Maternal and newborn health, Nigeria

Standard care for mothers and newborn babies. Improving quality of care for maternal and new-born health: a pre and post evaluation of the safe child birth. Health policy i.e. the right services at the time, in the right ways.

Reduction of maternal and newborn mortality. Nigeria’s infant mortality and under-5 mortality rates are estimated at 59.181 deaths per 1000 live births. In 2015, Nigeria’s estimated maternal mortality ratio was over 800 maternal deaths per 100,000 live births, with approximately 58,000 maternal deaths during that year. The maternal, newborn and child health indices in Nigeria are typically worse in rural areas. These accounts for 59,000 deaths of women annually.
Nigerian women are 500 times more probable to lose their lives in child birth when compared to most advanced nations of the world. Nigeria is ranked second after India in global maternal mortality. Furthermore, Nigeria’s mortality rate is reported to be 545 per 100,000 birth. The prevalence of maternal in Nigeria has become very disturbing as every birth procedure becomes a potential incidence for the report above. These are made possible by poor access to standard care for mothers and newborn babies.
The cause of maternal death in Nigeria is due to haemorrhage, infection, unsafe abortion, hypertensive diseases of pregnancy, and obstructed labour. The cause of infant death in Nigeria as at 2017 include: preterm birth complications, sepsis/tetanus, congenital abnormalities, diarrhoea, pneumonia and other conditions.

To increase access to health care by addressing the barriers to quality maternal and new-born health care. We do this by working with country-laid programs. Our solution will:
1. Enlighten and train Traditional Birth Attendants (TBA), religious leaders and community leaders to change their beliefs and traditions that are risky to mother and child health.
2. Enlighten parents and the girls to discourage early marriage of the girl child.
3. Form a network with readily available tricycles in rural communities to act as mobile ambulances to convey pregnant women and nursing mothers to the health centre in times of emergency.
4. Introduce the use of mobile application in the mobile phones of pregnant women and nursing mothers for them to reach health workers and for health workers to reach them for periodic check-up.

Pregnant women and nursing mothers. The maternal and child health program aims to achieve the following objectives:
1. Increase utilization of quality family planning, maternal, neonatal and child health services, improve nutrition and water, sanitation and hygiene practices.
2. It will reduce waste of time in various care facilities and improve prompt attention to both mother and baby.
3. To facilitate the worker and improve the care to both mother and baby.
4. The use of available tricycles as ambulance will increase quick access to the health facilities and waiting time will be reduced.
5. To reduce maternal and infant deaths in making quick decision to go to the facilities.

1. We will train Traditional Birth Attendants (TBA) in rural areas on maternal and newborn health care to ensure that they have the skills to care for mothers and babies in emergency cases within their rural communities.
2. We will provide quick access to health centre facilities by frequently monitoring pregnant women and nursing mothers through mobile application on their phones and connect them to the nearest Health Centre.
3. We will network with readily available rural-based tricycle drivers to act as ambulance to carry these rural-based pregnant women and nursing mothers to the nearest health centre.

Our solution is unique because it will use an application in the personal mobile phones of the pregnant women and nursing mothers to connect them with health centers through readily-available tricycle ambulances in their rural communities. This idea is unique and novel, as it has not happened anywhere in Nigeria.

The solution is a new business model that will rely on a mobile phone application for communication between midwives and nurses at health centers, pregnant women and nursing mothers, and Traditional Birth Attendants and tricycle  (ambulance) drivers in rural areas. With the aid of Google map and the mobile phone application, the location of each registered pregnant woman and nursing mother will be known to the health workers and ambulance drivers. Immediately a woman sends an emergency signal on her application, the nearest health workers will respond and be on alert, and the nearest ambulance driver will be contacted to take the woman to the nearest health facility/or Traditional Birth Attendant (in case of extreme emergency).

In the wake of Covid-19 pandemic, the United Kingdom health authorities are turning to mobile applications to help track and slow the spread of COVID-19 across the country (https://www.forbes.com/sites/zakdoffman/2020/04/07/covid-19s-new-normal-yes-your-phone-will-track-infected-people-nearby/#1daf649e7f0d, https://www.computerworld.com/article/3538910/uk-turns-to-mobile-apps-to-help-curb-coronavirus-spread.html). This could serve as a model for our solution.

Rural women and children find it difficult to have access to health facilities ( Adedini, S. A., Odimegwu, C., Bamiwuye, O., and  Fadeyibi., O., 2014). This is partly due to their dependence on traditional home health practices and also due to poverty, which reduces their chances of traveling to urban-based health centers. The modern traditional health practices that rural women rely on are not always effective, so most times, after several failed attempts at home, these pregnant women or nursing mothers arrive at the health centers when complications have set in. Additionally, most health centers suffer from shortages of health workers and drugs for the pregnant women and nursing mothers ( Ntoimo, 2019).. This problem also discourages rural women from "wasting" their time, hard-earned money and energy to come to the centers.

With our solution, the health center at Owhrode village will  be funded. This funding will make health workers, drugs and other facilities available for rural women and children. Through enlightenment/educational programmes we will reach out to rural community leaders, women leaders and the entire communities in the region. The provision of the mobile phone application and ambulances will help facilitate the participation of the women in the project.

References

 Adedini, S. A., Odimegwu, C., Bamiwuye, O., and  Fadeyibi., O. (2014). Barriers to Accessing Health Care in Nigeria:Implications for Child Survival. DOI: 10.3402/gha.v7.23499

 Ntoimo, L. (2019). Why rural women do not use primary health centres for pregnancy care: evidence from a qualitative study in Nigeria. DOI: 10.1186/s12884-019-2433-1

This is an idea being explored for its feasibility to build a project service. However, in one year, we hope and plan to serve 500 women and 600 children in Udu Local Government Area of Delta State, Nigeria. In five years, we would progress to serve 3000 women and 4000 children.

Through our organizational impact and replication by others in nearby Local Government Areas nearby, we aim to achieve the following goals:

• Increase utilization of quality family planning, maternal, neonatal and child health services, improve nutrition and water, sanitation and hygiene practices.
• It will reduce waste of time in various care facilities and improve prompt attention to both mother and baby.
• To facilitate the worker and improve the care to both mother and baby.
• The use of available tricycles as ambulance will increase quick access to the health facilities and waiting time will be reduced.
• To reduce maternal and infant deaths in making quick decision to go to the facilities.

Our organization faces financial, technical and cultural barriers to this project. Financially, we have not received any funding for our plans. Technically, the road network in the rural areas is bad, and this may limit the movement of tricycle ambulances during the rainy seasons.  Culturally, many rural people hold to traditional beliefs about witchcraft, charms, and spells, so instead of seeking medical help, they may seek assistance for shamans and ignore health facilities until it is late. 

With the possible funding from SOLVE, we will be able to overcome the financial barrier. However,it will take a lot of educational and enlightenment campaigns to remove the cultural and technical barriers. Through these campaigns, we plan to involve the communities through the leaders, in community service and repair of roads. While doing these at the community level, we also plan to reach to the government to provide good roads. Our campaigns will also create awareness on the advantages of seeking health care.

7 part-time staff

Our team comprise a medical doctor, a Registered Nurse and Registered Midwife, a trained auxiliary nurse, a trained Traditional Birth Attendant, a trained medical laboratory scientist and a driver to handle logistics. All members of the team have several years of working experience in their respective expertise.

We are partnering with Akposdiete Technologies, a division of South-Western Edoid Multicultural Services to provide the technological assistance we need to facilitate the project. They are providing technical assistance with the mobile application.

This is a non-profit project aimed at complementing government services to poor rural women and children. The services we provide will be life-saving and impactful services for poor rural pregnant women and nursing mothers. Therefore, the lives of these poor rural people will be impacted positively. This impact will in turn motivate politicians and other people donate to our course.

The project will be funded through sustained donations and grants. Therefore, we have a volunteer fundraiser who  constantly works on the aspect of fundraising to sustain our income.

What barriers currently exist for you to accomplish your goals in the next year and in the next five years?

Our organization faces financial, technical and cultural barriers to this project. Financially, we have not received any funding for our plans. Technically, the road network in the rural areas is bad, and this may limit the movement of tricycle ambulances during the rainy seasons.  Culturally, many rural people hold to traditional beliefs about witchcraft, charms, and spells, so instead of seeking medical help, they may seek assistance for shamans and ignore health facilities until it is late. 

How can Solve help us overcome, and which?

With the possible funding from SOLVE, we will be able to overcome the financial barrier. Solve can also assist us with monitoring, guidance and advisory support.

Our local partner, Akposdiete Technologies is all that we need for the project.