Written by Ijeoma UKAZU

How a community effort is reducing maternal, infant deaths in Oyo

It is inspiring when community contribute in whichever shape or form to the well-being of individuals within its locality.

Community based care is an essential component that has the potential to substantially improve maternal, newborn, and child health outcomes.

In Oke Adu Community, a suburb of Ibadan, Oyo State is comprised of 18 compounds, with each having about 200 residents with a Primary Health Centre to cater for the health needs of the people.

Through mobilization efforts to ensure that mothers and their babies are brought home alive, residents contribute N50 each to render help to women who can't afford healthcare services during delivery.

"We have been able to help many pregnant women going into labour that do not have money or do not have good husbands. We must help them deliver safely," says Alhaji Busari Mamunu, head, Oke Adu Community Development Unit.

According to Mamunu, "with N50 each raised among ourselves we have been able to assist a lot of women whose relations are not around. This is to ensure that she gets to the hospital to deliver her baby safely."

Speaking with so much passion and zeal, it was evident that healthy babies and mothers were ultimate in the minds of Alhaji Mamunu.

Unfortunately, many women in Oke Adu community still resort to delivering their babies at home or with Traditional Birth Attendants, TBAs. Even after delivery, their babies miss out on vaccinations against childhood killer diseases as a lot of pregnant women do not want to go to the hospital.

Alarmingly, Oke Adu is like many other communities in Ibadan North East, Saki West, Ibarapa North Local government areas. Communities in these LGAs are ranked highest in child deaths in Oyo state in 2016. In fact, these were places unsafe for babies to be born, before the advent of the Accelerated Action for Impact project.

To tackle the problem of neonatal mortality, which is the probability of a child dying within 28 days and constitutes more than half of the under five deaths in South-West States of Nigeria, Oke Adu community is also supporting the government through various outreaches.

Alhaji Dauda Odelade, Community Development Council, CDC, Chairman, Ibadan North East, stated that the National Orientation Agency worried by the situation had approached the community to intervene.

According to him, "we went from one house to another educating that pregnant women should deliver their babies at Primary Healthcare Centres and that afterwards, they should ensure their babies take all the immunisation. We told them that children not immunised easily develop measles and other diseases."

During one of the outreaches, Alhaji Odelade said many parents claimed that they did not know that they ought to go to the health centre rather than a faith-based home to deliver their babies but going forward, their orientation has changed.

The CDC secretary, Alhaji Ahmed Yusuf, added that "we organise seminars and do house-to-house campaign to educate the people on the need to take good care of their children and the pregnant women not miss attending antenatal clinic."

Describing the impact of National Orientation Agency, NOA, and United Nations Children's Fund, (UNICEF), Yusuf said are "important partners" as most mothers "didn’t want clinics due to lack of education. But with education as these facilitated and supported by NOA and UNICEF, a lot of mothers orientation has changed."

The AAI Intervention Improving Health Outcomes for Children in Oyo state through Accelerated Action for Impact, AAI, UNICEF Health Specialist, Akure Field office, Dr Bola Hassan said Oyo State is one of the states where child deaths is very high based on the National Bureau of Statistics, NBS, in 2016.

Dr. Hassan revealed this during a two-day South West media workshop stating that, "Oyo State is the third highest contributor to neonatal deaths in absolute numbers in South Western Nigeria in 2016; it ranked with 15 other States contributing 50 percent of newborn deaths in Nigeria."

Sadly, she said, the babies were dying because of many factors, including poor cord care, immunisation, vitamin A and hand washing, as well as inadequate exclusive breastfeeding, poor health-seeking behaviour, and poor access to quality health services.

To crash the high neonatal mortality, Hassan applauded UNICEF and Oyo for deploying the use of Accelerated Action for Impact which is currently yielding great results.

According to her, "these are preventable newborn deaths and using interventions, addresses all these issues until the child becomes an adolescent in these high burden States, thus crashing the overall neonatal rate for Nigeria."

Also speaking on intervention, Mr Mosudi Olaleye, a deputy Director of Programmes, NOA, Oyo State said in Ibadan North East, Saki West and Ibarapa North Local government areas, the Agency with support of UNICEF, started community dialogues on promoting immunisation, exclusive breastfeeding and practices that eliminate neonatal deaths.

These dialogues, Mr Olaleye, said were also supported with IEC materials, Information, Education and Communication, to promote immunisation, exclusive breastfeeding and elimination of neonatal deaths. Compliance of households was tracked using the UNICEF/NOA support checklist.

He added that "the engagement of community leaders in household sensitisation and mobilisation impacted positively on patronage. Also, now nursing mothers and pregnant women are promptly referred by Community Birth Attendants (CBAs) and Traditional Birth Attendants (TBAs) to approved health facilities for immunisation and other child health services.

"Sensitisation and mobilisation of nursing mothers and general community households have now become a continuous exercise through the field activities of Community Development Association volunteers."

In assurance, Mrs Eunice Niyilola, the state’s immunisation officer, assured of improvements in immunisation coverage now in these AAI intervention LGAs.

She said, "before the intervention, Ibadan North East, Saki West, Ibarapa North Local government areas had over 2000 children that were not reached with immunisation. This had reduced to 510 children in these LGAs.

Niyilola also said that behavioural change training for health workers and increased involvement of community, traditional and religious leaders, as well as landlords, had ensured more children are vaccinated in these communities.

Evaluating the intervention, Dr Khadijat Alarape, nutrition officer, Oyo State Primary Healthcare Board, stated that, " the three months, post-intervention review of NOA indicated an improved knowledge in the practice of exclusive breastfeeding."

In addition, she said, "the severe and acute malnutrition case identified at the baseline reduced from 16 to 12 during the intervention that was carried out between May and November 2018."

On the part of UNICEF, Mrs Blessing Ejiofor, communications officer, said that the dialogue was organised to provide the media with information and materials to support informed media advocacy on preventable-child death and the Accelerated Action-Impact Initiative as a game changer to fast track reduction of preventable child death in Nigeria.

Ejiofor said the essence of the programme was to draw the attention of the government to the need to scale up actions with a view to reversing the trend of newborn death in the country, as there is urgent need to improve the health outcomes for children in Nigeria as a whole.

 

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