It is every woman’s dream to give birth to a healthy baby and for that to happen, the woman needs to be healthy herself. This involves early Ante-natal Care (ANC) and eating healthy from early conception to delivery. A recent survey carried out by ODIRI UCHENUNU reveals that most women in Nigeria do not know the implication of not having early ANC.
The World Health Organisation (WHO) has over time reaffirmed the need for pregnant women to go for their ANC at least four times before delivery, but with the recent investigation carried out by LEADERSHIP, it is surprising to know that at this age of civilization; most Nigerian women who live in urban areas do not know the importance of early antenatal care.
Pregnant women who spoke with LEADERSHIP said early antenatal care is a waste of money and time, adding that the proper thing to do is to register when they are already five months pregnant. Others claimed that the reason they would register for antenatal at all is because they want to give birth at the General Hospital closer to them because if they don’t register, they won’t be allowed to give birth in any government health facility.
Mrs Ufuoma Dede, who is six months pregnant, said she just registered for her antenatal last month. When asked why the late registration, said, “Registering for ANC at early pregnancy is a waste of time, energy and money. I registered four months to delivery for my two babies and they are healthy and okay. The reason why i even register for antenatal is because i want to give birth in the hospital.”
Mrs Vicky Okeke who is two months pregnant, said she visits Traditional Birth Attendants (TBA) because they are more effective. She said, “I do visit Baba once in a week. He helps to massage my body and position the baby in my womb, thereafter give me “agbo” to drink if need be. Baba will also be the one to deliver my baby because a lot of people in this area patronize him and there have never been any case of emergency.”
Still, one Madam Omoh Ohwerie said she patronised TBA and also registered for antenatal. She said, “By so doing, i don’t have any reason to be worried about myself and my baby.”
If pregnant women living in the urban area don’t know the importance of ANC, what about those living in rural areas? Residents of Ibeshe community, under Oriade local council development area, Lagos state, who spoke with LEADERSHIP, said they patronize TBA because they are more effective and are readily available when they need them unlike primary healthcare centres that lack adequate facilities, electricity and nurses.
Chairman, ward health committee, Ibeshe, Alhaji Sarafa Amodu, said about 10 communities in Oriade local council government area have just one healthcare centre which is the Ibeshe healthcare centre and the distance from these communities to Ibeshe is like an hour drive with the help of a boat.
Amodu said another challenge is that there are no enough nurses as the healthcare centre has only one nurse, one warder and one gardener and there are no enough drugs for the people, adding that pregnant women in these communities have no choice than to patronize the TBA.
The issue of electricity, according to Amodu is one issue government needs to address. He said for the past seven years, Ibeshe has no electricity until recently and the light is not stable.
A member from Transformation and Development Centre, Mrs. Elizabeth Sowoh also told LEADERSHIP that some of the men in Ibeshe deliver their wives and daughters during childbirth due to lack of healthcare facilities. She said the people are yearning for good healthcare centre, shelter, road/free boat to be able to access the healthcare centre and electricity.
One of the pregnant women, Omolara Hassan, said there are things the healthcare centre cannot provide for them, hence they patronized TBA. Hassan said, “There are some things the Ibeshe healthcare centre cannot provide for us. Even nurses in the healthcare centre do refer us to herbalists. This is like we don’t have hospital because if we even patronize the healthcare centre, we will still be referred to TBA.”
It is no news that the Lagos state government recognises the relevance of TBA especially in the remote areas where they are top choices and sometimes, the only available choice, hence the decision to train them in government hospitals and imbibe them with the power of referral, such that they are able to refer patients who need special medical attention. They now also get certifications, licensure and registration.
The director, family health and nutrition, Lagos state ministry of health, Dr. Folashade Oludara, while speaking with LEADERSHIP said, “It is not that Lagos state intentionally embraced TBA. We have just come to realization that TBAs are highly patronized by citizens in Lagos state even though the government is making extra effort in trying to make people realise that the best pregnant women can get is actually by allowing themselves to be taken care of by skilled birth attendants.”
Oludara said looking at the number of TBAs we have in our communities and having realized how important they are to community people, the state government went ahead to ensure that at least all registered TBAs must have a form of formal training to be able to identify danger signs in pregnancy and then to be able to identify when to refer, so that pregnant women will not be in danger which in return will avert the death of maternal and even the unborn children.
She said, “Things that kills babies or deformed them occurs in the first one week of pregnancy. We are also advocating that every pregnant woman should go through at least four ANCs so that they can be given the necessary drugs that would help to prevent their child from deadly diseases, and deformity, even though they want to patronize TBAs.”
According to the World Health Organisation (WHO), it is not a matter of choice for the expectant mother to undergo early antenatal because it is one sure way to confirme if the mother is healthy and to detect any form of abnormality or malfunction of the baby that can be averted even right from the mother’s womb. ANC visits, according to the organisation include tetanus toxoid vaccination, screening and treatment for infections and identification of warnings signs during pregnancy, adding that pregnant women are also tested for various diseases, and if positive they would receive help and guidance to avoid transmission to their babies.
At the just concluded 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, stakeholders emphasized on the importance of folic acid before conception and during early pregnancy as it 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 percent.
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.
Lawal-Aiyedun said, “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.”
She 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 said, “Adequate folic acid intake is very important before conception and at least 3 months afterward to potentially reduce the risk of having a fetus with a neural tube defect.”