Hafsat Marnoma, from Manona village in Wurno local government area of Sokoto State, was married off at the tender age of 14 some 30 years ago. She has had five children over the years, but none of them was delivered in a hospital or primary health facility, though these are readily available. Hasfat is just one of thousands of womenin the state who would gladly stay away from a standard health facility when labour pangs begin, and instead look for help from Traditional Birth Attendants (TBAs), and there a surfeit of them. A United States Agency for International Development (USAID) report released recently indicatesthat about 95 percent of pregnant women in Sokoto deliver their babies at home. The deputy chief of party, Target Stated High Impact (TSHIP) of the USAID in Sokoto, Dr. Abubakar Maishanu, gave these chilling details at a meeting of ‘communities of practice’ forum on maternal and child health under the National Demographic Health Survey 2013, recently. He said only 4.7percent of women in the state give birth in a health facility a situation he observed has worsened the incidence of maternal deaths in the state, adding that the likelihood of receiving assistance from skilled provider during delivery was low. Maishanu noted that only 17 percent of mothers received ante-natal care from a skilled provider. Some expectant mothers who spoke with Weekly Trust said they shun hospitals due to religious, cultural and economic reasons, among other factors. They explained that Islam forbids a man from seeing the nakedness of a married woman except he is her husband, so they cannot allow any man come close to them especially during labour, when they are more exposed. “It is a taboo for a woman to allow male medical personnel to deliver her baby with so much body contact to undergo during labour,” Hafsat Amadu said, adding that the TBA in the village is qualified and that the women feel safer in her hands during delivery. The women, whose ages range between 20 and 45, stressed that it was only complications that cannot be handled by TBAs that warrant them going to the hospital. They also cited the difference in the positions in which expected mothers are expected to assume during labour at home and in the hospital, as another discouraging factor. Women stay in a squatting position at home, but in the hospital they lie backwards and spread their legs.
[eap_ad_1] “This does not go down well with us,” Hafsat said. Weekly Trust learnt that the situation is so bad that when any woman develops complication during childbirth and is taken to the hospital, she is ridiculed by her peers as someone whose body has been exposed to hospital staff, who are not her husband. The dearth of female medical personnel is largely to blame for this, the women, who spoke in different parts of Sokoto, including Manona, Ruggar Giwa, Gidan Bahure, Assada, Gadu and Runjin Ragga areas, said. There is also the cultural aspect. Young women are usually sent to their mothers for their first delivery so they can get adequate care; because during labour, the parents would get an experienced birth attendant to handle the delivery at home. But other women like Mallama Aisha complained about the attitude of hospital staff, saying many expectant mothers risk their lives by not going to a health facility to avoid what they consider as the staff’s debasing bahaviour. Rather than sympathise with women in labour, many health workers tend to ridicule,disparage or mock even those who arrive in critical condition. “They display all sorts of unprofessional attitudes to pregnant women which negatively impacts on our perception of hospitals,” Aisha told Weekly Trust. But the nation’s bad economy could also be a key deterrent to most would-be mothers patronising hospitals. Investigations showed that husbands and their pregnant wives shun hospitals during delivery because of certain demands made on them. This range from what they termed unnecessary prescriptions; bribing hospital staff for proper care and expenses attached to the care of both new-born and mothe. “The hospital today is beyond the reach of the common man, especially when there is need for admission.Some of us, out of concern for our husbands, endure so much and remain at home rather than expose their meagre income to outsiders, which may attract shame,” Halima Aliyu, a mother of seven, told Weekly Trust. However, stressing the need for women to ensure they deliver in health facilities, TSHIP deputy chief of party, Dr. Maishanu said that: “Delivery is a natural phenomenon but one thing you cannot predict is complication; that is why it is recommended to do simple preventive activity, going for ante-natal.” He also stressed the need for adequate manpower at the state’s health facilities.Though he acknowledged that there are health facilities across the state, Maishanu said: “It is not good enough to build hospitals, you have to have the minimum requirement of workforce.” For instance, he asked: “Do we have the minimum requirement of four midwives to work 24/7 in all general hospitals /local government areas? How many clinics/centres have the minimum of two community health extension workers?” Maishanu stressed the need to train health administrators, begin community midwifery training,pool resources to strengthen referral centres and ensure unconditional recruitment of needed staff and adapt the Community Based Health Volunteers (CBHVs) programme among others. Sokoto State government absorbed itself of blame, saying it has well-equipped facilities, including specialists and general hospitals and 230 primary health centres among others and that it has continued to give priority attention to the health sector. Director, primary health care (PHC) in the ministry for local government and community development, Dr. Junaidu Mohammed, who expressed concern over the USAID report,stressed that the state was doing its best to deliver healthcare services to the people. Similarly, special adviser to the governor on primary healthcare, Alhaji Ibrahim Jibril, noted that it was a demonstration of the government’s commitment to ensuring health care delivery in the state was taken to the doorsteps of the people that the state recently procured 230 ambulances for its primary health centres. (Daily Trust)