Gynaecologist Tasks Government, Healthcare Providers On Prevention Of Maternal Mortality

Faith Okerinmodun, OAU Ile-Ife

A Professor of Obstetrics and Gynaecology at Obafemi Awolowo University, (OAU) Ile-Ife, Professor Olabisi Morebise Loto has tasked government at all levels, healthcare providers and other individuals connected with childbirth to be proactive always in taking necessary steps to prevent maternal mortality.

Delivering the 305 inaugural lecture of the University entitled “Give Me Children…Let Me Live: Combating the Misery of Infertility and Preventing Maternal Mortality”, Professor Loto said the pregnant women should always be well prepared for pregnancy and childbirth.

Professor Loto urged government to ensure that hospitals are well equipped with necessary facilities and quality professionals that are capable of handling the situation before, during and after the childbirth.

He also appealed to government and policy makers to transform the hospitals and ensure that they are well functioning. He emphasised the need to ensure adequate funding for the health sector and improvement in the infrastructural development and the human capital development in the hospitals.

He urged government to expand the National Health Insurance Scheme (NHIS) to cover more of the populace and to also provide more therapeutic interventions to reduce the crippling out of pocket expenditure by patients.

According to him, “the pregnant women should always be prepared knowing that pregnancy is a nine month journey. A pregnant woman and her husband should put some money apart in case of emergency and also liaise with a transporter for emergency transportation at night, if need be.”

“Health providers should constantly update their skills and knowledge so as to be aware of the current evidence-based best practices in the management of pregnancy, labour and delivery. They also need to improve their relationships with patients and their relatives so that they do not, inadvertently, drive them away from the hospital as a result of their attitude.”

“The government and policy makers need to make sure that our hospitals do away with the mere consulting clinic status that they have come to be known for over the years. They should be transformed to real functioning hospitals by improving on the funding, infrastructural development and the human capital development in these hospitals. The government also needs to expand the National Health Insurance Scheme (NHIS) to cover more of the populace as well as provide more therapeutic interventions to reduce the crippling out of pocket expenditure by patients”, Professor Loto said.

Also speaking on the issue of infertility, Professor Loto said prevention is far better and cheaper than cure. He added that living healthy lifestyles, such as avoiding alcohol, smoking and unhealthy dietary habits will help to reduce the risk of infertility.

His words, “the prevention is achieved through the avoidance of risky sexual behaviours that leads to pelvic infections, unwanted pregnancies and its termination as well as delivering babies in unhygienic places, which may lead to puerperal sepsis.”

“Health care providers should use every opportunity to canvas for healthy lifestyle and talk about prevention. They should avoid unnecessary pelvic operations in young women and manage pelvic infections promptly using the recommended evidence based guidelines.”

“Couples with infertility problems should always seek medical services early in government approved hospitals. This is because in trying to treat infertility, women may be subjected to numerous ineffective treatments which are expensive and time consuming by quacks and even some supposedly professionals.”

This is not only prevalent among alternative health practitioners, but qualified medical personnel are also guilty of this. The end result is an increase in the misery and financial problems of these hapless couples.”

“It is unacceptable and totally unprofessional that in this era of evidence-based medical practice, people still use modalities of treatment that have been found to be ineffective and sometimes harmful.”

“In the case of an infertile woman, any time wasted on unnecessary treatment is harmful because her biological clock continues to tick each passing day with each tick representing a stroke in the dimming of her hope for fertility for life as it pulls her towards menopause. So it is important that professionally acceptable treatment be used for the woman as early as possible.”

“In the interest of the people, the government and policymakers should ensure that our hospitals are the places where there is provision of adequate funding for the procurement of standard equipments and staffing.

“Government should set up highly subsidised IVF Units to manage the infertile couples whose only option is IVF for the resolution of their infertility problems. The cost of accessing this treatment still remains prohibitive because infertility treatment is excluded from the insurance scheme and couples have to pay out of pocket.”

“While so many NGOs spend millions of dollars on family planning to reduce the population, none is spending money to help infertile couples achieve their aim of parenthood. It is unfair to impose the burden of over-population on women and men suffering from infertility as all children contribute equally to the problem of overpopulation and not just those born from fertility treatment.

“Family-planning and infertility are clearly linked and should be handled in the same centres. Public education on prevention of infertility includes not only prevention of STDs and pregnancy-related infections, but also life style factors, such as iatrogenic infertility, environmental pollution and contamination.

“Infertility treatment should be part of an integrated reproductive care programme including family planning and contraception, mother care, and reproductive health issues. We need to transform the paradigm of family planning into the planning of a family, and deploy human and material resources into helping infertile women and men become loving and caring parents.”

Professor Loto also canvassed for health education programmes which he described as very essential and should be encouraged at appropriate levels and be carried out by appropriate individuals and institutions.

“Raising awareness is another very important issue and should be done with great care. It is important that focus must be on changing the existing moral and socio-cultural beliefs to a level where childless couples are no longer isolated, stigmatized and discriminated against.

“The media, patient organisations and interested politicians are needed in this regard. This will definitely not be a stroll in the park; obstacles will be numerous depending on local socio-cultural, political and religious influences but it is achievable by all standards. Providing infertility care in developing countries can only be successful if we are able to diminish the socio-cultural, psychological and economic consequences of unwanted childlessness.”