Will Making New Demands Improve Midwifery in Nigeria?. The 2016 International Day of Midwives has come and gone and like other specialised days, demands have been made to bring out the profession from the doldrums of lack of training and inadequate incentives among others. Will making new demands in the face of existing and prevalent socio-economic realities help the call? KUNI TYESSI writes.
Every 5th of May has been dedicated globally to be the day of midwives. In Nigeria, it is a day set aside for stock taking as far as midwifery is concerned. This has to do with patient/midwife relationship, number of deaths recorded in terms of child-maternal health care due to poor ratio of midwife to patients, governments commitment in terms of disbursement of funds, provision of infrastructure, such as light and water especially in rural areas, and many more.
This year, the national president of the National Association of Nigerian Nurses and Midwives (NANNM), Mrs Margaret Akinsola drew the attention of the federal government, development partners and other stakeholders to the plight of the Nigerian midwives which she claims cannot give maximum output due to harsh working conditions.
While appreciating the fact that there are few good hands in midwifery and at thesame time acknowledging the retirement of old qualified hands, she demands that there is a need to go back to the community era where there were specialised training schools for midwives. She says this will boost the profession and will encourage further studies especially as midwifery is not offered as a discipline in Nigerian universities.
She also calls for the renovation of the midwifery school which will also have a role to play in the psychological enhancement of the midwives. Another is to renew contracts with retired midwives who are not tired and still willing to give in their best especially in the training of new hands.
For development partners, the call is for them to channel their resources towards the training and re-training of the midwives as they have not been getting it right in their support.
For while it has been established that midwives are expected to be endowed with skills and competence to deliver, as no professional in the health sector can take their place, the question being raised surrounds their competence in managing and handling their patients who are mostly women and children under five, in reproductive health and family planning as several reports have indicated that several women in labour have had to go through the torture of the midwives to bring forth their babies.
Ritidzai Ndhlovu, UNFPA resident representative in Nigeria, in her speech, commemorating the day, said the roles of midwives are not just physical but psychological which she says has been neglected. Although, not been in support of some of the inadequacies of midwives, she agrees with the national president that so much needs to be done by major stake holders to cushion the profession which is suffering a dearth in population, no thanks to traditional birth attendants who need to be trained in order to recognise danger signs and quickly do a referral.
Some of the challenges which must have led to their undoing also lies in the unavailability of funds despite been sent to rural areas where they are mostly needed and this is with little or no support. Statistics shows that every midwife is expected to get N40,000 from the federal government, N30,000 from state government and N10,000 from the local government including accommodation. It also reveals that the funds are always allocated in the budget but not released for their payment and as such, it becomes almost impossible to work.
Frances Day-Strik, the President, International Confederation of Midwives says every woman ir required to have access to a midwife who has skills and is educated as Nigeria is known to have a bad statistics and is competing with India followed by eight other countries, all which are low and middle income countries.
“By 2030, the child-maternal mortality rate is expected to increase to 62%. 12.8 million pregnancies must be responded to by 2030 to curb the number”. The statistics looks outrageous and feels disturbing and she advices that Nigeria must start the journey of a million miles today.
Commitment to this cause must start from allocation and backed up with a release as the UNFPA rep has called on the need of having at least two midwives in every primary healthcare centre. Statistics has also shown that once the National Health Act is being implemented, there will be a release of about N50 billion annually depending on Nigeria’s cumulative income. With this, it is expected that the lives of 3,131,510 mothers, newborns and children under five years of age will be saved by 2022 and this will in turn support Nigeria’s response to poor indices.
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