The verdict by Bill Gates on Nigeria as one of the most dangerous places to give birth did not come as a surprise. Gates should know and he knows what he is saying.
As the world’s second richest man and co-chairman of Bill and Melinda Gates Foundation, he has contributed immensely to child and maternal mortality issues across the globe, particularly the African continent.
Gates, who recently spoke at the Expanded National Economic Council (NEC), presided over by the Vice President, Prof. Yemi Osinbajo, in Abuja, said Nigeria had the fourth worst maternal mortality rate in the world behind Sierra Leone, Central African Republic and Chad.
The philanthropist also disclosed that his foundation’s biggest office in Africa was in Nigeria where he had committed over $1.6 billion with the intention of increasing his commitment in the country.
He said: “Nigeria is one of the most dangerous places in the world to give birth with the fourth worst maternal mortality rate in the world ahead of only Sierra Leone, Central African Republic and Chad. One in three Nigerian children is chronically malnourished.” Health issues generally have become problematic in Nigeria.
There has been a steady increase in child and maternal mortality rate in the country. On a daily basis, women die as a result of pregnancy or pregnancy related cases in Nigeria.
Every day, 145 women of child-bearing age die while 576 maternal deaths occur per every 100,000 life birth in Nigeria every year, according to the 2013 Nigerian Demographic and Health Survey (NDHS). Also, the World Health Organisation (WHO) rates Nigeria as the second country with highest maternal death rate in the world with its contribution of 15 per cent of annual global maternal deaths.
According to WHO, the country with the highest number of maternal death globally is India, followed by Nigeria. India’s population is about 1.3 billion while Nigeria has about 183 million people.
Sever a l f a c t o r s , such as policy summersault on the part of government because of changes in government, lack of funding from government, high unemployment rate, poverty, high cost of medical servic e s, inadequate healthcare p e r s o n – nel, lack of drugs, among others, greatly affect access to healthcare delivery.
For instance, provision of free medical services, especially for pregnant women, anchored on the ‘Mother and Care’ module, was the fulcrum of the immediate past administration in Ondo State.
The Mother and Care hospitals offered free pre-natal and post-natal treatment for pregnant women, delivery as well as their children after birth. This improved chances of survival for pregnant women and therefore, reduced child and maternal mortality rate in the state.
Today, that is history in the state. The present administration has abolished the free treatment for pregnant women in the Mother and Care hospitals. Five women die of child birth every hour in both rural and poor urban centres and over 400,000 women die annually in Nigeria from child birth related complications, while one in 15 babies will die before their first birthday and about one in eight before their fifth birthday.
A recent World Bank report noted that in 2016, nearly 10 per cent of new born deaths in the world o c c u r r e d in Nigeria. Based on its ranking, Nigeria e m e r g e d third out of five countries accounting for half of all new born deaths in 2016. Also, a joint report by WHO, United Nation Population Fund (UNFPA), United Nations Children Fund (UNICEF) and World Bank says Nigeria recorded 58,000 maternal mortalities in 2015.
The report was presented at the 2017 Annual Faculty Day Lecture by the Faculty of Public Health and Community Medicine, National Postgraduate Medical College of Nigeria. Ms. Olusola Odujinrin, who presented the report, lamented the number of women who lost their lives to pregnancy and child related causes. She said: “The prevalence depends on several factors, including living in an urban or rural area, socio-economic status and geo-political zone.
“The most worrisome is the report from North-East where MMR is highest: 1,549/100,000 live births in comparison to the South-West where 165/100,000 was recorded.”
The Minister of Health, Prof. Isaac Adewole, also said: “Nigeria is next to the worst which is Chad. While Nigeria contributed only 2.4 per cent to the global population; it is unfortunate that we contribute 14 per cent to global maternal mortality, a trend which needs to be reversed.”
It is unacceptable that pregnancy and delivery will still serve a death sentence for women at this age in Nigeria. We, therefore, urge government at every level to take conscious effort to reduce drastically, if not eliminate, maternal mortality.
This can be achieved by eliminating factors preventing the provision of quality healthcare delivery. It is possible with determination, commitment and sincerity of purpose.
This, Adewole agreed, is possible when Nigeria could achieve below 100 ratio by 2030 and 300 maternal mortality rate in 2018. According to him, it is achievable if government strengthens the various social intervention programmes.
Ending assault on judiciary
What happened in Rivers State last week where a group of youths backed by some powerful politicians attacked the judiciary, chased away lawyers, judges and litigants out of a High Court premises during proceedings should be condemned by stakeholders if Nigeria’s democracy must thrive. It is bizarre that politicians have always seized every available opportunity not only to launch tirade against the judiciary when displeased with its verdicts, but engage thugs and hoodlums for physical attack. This is unacceptable.
The attack on the Rivers court amounted to abomination. It must be condemned as these hoodlums not only viciously attacked the premises of the High Court of Rivers State, Port Harcourt Judicial Division but destroyed property valued at millions of naira while leaving several persons injured.
According to reports, the gangsters with their backers, allegedly aided by security operatives invaded the court’s premises and chased away judicial officers following a disagreement between two factions of the All Progressives Congress (APC) over local government congress, where an aggrieved faction had gone to court to seek redress. And while the siege lasted, the hoodlums freely harassed innocent persons, leading to destruction of public property such as equipment, furniture stolen, vehicles were ransacked and damaged. This is not the first in our history.
Four years ago, a judge in the Ekiti Division of the court was assaulted while presiding over a political case. Thugs loyal to the then Governor-elect, Mr. Ayodele Fayose, disrupted proceedings and chased judges, lawyers and litigants away. Although Fayose denied that his supporters beat up a judge, describing the allegation as not only unfounded, but spurious, the thugs were allegedly identified by the then Chief Judge, Justice Ayodeji Daramola.
Four years on, perpetrators were not brought to book despite an open letter detailing the attack by Justice Daramola. It is also on record the judiciary has always been assaulted since the coming of President Muhammadu Buhari to power.
J u d g e s ’ residences were raided and Justices arrested in the odd hour of the night like common criminals. It is sad that those that are constitutionally charged and empowered to protect us from tyranny and the abuse of power are themselves under siege.
The judiciary needs to take its stand to forestall further recurrence of such if not it will become a recurrent decimal”. The Rivers court’s attack must not go the way of Ekiti State; it must be investigat-ed and perpetrators must be brought to justice as mere condemnation by stakeholders would not assuage the judiciary of the negative impact the assault had caused the third arm of government. We support the Chief Justice of Nigeria (CJN), Justice Walter Onnoghen, that perpetrators must be brought to book.
If they get away with the assault on the judiciary and the perpetrators allowed to go the way of Ekiti, the criminals may be encouraged to launch similar attacks on the appellate courts especially when they p e r c e i ve that a judgement would go against their interest. Judiciary must be strengthened not weakened; this is not too much for the country especially when another elections beckon.
There is no doubt the attacks on the Rivers court was an ominous sign of a constitutional crisis already founded and being funded by the political class. Our country cannot afford a constitutional crisis at this time. This, however, called for quick intervention of stakeholders in the judiciary.
They must rise up at this moment to defend the sanctity of the third arm of the government which is the conscience of the people and the last hope of the common man. It is time politicians must have a rethink moreso as we approach another general elections next year. Efforts should also be intensified to ensure that the culprits are apprehended, prosecuted and jailed to serve as deterrent to others. We decry the conduct of the security agencies in the attack. Video clips of the attack show that security agents provided cover for the attackers.
This is unacceptable. We demand probe of the involvement of security operatives in the unfortunate incident. Also, the lack of response from the security agencies when the attack lasted is unfortunate. Does it mean that if the attackers had killed judicial officers, lawyers, litigants and others and burnt the court’s buildings, no preventive measures or help would have come from the security agencies. This is really unfortunate.
The police, for instance, should not dance to the tune of the government in power. Neutrality should be their watchword. Hands must be on deck to ensure that democracy thrives in Nigeria. Also, the Federal Government must develop the will power to address these issues just as institutions must be allowed to evolve on their own.
This has again reinforced call for separation of the office of the Attorney-General of the Federation from that of the Minister of Justice in order to tackle some of these problems. We, like the CJN, condemn this latest act of intimidation of the judiciary. This is a show of shame of the Rivers State chapter of the APC.
World Cup: Rohr’s provisional list
With barely three weeks to the 2018 FIFA World Cup competition, the fever is everywhere across the world as managers of teams released the provisional lists of players expected to entertain the world between June 14 and July 15. Some coaches were brave enough to come out with a 23-man list which could only be changed due to injury. The national team Managers of Brazil, England, France, Portugal, Iceland, Costa Rica, Sweden and Senegal did not release provisional but final list. We believe they did this due to the chemistry that exists in their teams overtime respectively.
Super Eagles Manager, Gernot Rohr, came out with a 30-man provisional list for the competition and we observed that there were no surprises except Junior Lokosa of Kano Pillars and Nwankwo Simeon of Crotone FC of Italy. Lokosa’s exploits (18 goals) in the domestic league has been impressive while the consistency of Simeon in the Serie A is commendable, but whether they have the experience to boost the Eagles’ for Russia is another issue entirely. Of the eight strikers invited, one or either of these two players will drop. Brown Ideye and Henry Onyekuru should have been given another chance to compete for shirts.
The list showed that Rohr has made up his mind to stick with the players that earned the country a ticket. Odion Ighalo is the arrowhead in the attack but there is need for a very hungry and experienced alternative equally as good as he is. We make bold to say that Kelechi Iheanacho and Alex Iwobi are best as support strikers. The current Eagles attack is still deficient, but we expect Rohr to capitalize on the good form of Chelsea’s Victor Moses to wreck opponents at the Mundial. Only last weekend, Moses was in the Chelsea team that won the FA Cup trophy in London.
We applaud the selection of players for the midfield where eight players were also invited to begin the run-in preparations. This area is the strength of the Super Eagles but the efficiency on the pitch will depend on how the players are deployed respectively. Skipper Mikel Obi is the commander and he has to stay fit because his presence is always a boost to the team. On the other hand, his absence leaves a huge gap in the team.
Super Eagles’ defence is a major area of concern. Rohr admitted that defence was his major headache. Ten players were invited to vie for shirts but we strongly believe one or two more should have been called to give room for competition which will be good for the coaches to pick the best. Efe Ambrose who has been consistent in Scotland should have been invited especially because he scores goals from set pieces due to his aerial prowess for Eagles in the past and also does so currently for his team, Hibernian.
Dele Ajiboye’s inclusion in the keepers list is good for healthy competition but we urge the goalkeepers’ trainers to give the four goalies comprehensive assessment to get the best three. Francis Uzoho and Ikechukwu Ezenwa are sure bets but whether Daniel Akpeyi is better than Ajiboye is what the coaches have to determine.
With the current setting, it is almost certain that Rohr has made up his mind on his final list. At this stage, sentiments must be avoided for merits. We have trust in Rohr to deliver in Russia, but some people around him are working for their personal rather than national interest.
Meanwhile, as we countdown to the event, a report has rated Joachim Low of Germany as highest paid FIFA World Cup coach with an average wage bill of €3.85 million. Next to Joachim is a Brazillian Manager, Tite. Tite’s average wage bill reaches up to €3.5 million which is same as that of Didier Deschamps of France.
Super Eagles’ Rohr earns €500,000 per annum and he is ranked 24th. In Group D, the Argentine coach has the best salary and he is followed by Iceland and Croatia. What the coaches earn is not enough to determine the performance of the team but it goes a long way to show motivation and the football development level in the country.
We urge NFF boss, Amaju Pinnick, to be careful not to allow politics to ruin the good work the federation has put in so far for this team. NFF has done really well.
Let us emphasis that the coaches should be brave enough to drop any player below 70 per cent fitness for the next available player.
So far, it is not clear whether the team has a psychologist and it is very important to have at least one for the World Cup. Overall, the players have a key role to play by coming all out to do their best for the country. The expectations of Nigerians are high and so it is expected they work hard and be determined to excel at the Mundial.
End health workers’ strike now
The game being played by the Federal Government and health workers under the auspices of the Joint Health Sector Unions (JOHESU) is dangerous to the health of Nigerians and the economic wellbeing of the Nigerian nation.
On April 17, JOHESU called out its members, which include the Senior Staff Association of Universities, Teaching Hospitals, Research Institutes and Associated Institutes (SSAUTHRIA), National Association of Nigerian Nurses and Midwives (NANNM), the Non-Academic Staff Union (NASU), Medical and Health Workers Union (NHWU) and the Nigerian Union of Allied Health Workers (NUAHP), on a nationwide strike to force the hands of the Federal Government to accede to its requests.
JOHESU’s demands include the implementation of the adjusted Consolidated Health Salary Structure (CONHESS), the payment of specialist allowances to deserving health professionals, payment of arrears of the skipping of CONHESS 10, increase of retirement age of health workers from 60 to 65 years and the review of the composition of the Boards of Federal Health Institutions (FHIs), as well as the abolition of the position of Deputy Chairman Medical Advisory Committee (DCMAC), among others.
But the Federal Government, from all indications, is not ready to accede to the striking workers’ demands.
In one of his reactions to the strike, the Minister of Health, Prof. Isaac Adewole, said JOHESU’s demand to be on the same pay level with doctors was not realistic. Adewole, said instead, salaries and wages of the health workers would be adjusted.
While the altercation between the union and the Federal Government is going on, the Nigerian Medical Association (NMA) threw its hat in the ring.
The association threatened to embark on strike if the Federal Government acceded to JOHESU’s demands. Both the F e d e r a l G ov e r n – ment and the NMA seem to be on the same page in terms of their stand on the JOH E S U ’ s strike. But while the Federal G ov e r n – ment and the medical pract i t i o n e r s have taken healthcare to the chess b o a r d , many people, the majority being the poor, are paying the price.
While patients have been sent away from public health facilities, those who could afford to pay have gone to seek medical attention in private hospitals.
But those who could not pay have resigned to fate. It may be difficult to get the number of those who might have died because of lack of data in Nigeria. But certainly, a lot would have needlessly lost the battle to stay alive, albeit due to what could be termed minor health challenges, because of the ongoing strike. The strike has claimed lives. We sympathise with the 19 members of JOHESU who were injured in an accident on the Benin-Auchi Road on Saturday.
About 40 health workers, said to be staff of the University of Benin Teaching Hospital (UBTH) chapter of the union, were on their way to a function in line with the strike in Auchi, when the accident occurred. An engineer with an information technology firm reportedly lost his life.
The man, a victim of armed robbery, was reportedly rejected at a private hospital because there was no police report, but there were no health workers to attend to him at the government-owned health facility he was later taken to.
So the breadwinner of a family lost his life because of the strike. Several others are dying but their deaths are probably not reported. Unfortunately, the strike came when the President also had to take a medical trip to the United Kingdom. But apart from the leaders, how many Nigerians could afford to go outside the country for medical attention?
That probably explains why the leaders may not be keen in addressing the demands of the striking health workers.
While we cannot deny workers, particularly those in the health sector, the right to take steps to seek redress to their perceived short-change in the hands of their employers, going on strike at the slightest opportunity does nobody no good. In other climes, strikes have gone out of fashion. We encourage workers’ unions in Nigeria to devise new but proactive means to get employers to accede to their demands.
It is also pertinent to note that JOHESU was yet to comply with the directive by the National Industrial Court (NIC), Abuja, which, last Thursday, ordered the union to suspend its strike and resume duties within 24 hours.
Justice Babatunde Adejumo, who is president of NIC, gave the order after listening to the submissions of Mr. Okere Nnamdi in an ex-parte motion filed by a non-governmental organisation, Incorporated Trustees of Kingdom Human Rights Foundation International.
Adejumo ordered the Ministers of Health, Labour and Employment, among others, to immediately set up a committee to address issues raised by labour.
The judge ordered that the parties should arrive at an acceptable and amicable solution in the interest of Nigerians who are bearing the brunt of the strike action. We also implore the Federal Government to immediately find a lasting solution to the incessant strikes in the health sector.
This is necessary in order to safe many more souls which will be lost to the strike. A failed nation is it which cannot provide for the economic and health needs of its citizens.
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