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Reducing maternal, perinatal mortality through community participation

Despite significant progress made over the years, maternal, neonatal, and under-five mortality is still a problem, especially in Nigeria where maternal mortality stands at 512 per 100,000 live births. According to the United Nations Population Fund (UNFPA), 808 women die from pregnancy or childbirth-related causes daily around the world. Sadly, eighty-five percent of these deaths occur in developing countries, with Nigeria accounting for nearly 20 per cent of global maternal deaths between 2005 and 2015. Also, an estimated 5.9 million children under five die each year globally, including 2.7 million within the first month of life, with sub-Saharan Africa accounting for the large chunk of the deaths.

The good news is that most of the deaths and injuries are preventable. To provide a linkage between patients, communities and care givers with a view to improving effectiveness in service delivery, the management of Lagos Island Maternity Hospital (LIMH) held a stakeholders’ forum to engage patients, mothers, market women, and traditional birth attendants on Tuesday.

The Medical Director of LIMH, Dr. Femi Omololu, said every hospital that seeks to improve its services is expected to link up with the community to create a joint force to provide better healthcare delivery. He added that his hospital, which handles an average of 3,500 deliveries per year, decided to focus on maternal and perinatal health because many cases are often brought into the facility when it is almost too late. This often exerts undue pressure on healthcare workers who have to do extra work to salvage the situation – sometimes without success. “When some cases come to us, they are challenges that have been battled with in the community before they get to us. It is always more difficult for us to get them to recover. So if we can avoid those delays, both outside and within LIMH, then we are able to save more lives,” he said.

Explaining community participation as a strategy to understand local realities in health promotion and how to include local communities in planning and implementation of health programmes, Omololu advised mothers to always register their pregnancies in registered health facilities where they can get quality care and information on how to improve themselves, especially how they can handle the pregnancy journey safely.

In his presentation, Dr. Simeon Bazuaye, consultant obstetrician and gynaecologist at LIMH, said pneumonia, diarrhea, malaria, and inadequate nutrition drive early childhood deaths, with undernutrition remaining a primary underlying cause of maternal and child deaths each year in Nigeria.

Although maternal mortality is caused mainly by postpartum haemorrhage, preeclampsia, eclampsia, and sepsis, he added that a large proportion of maternal deaths could also happen as a result of lack of or limited access to skilled care during and after childbirth as well as limited access to family planning services and safe abortions.

To reduce or prevent maternal mortality, he called for an improvement in the referral system, health education for pregnant women or women of child bearing age, prompt accurate diagnosis for effective management, better collaboration with other specialists, prompt multidisciplinary evaluation and co-management of patients, and advocacy for increased uptake of proper antenatal care and appropriate use of health facilities.

During the interactive session, which allowed questions and answers, speaker after speaker described the presentation/discussions as eye-opening; while appreciating the opportunity provided by the hospital to allow the public to know more about issues and challenges the health facility and its healthcare workers contend with in their bid to deliver care.


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