Engaging Traditional Rulers In Curbing Infant, Maternal Mortality

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By Philip Yatai


A recent survey by the United Nations Children’s Fund (UNICEF) shows that 12 million children die across the world every year before their fifth birthday.

The data also shows that every day, Nigeria loses many less than five-year old children and 145 women of child-bearing age.

It notes that preventable or treatable infectious diseases such as malaria, pneumonia, diarrhoea, measles and HIV and AIDS account for the death of more than 70 per cent of these persons in that age groups.

The survey, however, identifies malnutrition as the underlying cause of morbidity and mortality of a large proportion of children, accounting for more than 50 per cent of deaths of children in the age bracket.

UNICEF observes that although many of the deaths are preventable, the coverage and quality of health care services in the country is inadequate.

According to the survey, less than 20 per cent of health facilities in Nigeria offers emergency obstetric care and skilled birth attendants manage only 35 per cent of deliveries in various health institutions.

Worried by this report, Dr. Steve Daniel of the Department of Theatre Arts, Ahmadu Bello University, Zaria, solicited a more pragmatic approach to improving women’s healthcare, especially when it involves child-bearing.

Daniel said 10 million women and adolescent girls experienced complications during pregnancy yearly out of which 1,500 women might die from problems related to pregnancy and child-birth.

“Similarly, studies also reveal that 15 children out of every 100 children born in Nigeria may die before their fifth birthday due to malnutrition related diseases.

“This could have been prevented with simple household practices and positive behaviours towards health services,’’ he said.

For instance, he said a demographic health survey in 2013 showed that out of 337,000 births recorded yearly in Kaduna State, 66,000 might die before their fifth birthday.

The survey notes that the deaths are largely caused by preventable and treatable diseases such as malaria fever, pneumonia and diarrhoea.

To stem this trend, UNICEF, in collaboration with the National Orientation Agency (NOA), recently engaged district heads across the state to enlighten and enlist their support in propagating essential family practices to curb infant and maternal deaths.

The essential family practices comprise ensuring that all children are immunised, nutritious food for the households and a compulsory antenatal care attendance for pregnant mothers.

Others include sleeping under treated mosquito nets; discouraging open defecation, regular hand washing and practice of good hygiene and environmental sanitation, among others.

Mrs Margaret Duniya, former UNICEF’s Communication Officer, Kaduna Field Office, said the deaths of women and children in the state from preventable diseases were common and unacceptable.

She said deaths from such diseases could be prevented with information and knowledge on how to tackle them.

“It, therefore, becomes necessary to bring the traditional rulers on board and enlighten them on the need to promote essential family practices to tackle infant and maternal deaths in Kaduna State.

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“We equally expect the traditional rulers to engage religious leaders to enlighten their followers on the consequences of unhygienic practices and other attitudes that predispose women and children to preventable diseases,’’ she said.

The Director of NOA in the state, Alhaji Galadima Soba, said engaging the traditional rulers was crucial in ensuring the success of any government programme and interventions, especially on developmental issues affecting rural communities.

“This is because traditional rulers wield significant influence on their people, and as such, become a rallying point for any intervention to succeed.

“It is on this platform that NOA and UNICEF decide to engage the traditional rulers to take ownership of government programmes in their domain,’’ he said.

Also, Malam Lawal Ibrahim, UNICEF’s focal person in NOA, Kaduna, described traditional rulers as crucial stakeholders in promoting ideal hygienic family practices and routine immunisation.

“We equally want their support in discouraging violence and exploitation against women and children in their communities.

“We want them to know their responsibilities as royal fathers in reducing child and maternal death by taking ownership of health services.

“At the end of the day, we will all agree on how to continually engage them on positive behavioural changes in communities to ensure children’s survival and development,’’ Ibrahim said.

Noting the crucial role of traditional rulers in social mobilisation, Dr. Bello Abdulkadir, Medical Director, Zaria Clinic, said the rulers had the potential of carrying every stakeholder along in ensuring that key messages on essential family practices gets to every household.

In response to this, some of the traditional rulers complained that government officials and politicians would not carry them along on issues of development in their localities.

One of them, Malam Shehu Umar, District Head of Tsebiri, Giwa Local Government, said the government and politicians only remembered them when things went bad.

“Government officials and politicians execute projects in our localities without our knowledge.

“They only involve us when such project is damaged. Sometimes, they even blamed us for not securing projects executed in our localities without our knowledge,’’ Umar said.

Similarly, Mr Joshua Kogaya, Village Head of Agban in Kagoro, Kaura Local Government, claimed that some of them were even taken to court for maintaining order in their communities.

“The situation is so bad that when you discipline a child for waywardness, the parents would take you to court. This is making our ability to mobilise and provide leadership to our people very difficult,’’ he said.

They, therefore, urged the government to involve them in designing development programmes and support them in maintaining security to assist them in mobilising their subjects for the overall development of their communities.

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Mr Danlami Barde, the District Head of Jagindi Tasha of Godogodo Chiefdom, Jema’a Local Government Area, said his community lost not less than five pregnant women monthly due to lack of access to healthcare services.

He explained that the area had only a clinic without proper health officer to ensure safe delivery, observing that women always travelled to Kafanchan to give birth.

“As a result, pregnant women from our community lost their lives while struggling to access nearby hospitals.

“In our case, Kafanchan General Hospital happens to be the nearby hospital, but it is more than 35 kilometres from Jagindi Tasha,’’ he explained.

The district head called on the state government to look at the issue and construct a general hospital in Jagindi and other communities in need of health facilities.

The traditional rulers further called on the state government to stop the proliferation of illegal clinics and patent medicine stores run by ill-equipped medical officers in rural communities.

They noted that incompetent health officers could take advantage of the insufficient health centres in rural areas to illegally operate clinics and patent medicine stores.

According to Mr Bulus Ejim, District Head of Bade, Nyankpah Chiefdom, Jema’a Local Government Area of the state, these outfits are operated by junior community health workers or those with basic nursing certificates.

“Such certification is not enough to run a clinic and they should stop gambling with peoples’ lives.

“Whenever you go to such outfits, the first thing they do is to give drip to patient, irrespective of his or her ailment.

“In some cases, patients eventually die, because the officers are busy addressing the wrong ailment and giving wrong medications; we have lost a number of our people through such unprofessional practices,’’ he said.

In his view, Mr Linus Magaji, the District Head of Zagom, Ikulu Chiefdom, Zangon Kataf Local Government Area, said traditional rulers should be involved in the monitoring and supervision of such outfits.

“That way, we will be able to report to appropriate authorities to ensure compliance to best practices,’’ he said.

Mr Zakaria Magaji, the District Head of Aduan, in Jema’a Local Government Area, however, blamed the development on the shortage of government-owned clinics and personnel in rural areas.

He observed that unless government addressed the shortage of manpower and service outlets, quacks would continue to flourish in rural communities in the guise of providing health services.

All the same, the traditional rulers promised to support the government to enlighten their subject on essential family practices in ensuring the survival of women and children.

They, nonetheless, called on government to address challenges in the health sector and save rural dwellers from quacks.

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