Don recommends Mimiko’s Abiye Initiative for intervention

The adoption of an indigenous midwives initiative across the country will significantly improve Nigeria’s maternal mortality according to John Sotunsa, a professor of Obstetrics and Gynaecology.

He said this while speaking at Babcock University’s 49th inaugural lecture in Ogun State on Thursday.

The lecture was themed: “Beyond Superficial Success: Holistic Approaches to Maternal Mortality.”

Mr Sotunsa, Provost of the Benjamin Carson Senior College of Health and Medical Sciences at the institution, said addressing Nigeria’s maternal mortality crisis required a proactive and indigenous approach that brings health care for pregnant women increasingly closer to the grassroots.

To make strides towards reduction, Mr Sotunsa suggested the adoption of the Ondo State Government-driven Abiye Initiative which used traditional midwifery to access women in remote communities less inclined to visit a medical facility across the country.

He said the Abiye programme addressed all the delays that affected maternal mortality and harmonised the efforts of primary and tertiary health care centres with the aid of government-recruited and trained health rangers.

He said: “It was high time all causes of maternal death were eliminated to change the negative narrative. He, therefore, called on government and private organisations to find ways of minimising the delays associated with high maternal mortality rate.

“Statistics showed that the delays in areas such as seeking help for pregnancy and childbirth, reaching specific facilities as well as getting care and referral when needed were among major risk factors to Nigeria’s high maternal mortality.”

Improved health indices

In the first year of the programme, the maternal mortality rate in Ondo fell to 100 per 100,000 live births, a far cry from the national MMR of 545 per 100,000 live births.

This is a substantial decrease compared to the national rate of 545 per 100,000 live births.

Years ago, the World Bank recommended the adoption of the Abiye Initiative as a model for achieving the targets of the Millennium Development Goals on maternal health within the African continent.

The World Bank African Region Vice President at the time, Oby Ezekwesili, said “Ondo State had provided a role model and benchmark for the African continent in tackling infant and maternal mortality rate.”

Speaking on this, Mr Sotunsa said the initiative was a success because it provided accessible and affordable health care in every corner of the state.

He believes that improving accessibility, availability, affordability, and the quality of primary healthcare centres in the country would greatly improve the health indices.

Mr Sotunsa also recommended social networks and support as well as social insurance schemes to stem maternal mortality.

According to him, adequate social support would not only enhance a positive pregnancy experience but reduce the risk of premature deaths by 26 per cent as well as reduce depression, anxiety, stroke, heart disease and dementia.

“We can keep our women alive if we look inward and maximise our opportunities,” he said. “What we have, know, and do can prevent the majority of maternal deaths in Nigeria if we are available, consistent, ingenious, committed and sacrificing,” he noted.

Abiye Initiative

The Abiye Initiatives is a home-grown initiative which seeks to tackle the challenges of maternal mortality and morbidity in Ondo State, Nigeria.

The project is the brainchild of Olusegun Mimiko’s administration, a former governor of Ondo State.

It was established in 2009, following the release of the 2008 Nigeria Demographic Health Survey (NDHS) which ranked Ondo as the state with the worst maternal and child health indices in the south-west of Nigeria.

The Abiye Initiative aimed to improve maternal health care service delivery in the state and to ensure accessibility as well as a high level of efficacy will ensure a reduction in the rate of maternal and infant mortality.

Maternal mortality in Nigeria

In Nigeria, maternal mortality remains a key issue affecting women of reproductive age.

Nigeria currently contributes 10 per cent of global deaths for pregnant mothers.

A report by the United Nations Children’s Funds (UNICEF) showed that 40 million women of childbearing age, between 15 and 49 years of age, suffer a disproportionately high level of health issues surrounding birth and considering the poor birth registration which in some areas up to 62 per cent, known data about child health issues are likely to underestimate the true scale

Despite the global decline in the maternal mortality ratio (MMR) to 34.2 per cent between 2000 and 2020, MMR is still a disaster in the country and the Africa region at large.

An estimated 287,000 women die every year from preventable causes related to pregnancy and childbirth and 70 per cent of these deaths occur in Sub-Saharan Africa.

Across the continent, complications from pregnancy and childbirth are also a leading cause of death among young girls between the ages of 15 and 19.

Neonatal mortality rates are also a major cause for concern with 48 deaths per 1,000 live births compared to four deaths per 1,000 live births in high-income countries.