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COVID 19: Maternal Mortality May Increase with Less Emphasis on Pregnant Women

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Maureen Okpe

The emergence and global spread of the coronavirus disease (COVID-19) poses a significant threat to public health globally, especially for health systems in low- and middleincome countries. Since the first case was reported in Nigeria on 27 February 2020, the rise in the number of cases has been exponential.

The ability to effectively respond to public health emergencies such as this is strongly influenced by the extent to which they have been assessed in advance and prepared for with corresponding prevention and mitigation measures.

This Pandemic has created a sort of shortage for preference of hospital in the capital city, Abuja as most government established hospitals are seen to be running selective services as all other treatment are suspended except for cases of emergency.

In a visit to some hospitals, the Asokoro General Hospital, was noticed to have skeletal services as many were turned back or referred to the nearest Primary Healthcare Centre, with patients lamenting. Some of them interviewed by Global Sentinel could not contain their anger and disappointment with the shabby manner they were being treated by the hospital staff.

“This is inconsiderate of the hospital personnel to have asked us to change hospitals as this is not going down well with us because most of our medical records of years have been with our respective hospitals. So what do we do now that they are rejecting us. Are we to start afresh again especially for pregnant women with due dates,” a patient queried anonymously.

A similar scenerio played out at the Nyanya General Hospital, patients were being turned back at the gate by the security personnel on the guise that they were authorized to only allow those with emergency cases into the hospital premises as all other persons were advised to seek help elsewhere.

Also at Gwagwalada Specialist Hospital one of the centers used for the treatment of COVID 19, the same experience was meted out to the people seeking medical help as patients were told they could only attend to emergency cases.

It is against this backdrop that the National Primary Healthcare Development Agency (NPHDA), in line with its mandate to provide technical and programmatic support to states on the development of Primary Healthcare in Nigeria, has deemed it necessary to augment the national COVID-19 disease control efforts by constantly remaining on duty despite the almost shut down of most government controlled hospitals.

The Primary health care is assumed to be the bedrock of the Nigerian health system and supposedly the first level of contact between Nigerians and their health system but most Nigerians do not make sufficient use of these facilities as they prefer the ‘more equiped’ hospitals.

The inability to access other government controlled hospitals, has resulted to the influx of individuals, who can not patronise private hospital due to high cost to Primary Health Care as an option to seek medical care especially pregnant women who go for routine visit of Ante-natal.

According to Mr Akila, The In-Charge at the Karu Primary Health Care Ante natal classes, provide windows for expectant mothers to check and monitor the development of their health as well as those of their unborn children during pregnancy, in such a way that mortalities can be reduced or eliminated.

“If focus on this area is neglected, the statistics on Nigeria’s maternal mortality may increase.

“Good antenatal care include regular screening, which can detect and prevent early complications such as hypertension and pregnancy-induced diabetes, all of which can affect the foetus,” he said.
“Also, this antenatal class is an avenue to advise women on good nutrition and important vitamins to take to improve mothers’ immuned system even from the Coronavirus,as well as that of the unborn baby,” he added.

Antenatal classes in a Nigerian hospital

Akila stated that despite the increase of cases of COVID 19 and the health scare it poses there is need for enlightenment of pregnant women on the need to attend antenatal care adding that the center only have to be proactive to fashion out ways to ensure the strict compliance to the rules of Nigerian Center for Disease Control (NCDC)

He said: “We have to think outside the box to have an efficient work environment,just to reduce the number of people in a particular area we designated two areas for the Ante-natal visit and not only educate them on pregnancy issues but also make it an avenue to discuss COVID 19 pandemic with them.

“Usually we used to have only morning sessions but we added an afternoon session to make sure that we reduce the crowd to the barest number possible.

“I must state that it has not been easy, as we have more people registering in the facility now than before but we go on because it is our duty and we are called to serve, “he added.

For Ms. Salome Audu, the change means more stress as she was referred to a primary health care as this would not have been the case if her initial hospital is operational.

“The only thing is that with the situation one has to leave home very early because I livd in Kugbo. Usually my husband will bring me to the hospital but the police on the road will not allow us to pass they asked him to go back that I am the only one who is pregnant.

“He was denied access, so they allowed me alone with pregnancy. I had to trek a distance to where I can get bike and just from Karu bridge to this hospital I was charged 350 naira and while going home in this hot sun I will still face the stress of walking a distance because the police will still be there,” she narrated her ordeal.

In the same vein, Ms. Blessing Eze, narrated how she started her Ante-natal at Asokoro then was transferred to Karu Primary Health Care due to proximity to her home but now she has been booked for Cesarean Section and have been referred to Nigerian Custom Service Hospital.

“I started my ante natal at Asokoro hospital but with the Coronavirus issue the hospital is not working they do not attend to patient there.

” In Asokoro I am under National Health Insurance Scheme (NHIS) which makes things easy for me as I have to pay just ten percent of all charges but here I cannot use that services because I have registered at Asokoro already and for me to be able to enjoy that service here Asokoro hospital will have to issue me a referral.

“This has not been possible because the hospital is not functioning, it has really stressed me because I usually have my babies through Cesarean Section (CS) my last baby after everything I paid just 20,000 that means if things do not change and I have to carry out the CS here that means I will be needing as much as 200,000 or above, where will I get such amount from,” she lamented.

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