenatal registration has been linked with
optimal utilization and appreciable reduction of perinatal morbidity and
mortality.
But, many studies have shown that the vast
majority of Nigerian women register for antenatal care late and the causes may
differ from those found in developed countries.
Evidence from Lagos State Demographic Health
Information Survey (DHIS2), Maternal and Newborn Health Service Delivery
scorecard, shows that the proportion of pregnant women who reported for ANC at
less than 20 weeks of pregnancy in the State were between 42 and 45 per cent,
for 2014 and 2015 respectively.
Research confirmed that most women book late
because of a belief that there are no advantages in booking for antenatal care
in the first three months of pregnancy. This seems to be because antenatal care
is viewed primarily as curative rather than preventive among women.
According to the scorecard developed by Lagos
State Accountability for Maternal and Newborn Health (LASAM) with support from
Mamamye, Lagos state has made insufficient progress in quality service in
maternal and newborn health.
However, LASAM urged the State to increase
awareness on the benefits of early registration for antenatal care before 20
weeks of pregnancy.
Experts have insisted that research is needed to
determine the best approaches for health education programmes to correct the
misconceptions about antenatal care.
Amina Umma Bala, a family planning expert, Fistula
Care Plus, noted that ANC provides care which can prevent and treat
complications of pregnancy.
“Skilled attendance at birth reduces the chance
that a woman will die at delivery; therefore, every woman should have antenatal
care and should deliver with a skilled birth attendant,” Bala told Independent
in an interview.
The family expert also said that one of
intervention during ANC visits is the measurement of weight and height and
assessment of nutritional status of the women.
Similarly, stakeholders emphasised on the
importance of folic acid before conception and during early pregnancy.
Speaking at a recent stakeholders dialogue on food fortification hosted by the
Global Alliance for Improved Nutrition (GAIN) and the National Agency for Food
and Drug Administration and Control (NAFDAC) with the theme, “Sharing our Successes and Challenges: Align
on the way forward, the experts
said that folic acid helps to reduce the risk that babies would be born with a
serious neural tube defect (a birth defect involving incomplete developments of
the brain and spinal cord) by up to 70 per cent. For instance is cerebral palsy
as in the case of Yinka.
Folic acid, according to the founder, Spina Bifida
and Hydrocephalus Care Foundation of Nigeria, Comrade Olubunmi Lawal-Aiyedun,
is a B vitamin (B9) found mostly in leafy green vegetables like kale and
spinach, orange juice, and enriched grains.
“The most common neural tube defects are spina
bifida, an incomplete closure of the spinal cord and spinal column;
anencephaly, severe underdevelopment of the brain and encephalocele, when brain
tissue protrudes out to the skin from an abnormal opening in the skull,”
Lawal-Aiyedun said,.
“All of these defects happen during the first 28
days of pregnancy usually before a woman even knows she’s pregnant and that is
why it is important for all pregnant women to register for early antenatal care
so that folic acid along with other essential drugs can be given to them to
make them and their unborn babies healthy.”
She added: “Adequate folic acid intake is very
important before conception and at least three months afterward to potentially
reduce the risk of having a fetus with a neural tube defect.”
Long-term advocacy and investment in female
education will contribute significantly to primary prevention of late or
non-attendance of ANC.
