By Abubakar Jimoh
“There should be zero tolerance for maternal death in presence of the on-going renewed efforts by the Kano State Government to ensure adequate, accessible and affordable health care services in the state”, the Permanent Secretary Kano State Ministry of Health, Mallam Dahiru Musa has said.
The Permanent Secretary disclosed this during an Executive and Media dialogue on Maternal Health organized by Civil Society Legislative Advocacy Centre (CISLAC) in Kano state to bring the state’s executives and media under one roof to brainstorm on necessary action for timely release and effective implementation of maternal and child health budget in the state for efficient intervention and maximum impacts on the citizens.
He said: “There should be no maternal death. The state has put in place adequate Health Management Information System, which is subjected to periodic review by the instituted Maternal Death Review Committee to ensure qualitative and accurate maternal health data collection and use in policy decision.
“Medical students are through the state’s scholarship engaged on overseas training programmes to bridge the high patients-to-doctor ratio and boost human resources for heath in the state; and established Community Midwifery College in Gwarzo for training of young girls to augment existing skilled birth attendance.
“The State Government has created the State Health Contributory Scheme with an established Agency to administer the Scheme, as a palliative measure to address the emerging dwindling revenue resources from Federation Account to the health sector.”
Musa added that the sum of 50 million naira was recently provided by the State Government to United Nations Children Fund (UNICEF) through co-funding arrangement for the procurement of Ready to Use Therapeutic Food (RUTF) to mitigate child death from malnutrition.
Also speaking during the Dialogue, Mrs. Zuwaira Omar, representing CHRICED, however, debunked unfriendly attitudes of some health workers as endemic challenges impeding timely realisation of adequate attendance for health care services at health facilities in the state.
She said migration of the state’s trained skilled health workers to other states or international community at the expense of state’s dire needs for adequate and accessible health care services had hampered efforts at addressing high patients-to-doctor ratio.
Presenting the issues affecting effective utilization of health budget, Muhammad Inuwa Shu’aib noted that maternal deaths account for 32 percent of all deaths among women between 15 and 49 years.
While commending the State Government’s effort at increasing budgetary allocation to health sector, amounting to 12.6% in current year as against 9.7% in 2016, he revealed that the sum of 180, 000,000 naira has been dedicated for maternal and child health services.
He noted: “In the past, the release was on quarterly basis. Some efforts demonstrated to use findings from Operational Research in 2008 played a vital role to influence decision making, where release was reviewed to monthly basis.
“Although there were some factors—bureaucratic process, poor timing that caused delay in the release of fund up till 2016, delay resulted in more death of pregnant women in the State. Currently, there is consistency in the release of Maternal Health fund particularly in this quarter January-March 2017.”
Shu’aib explained that high maternal and child mortality rates reported for the state could easily be attributed to “the fact that only 13% of deliveries in Kano were attended to by a skilled birth attendant, only 11% of deliveries in the state take place in a health care facility”.
According to him, the state’s Maternal Mortality Rate (MMR) data is 1,025 deaths per 100,000 live births.
Shu’aib added: “The free maternal health is provided mostly in designated secondary health facilities far away from majority of the rural settlements. It is not currently seen as a programme that can go beyond the present health facility-based implementation approach.
“The free maternal health is facing severe operational problems including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure and lack of participation of the local governments authorities in the provision of free maternal health.
“There is inadequate community involvement and participation in the planning and implementation process which has resulted to a lack of community ownership of the free maternal health.”
He attributed the challenges facing maternal health in the state to inadequate analyzed data for expected target beneficiaries—pregnant women; inadequate projection of costing per head; over dependence on development/donor partners for support on health related issues; low involvement of community existing structures Civil Society Organisations, Community Based Organisations and media in Maternal Health budget process.
Shu’aib He urged formidable effort by the media through evidence-based advocacy and investigative journalism in demanding accountability from relevant stakeholder to sustain existing achievements and enhance judicious utilization of maternal health funding in the provision of adequate, accessible and affordable health care services; and provision of appropriate monitoring system for the procurement and dissemination of commodities with timely release of appropriated fund for maternal and child health interventions.
The dialogue drew over 20 participants representing Ministries of Health, Planning and Budget, Women Affairs, Civil Society Organizations, and the Media.