The World Health Organization says that more than a half million women around the world die annually from pregnancy-related problems. Nigeria accounts for 10 % of the deaths, or about 52,000 women. Some organizations are working through campaigns to reduce the mortality rates. Voice of America reporter Isiyaku Ahmed in Kano tells us that northern Nigeria is the country’s most vulnerable region for maternal mortality.
Health workers say people in the north don’t know about some of the reasons for pregnancy-related deaths, so non-governmental organizations are taking the lead in educating the public. One such organization is the Abuja-based Society for Family Health (SFH.) The staff recently met at its regional office in Kano to review its activities in northern Nigeria.
Bright Ekweremadu is the managing director of SFH. He says there are many reasons why women die of pregnancy-related complications. He says one is that some women are too young. meaning their bodies are not fully formed so they cannot carry a baby to term, “A woman should not start having children too early in life because if a woman’s body is not ready to receive pregnancy the likelihood that that pregnancy is risky is very high. Our recommendation is that people should start having children at about the age of 18 or more.”
Ekweremadu also recommends that women should not have children too close together. He says couples should wait at least two years before having another child because it takes time for a woman’s body to fully recover from child birth.
Ekweremadu says women also die from unsafe delivery practices and from hemorrhaging when delivering a child.
SFH says pregnant women need better access to doctors and antenatal clinics for regular check-ups, and also to trained midwives during delivery. Clean razor blades, which can prevent tetanus, should be available for cutting an umbilical cord.
Ekweremadu says the Society for Family Health uses a number of ways to educate the public: “We do interpersonal communication at the community level. What we are doing now is more or less partnering with the communities in such a way that there is community ownership [of a project] and there is sustainability. We also do a lot of mass media using the radio, the television and print.”
Ekweremadu says the Society for Family Health also tries to get the message across using what he calls road shows, featuring dramas and street musicians. For example, a Hausa drama troup during a live road show in the streets of Kano explains to a street audience the importance of an HIV/AIDS test before marriage.
The Society for Family Health also has a continuing weekly 30-minute program on many radio stations throughout Nigeria. The program is offered in various languages including Yoruba, Igbo and Hausa. Ekweremadu says, “ We have a very interesting radio drama series, which is in four languages. In pidgin we call it “One thing at a time;’ in Igbo we call it “Oden-jin-ji;” in Yoruba we call it “Aburo ruko merin;” in Hausa we call it “Garin muna fata.”
SFH also recommends the use of contraceptives, although Ekweremadu says only 11 percent of women of childbearing age in Nigeria use any kind of birth control. He says the most popular forms are those injected into the body, like Depo-Provera.
Ekweremadu says the success in dealing with contraception and other reproductive health issues depends on how well the organization deals with people unaware because of certain cultural and religious practices. But he says SFH has started tackling these issues. “[As for] the issue of religion, what we have started doing is to work with faith-based organizations to help us in propagating this information. We are also working very closely with some traditional organizations like community-based agencies, which are also helping us to make information widely available to different groups of people.”
Ekweremadu adds that Muslim faith-based groups accept the use of safe motherhood initiatives that are consistent with Islamic teachings. For example, they agree that some verses from the Koran support the idea of feeding a baby exclusively through breast-feeding, which can delay ovulation in a first time mother for many months, thereby preventing her from getting pregnant again too soon.
A sura, or verse of the Koran, alludes to breast feeding, when it says, “Let the woman live [in iddah ] in the same style as ye live according to your means; annoy them not so as to restrict them. And if they carry [life in their wombs] then spend [your substance] on them until they deliver their burden: and if they suckle your [offspring] give them their recompense: and take mutual counsel together according to what is just and reasonable. And if ye find yourself in difficulties let another woman suckle [the child] on the [father’s] behalf. ”
The Society for Family Health is working in collaboration with the Nigerian government and several international organizations like the Global Fund for HIV/AIDS, Malaria and Tuberculoses, and with the Washington-based NGO Population Services International. Funding also comes from the US and British governments.
SFH is working to help Nigeria meet the UN’s Millennium Development Goals. One of the goals is to stop the spread of HIV/AIDS and to cut maternal and infant death rates by three quarters by 2015.