White Ribbon Alliance

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Expand RMC to address disrespect and abuse beyond childbirth

September 26, 2014
By Dr. Philippa Momah, White Ribbon Alliance Nigeria Board of Directors

Expanding the reach of RMC to address D&A beyond childbirth should have the effect of improving women’s access to quality health care in Nigeria, increase the uptake of services, and improve maternal health outcomes.

The Nigeria Demographic and Health Survey (NDHS) 2013 data revealed a Maternal Mortality Ratio (MMR) of 576 maternal deaths per 100,000 live births for the 7 year period preceding the survey. These results were not significantly different from the2008 NDHS MMR of 545/100,000 live births.

The 2013 data showed that 61% of pregnant women received antenatal care from a skilled provider, but only 38% delivered by a skilled provider. Eighty-five percent of the women who had access to skilled assistance during childbirth belonged to the highest socioeconomic quintile, while only 6% were from the lowest quintile. Sixteen and a half percent of respondents felt that the poor attitude of health care workers (HCWs) contributed to the problems of accessing health services.

Maternal health outcomes have not improved as anticipated. Contributory factors include: unmet government commitments; inadequate resources; and inequity and poor accountability - especially to vulnerable and underserved populations.

Quality concerns have been shown to contribute to the low uptake of maternal services, therefore health care workers, as the “duty bearers”, must be supported to ensure accountability in the provision of quality health services - from pre-natal, delivery and to post-natal care - according to needs. Each and every contact that a woman has with the health system provides an opportunity for health care workers to establish a good relationship with the mother, and this should improve the uptake of services.

Strong partnerships will be necessary to establish inclusive maternal health accountability systems, which should build on existing structures to ensure sustainability.

Global support is necessary in assisting National Alliances to strengthen existing community structures (such as the Ward Development Committees), to provide quality health services.