As many as 60 percent of deliveries in Nigeria are being attended by unskilled birth attendants. This high proportion, Dr. Muhammed J. Abdullahi, Director of the National Primary Health Care Development Agency (NPHCDA), said is part of the reasons why Nigeria is losing about 52,000 women annually to complications resulting from pregnancy.

According to Abdullahi, Nigeria is striving to meet the United Nations’ Millennium Development Goals (MDGs) on maternal health by next year.

To address the issue of poor access to healthcare services, the Nigerian government —through the NPHCDA is championing initiatives aimed at equipping primary healthcare centers across Nigeria. Essentials such as drugs, tools and manpower will help to manage baseline health conditions, and to provide first aid treatments during emergencies.

Announced by the federal government of Nigeria in 2012, the major route that the country has taken so far in tackling the challenges posed by insufficient skilled birth attendants is the Midwives Service Scheme (MSS). Under the program, the government deployed 2,323 midwives who were unemployed and retired to more than 600 primary healthcare facilities across Nigeria. The initiative serves roughly 11 million people.

Improving the Midwives Service Scheme

A recent visit to Ikereku Primary Healthcare Center in a rural community in Oyo state revealed a lot still needs to be done to make the scheme more successful; it also revealed that on its own, the MSS cannot achieve desired results.

“They work in shifts. Even with the arrangement, they are not always there as we would have loved them to be. They rarely come on time and they are always anxious to leave,” Abass Akinosun, a youth leader in Ikereku, Oyo state told AFKInsider about the midwives.

One of the drawbacks of the scheme is the posting of the midwives as a good number of them were assigned to areas that were far from their places of abode. For instance, even though they were posted to rural communities, some of the midwives live with their families in urban centers.

“If she is lucky enough, she will go into labor when the midwives are around. If contractions begin when the midwives have left, good luck to the pregnant woman,” Akinosun said, noting that the impact of a midwives’ trek depends on how fortunate a pregnant women is.

“We recently had a case of a pregnant woman delivering her baby on the roadside when efforts were being made to transport her to another healthcare facility since the midwives here had left.”

The Issue With Transportation

In Nigeria, there is an evolving referral system in place to take patients to bigger hospitals if their conditions cannot be properly managed or treated at the primary healthcare centers.

This however is not entirely effective as challenges of poor road networks, non-availability of ambulances and several others factors frustrate the system to the extent that some patients are being transported on motorcycles, bicycles and tricycles. Some are even carried on the shoulders of their relatives when in need of urgent treatment.