By John Townsend, Chair RMCH and Prof. Emmanuel Lufadeju, RMCH Nigeria National Coordinator
A young pregnant mother, Gift, is sitting alone in a rural community in Nigeria and is concerned about the rapid swelling in her feet and increasingly frequent headaches. She is worried that something may be wrong with her pregnancy and that the child growing within her is at risk. Even worse, Gift thinks about what would happen to her three-year-old daughter should she die during this pregnancy. Other women in the community have tragically died of preventable causes during pregnancy. So, she consults her mother and a community midwife for help.
With a mother’s death, her newborn is at particular risk of death as well. And for every woman who dies, nearly 30 women suffer from complications requiring additional health care and significant costs. This is critical in a country with over 206 million inhabitants growing at 2.5% a year, and accounting for nearly 20% of the nearly 300,000 annual maternal deaths worldwide. In this context, only about 12% of married women are able to use a method of contraception to avoid unwanted pregnancies, with only about one-third of the demand met with routine services.
Globally, it is estimated that a 30% reduction in maternal deaths would be achieved if all women interested in family planning were able to use modern contraception to space their births. During the first year after a birth in Nigeria, nearly 60% of women want to space their next birth, but are unable to do so as contraceptive supplies are frequently irregular and unpredictable, and many facilities still lack skilled providers. The poor and marginalized women face the greatest risks.
Fortunately, the Rotary Action Group on Reproductive, Maternal and Child Health (RMCH) has been working with the local community leaders, health providers,and citizens through dialogues,engaging with health systems, and training local health providers to address these disparities. Thankfully, Gift’s mother and her midwife were part of the Action Group’s training effort to address the symptoms associated with pre-eclampsia and ensured that Gift had a safe delivery and both she and her newborn received quality care postpartum.
For the past 25 years, Rotary District 9125 (Nigeria) has been partnering with Rotary District 1860 (Germany) and the Nigeria federal and state ministries of health to ensure that mothers do not have to die needlessly while giving life. Reaching 46 million beneficiaries through provider training and outreach, educating communities about the benefits of quality maternal and child health (MCH) care, and ensuring supplies of life preserving medicines, Rotary is making a difference at scale. In this effort, we closely collaborate with the Society of Gynecology and Obstetrics of Nigeria (SOGON), the Pediatric Association of Nigeria (PAN), and the National Association of Nigerian Nurses and Midwives (NANNM) when conducting our activities, as well as other civil society partners to sustain the gains made nationally. Of particular significance is support for the Federal Ministry’s national obstetric quality assurance platform (NOQA-Network) which tracks maternal and child deaths as well as monitors the availability of contraceptives throughout the state and local supply chains.
RMCH is committed to demonstrating the impact and sustainability of this MCH program in Nigeria and to share the experience with other Rotary clubs and districts around the world to scale-up this successful program. We will not accept deaths of other mothers like Gift or their children when it can be prevented. With the support of the Ministries of Health, the private sector, and the Rotary RMCH team in Nigeria, this effort will have a significant impact on health indicators and the lives of countless families in the largest country in sub-Saharan Africa.
For more information on this effort or ideas on how to get engaged in the MCH area of focus, please contact Prof. Emmanuel Lufadeju, RMCH Nigeria National Coordinator, Nigeria or John Townsend, Chair, RMCH.