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Towards reducing infant mortality in Oyo

One of Nigeria’s greatest health challenges is infant mortality, described by experts to be ‘unacceptably high’ in a population estimated to be in the region of 200 million.

Mortality of children within 28 days of birth is said to be more prevalent in 10 states of the federation.

Within these states, it has been discovered that those badly affected belong to the rural population. The states include Bauchi, Niger, Kebbi, Zamfara, Sokoto, kastina, Jigawa and Kano. Oyo and Lagos States complete the number of states with high neonatal deaths.

Survey indicates that the number of babies dying in Oyo state daily was higher in absolute number than others in the Southwest because of the population of the state.

Data from SMART Survey indicated that Oyo ranked third when compared with the ten states most affected by infant deaths.

For this reason, the United Nations Children Fund (UNICEF) chose Oyo to launch its Accelerated Action for Impact (AAI) for rapid impact. The international agency said; “if it could curtail neo natal deaths in Oyo State with its high population, it would in turn have reduced the scourge in the country.”

In her paper titled: Accelerated Action for Impact (AAI) and the role of UNICEF, at a recent Media Dialogue on Improving Health Outcome for Children in Oyo State through AAI, organised by the UNICEF, Dr. Adebola Hassan, a health specialist with the body, said six local governments were mapped through survey, which UNICEF considered as doing poorly in neonatal death, but added that three, including Ibadan Northeast, Ibarapa North and Saki West needed more intervention more than others.

She added that the AAI is to fast-track interventions on preventable infant deaths through a granular data from local governments, wards and communities considered heavily burdened by the neonatal death. Hassan said that this novel approach helped in scaling down the number of areas needing more intervention into the three local governments.

Prior to the UNICEF intervention, Hassan noted that 334,000 newborn babies were estimated to die due to inadequate health facilities, inadequate doctors and other health workers, as well as unequal distribution of nurses. For instance, she said that out of 538 primary health centres in Oyo State, only 270 were functioning.

She said most of the children die from preventable causes, adding that there was lack of information on exclusive breastfeeding, immunization and nutrition of children up till the age of five. This is even when available vaccines and good nutrition could have prevented such deaths.

As a result of the intervention in the three local government areas through community dialogue, which was made possible through the community development association volunteers, patronage of the health facilities has improved. Information on exclusive breastfeeding and immunization has also been scaled up.

Dr. Hassan said that accelerated action for impact should be replicated in other states. On why AAI should be scaled up, she said that no child should die from preventable causes. “All the children should reach their full potentials in health and wellbeing.”

In his paper titled: Community Involvement and Participation, the National Orientation Agency officer at the forum, Moshood Olaleye said that through the information materials produced to assist the CDA volunteers in the area of exclusive breast feeding and immunization, health workers and patients have been sensitized on the use of health facilities instead of patronizing Community Birth Attendants (CBA) or Traditional Birth Attendants (TBA).

Olaleye added that both CBA’s and TBA’s now synergizes with health workers such that they now refer patients to health centres.

He said that despite the interventions a lot still needed to be done. Olaleye said that health workers are still inadequate to cover night and day in approved health facilities. He also identified conflict of roles and coordination between CDA volunteers and health workers.

According to him, inadequate health facilities cause patients to travel 90 to 100 kilometres to access facilities. He called on the local governments to establish more health centres, as well as, organise periodic refresher training for health workers.

During the facility tour of the Ibadan Northwest health facilities, the Secretary General of CDC, Alhaji Ahmed Yusuf expressed the appreciation of the people to the UNICEF and NOA for their concern for the welfare of the people. “Immediately NOA contacted us, we embark on the sensitization of our people on the need for pregnant people to attend hospital for their ante-natal clinic and they have been doing so. We also educate them on the need for exclusive breast feeding. Going by our record, it has even been confirmed that there have been a lot of improvement from what it used to be.

“Prior to the intervention, most of them attend traditional birth places due to lack of sensitization and because of lack of education, they don’t fancy health institutions.”

Mrs. Akinyoye Oluwabisi, Community Health Worker at a health centre in Iwo road area of Ibadan Northwest, while fielding questions from journalists said, “concerning the exclusive breast feeding, we have been counseling them that at birth, they should give their baby breast without water because before now, some of them used to give baby local concoction (agbo). The reason they gave for this was that their mother in-law asked them to do so.”

On the assistance received so far, she thanked the UNICEF and WHO for their support. She said that at birth, they do give immunization provided by the WHO, which prevents the babies from diseases. “They are responding very well now that they have been sensitized. We made sure they bring their babies for immunization and insist on breast feeding without adding any water and we do close monitoring where we weigh the baby.”

A pregnant woman, Mrs. Bukola Samuel said that she has been sensitized enough and she knows that at birth, her baby must be given breast and fed for six month without giving the baby anything else. She said that the pregnant women do attend antenatal clinic on every appointed day in the week.

According to Mrs. Samuel, prior to the information and orientation of people in her area, many women gave birth at home through traditional birth attendants and many babies and mothers don’t survive while those that survive may develop complication that might lead to death.

She said very few people now patronize traditional birth attendants because they don’t want their babies to die.
 
Giving an insight into the media dialogue and advocacy, the UNICEF Communication officer, Mrs. Blessing Ejiofor said that the role of the media was to assist in giving further access to informed and accurate updates, not only by the policy makers but the public on the need to prevent child death through preventable causes.

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