For over a month, health workers across Nigeria have been on strike and one of worst affected groups are pregnant women. Dr. Vickie reports…
According to the United Nations Children’s Fund (UNICEF), antenatal care can help women to prepare for delivery and understand warning signs during pregnancy and childbirth. It can be a source of micro nutrient supplementation, treatment of hypertension to prevent eclampsia, immunization against tetanus, HIV testing and counselling.
In addition, medications to prevent mother-to-child transmission of HIV in cases of HIV-positive pregnant women could also be administered following proper guidance before, during and after labor. In areas where malaria is endemic, health personnel can also provide pregnant women with medications and insecticide-treated mosquito nets to help prevent the debilitating (and usually deadly) disease.
But since health care workers commenced a nationwide strike that has affected government-owned hospitals across Nigeria, antenatal care is currently on hold at tertiary, secondary and primary health care levels thus leaving pregnant women in dilemma especially those close to delivery and patients living with HIV.
“I don’t have a new plan yet, I just hope and pray the health workers resume as soon as possible, though I’m very close to my expected date of delivery”, said Mrs Adedapo, a trader at the entrance of a state government-owned hospital in Ibadan, southwest Nigeria.
Mrs Adedapo’s pregnancy was already 34 weeks old before the strike action began. When she was advised to consider private clinics, she said she could not afford it nor willing to repeat the tests already done. She is not the only one in this dilemma as there are thousands of pregnant women across Nigeria who are at crossroads over what to do as their expected time of delivery approaches.
“All my medical records from the onset of the pregnancy till date are with the state hospital, presenting at a private institution at this period would incur a huge sum, which I don’t have. As you can see, I am even struggling to carry out all my investigations in the state hospital. They are taking all my money. So I don’t even know what to do now,” she told healthnews.africa
As strike action continues unabated, the situation is worsening for pregnant women and nursing mothers in dire need of pre or post-natal care.
At government-owned hospitals visited, all the wards are locked, patients are being sent back from the hospital entrance.
Even though doctors are working at the outpatient departments, antenatal care and admissions, immunization visits, family planning, pharmacy and laboratory tests have all been sabotaged.
The nationwide strike, initiated by the Joint Health Sector Unions (JOHESU), which is made up of all health workers except doctors.
Thought leaders had repeatedly noted that while Nigerian government officials and their family members can afford the services of private institutions and can seek healthcare services outside Nigeria even at the expense of the government, healthcare workers would also be fully paid irrespective of the strike action. The only serious consequence is the pain of the masses coupled with a surge in the number of preventable deaths.
The procedures for registration for antenatal in public establishments require all the baseline investigations which are self-sponsored in all cases even though the government kept publicizing free antenatal care. These investigations include Ultrasound scan, full blood count, urinalysis, hepatitis screening with or without Electrolyte, Urea and Creatinine test depending on the medical facility. Ante-natal care also includes HIV counselling and testing.
In most Nigerian government hospitals, pregnant women cannot attend antenatal clinic without the result of all the investigations which often cost a minimum of NGN5,000 (about US$14), excluding registration fee.
This process would be repeated if such patient for any reason have to present at any other health care facility, be it government- or private-owned hospital.
This research showed that a large percentage of pregnant women using the public health facilities in Nigeria are illiterate, suggesting that with the high cost of private health services affirmed, a great number of poor pregnant women across Nigeria would consider cheaper but more dangerous birth options including home deliveries, traditional birth attendance or under religious settings.
According to UNICEF, every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.