Maternal and Child Health

‘Poor Nutrition Indices, Unacceptable in Kaduna State’ – Hadiza El-Rufai

By Abubakar Jimoh

The Wife of Kaduna State Governor, Hajia Hadiza El-Rufai has said the State would embark on drastic action to combat poor nutrition indices within its special programme for adequate healthcare system.

Speaking at Stakeholders’ Sensitization Meeting on Nutrition organized recently in Kaduna by Civil Society-Scaling up Nutrition in Nigeria (CS-SUNN) under the aegis of Partnership for Advocacy in Child and Family Health (PACFaH), Hajia El-Rufai, represented by Wife of the Deputy Governor, Mrs. Ladi Barnabas Bala Bantex, lamented that malnutrition among children constitutes 50% of the underlying causes of many communicable and non-communicable life-threatening diseases, in addition to the high level morbidity and mortality in the State.

She said, “Recent surveys have shown that 57% of children are malnourished and 41.7% of them are severely stunted in Kaduna state. Micronutrients deficiency such as Vitamin A and iodine is also common among these children (27.8%) due to poor intake. The malnutrition has also affected women significantly as 6.2% of our women in Kaduna state are malnourished and 23.4% have deficiency in iron. This indeed has disturbing implication considering the fact that women menstruate monthly and bear children.

“These poor nutrition indices will not be accepted. Appropriate actions must be taken without delay to drastically reduce the incidences. Our administration has special passion for health and education.”

The Governor’s wife noted that within the few months of inception of the administration, N180 million and N55 million were released to improve coverage of Routine Immunization and to double the number of secondary facilities (General Hospitals) providing rehabilitation of severe acutely malnourished children (from 6-12), respectively.

She further reiterated the administration’s commitment and support towards health intervention or initiative that would greatly benefit the people of Kaduna state.

Also, Prof. Ngozi Nnam, Chairman Steering Committee, CS-SUNN, added explained that malnutrition and nutrition-related diseases remain major problems to effective public health care system in Kaduna state with under-five mortality rate unacceptably high at 169 per 1,000 live births, stating that poor nutrition in the first 1,000 days of a child’s life can lead to stunted growth.

“The main indicator for malnutrition is stunting- when children are too short for their age. Stunted children have poor physical growth which is irreversible and associated with poor brain development and reduced school and work performance. In Kaduna, the Nigeria Demographic and Health Survey (NDHS) Results of 2013, reported prevalence of stunting at 56.6%, underweight 57.6%, and Wasting 42% in children under five years old. This means Kaduna with 56.6% of stunting has the third highest number of stunted children under-5 years of age in Nigeria after Kebbi with 61% and Katsina and Jigawa with 59% respectively,” she noted.

Prof. Nnam urged effective implementation of the National Strategic Plan of Action for Nutrition (NSPAN 2014-2019) at every level, with emphasis on maternal and child nutrition; increased funding for maternal and child nutrition at the Ministries of Health, Agriculture and other relevant sectors in Kaduna State; budgetary allocation and timely release of funds for maternal and Child nutrition practices and interventions, at state and local government levels.

Kano State Assembly and Renewed Commitment to Maternal Health

By Chioma Kanu

In line with its commitment to give greater attention to the plights of women and children in the country, Civil Society Legislative Advocacy Centre (CISLAC) with support from MacArthur Foundation paid an advocacy visit to the Kano State House of Assembly.

The visit aimed primarily at presenting the legislature with relevant findings and recommendations from various implemented activities in Kano State since 2013, to engage relevant stakeholders such as —Legislature, Executives, Civil Society, and the Media, on issues affecting maternal and child health.

During the meeting, CISLAC advocated to the State’s Legislature for appropriate action on its roles and responsibilities towards effective maternal and child health in the State.

It would be recalled that at previous engagements on maternal health held in the state, relevant stakeholders had lamented that in Nigeria one in 13 women dies during pregnancy or childbirth, and 12% of children die before reaching the age of five; every 10 minutes one woman dies from conditions associated with childbirth; and only 39% births take place with assistance of medically trained personnel, coupled with the scarcity of skilled attendants, absence of personnel among other factors impede the effectiveness of health services in the country; while no fewer than 1,025 deaths take place per 10,000 births in Kano State.

They observed lack of political will towards the implementation of various health development charters, which Nigeria is signatory to, such as African Charter on Human and Peoples’ Rights, Maputo Declaration on Health, 2000 Millennium Summit, 2007 Abuja Declaration on African Health Strategy, among others, have undermined the achievement of effective health care development across the country.

As at 2013, the State had achieved only 8% (of 15%) of Maputo Declaration on Health; and the budgetary allocation crisis among various sectors in the State had posed a setback to the State Government’s commitment and efforts towards the full implementation of 15% declared allocation to health sector.

Effective maternal health services in the Kano State had been challenged by a number of factors such as weakness in State House of Assembly and Executives’ oversights on health; lack of corporate social responsibility; unethical attitudes of health workers towards patients and socio-cultural believes in the State, discouraging women from attending maternal health services at various hospitals; rising number of women demanding maternal health services which has overstretched the State Government’s existing capacity to reduce maternal mortality; early child birth, high level of illiteracy, poor access to healthcare services and rising poverty level, which increased prevalence to maternal mortality in the State.

Other challenges intensifying the level of maternal mortality in the State reiterated by stakeholders at the meetings include: inadequate skilled medical personnel, irregular payment of salary, lack of political transparency and accountability; increasing vulnerability to maternal mortality among women in the rural communities as a result of over-concentration of skilled health personnel in the urban areas at the expense of urban counterparts; wide gap between the policy makers and Civil Society posing additional challenges to achievement of effective maternal health provisions in the State; lack of common data based advocacy on health by CSOs with particular reference to the State Ministry of Health.

As recommended by relevant stakeholders at various engagements, during the visit, CISLAC advised the legislature to consider among other things: increased resources and budgetary allocation to health sector; full-fledged political commitment towards effective implementation of various charters on health care services in the State; prompt domestication and implementation of the National Health Act to provide for effective maternal and child healthcare services in the State; effective citizens’ participatory and inclusiveness in legal framework to drive maternal accountability in the State.

CISLAC urged the legislature on training and retraining programmes for the State’s legislative members on their roles and responsibilities towards maternal accountability; establishment of joint advocacy, monitoring, public hearings and sponsorship among various committees of the Assembly to fast-track the domestication of National Health Act; establishment of joint executive-legislative working sessions to ensure effective implementation of relevant provisions in the Act to provide for workable maternal healthcare services; and development of common strategies and plan of action on maternal accountability across relevant committees in the Kano State House of Assembly.

While responding to the CISLAC’s advocacy call, members of the legislature said that advocacy brief by CISLAC presented the House with clear understanding of the existing challenges and commitments by government to the health sector; hence, provided the House with opportunity to constructively engage and give greater attention to maternal and child health.

According to the House, in collaboration with civil society groups, Free Maternal Health legislation will be prioritized to reduce cost burden for women seeking maternal healthcare services and encourage adequate attendance at healthcare facilities.

The House promised to intensify effort to complement existing commitment by the State’s executive at training local volunteers on midwifery services to reduce maternal deaths, giving assurance to partner with CISLAC to enhance members’ capacity on maternal and child health legislation and oversight.

The members explained that CISLAC’s advocacy note would be represented to the House during plenary for exhaustive brainstorming, immediate discussion and appropriate action.