Improving Maternal and Child Health Outcomes in Coastal Areas.

Maternal exposure to oil pollution is an important public health concern in the Niger Delta. The region is rated as one of the most oil spill vulnerable areas in the world with about 123 gas flaring sites. Several oil facilities are located close to the homes, farmlands, and water sources of host communities in this region. researchers have reported that living in areas polluted by oil have adverse effects on human health.

It is reported that oil pollution in the Niger Delta affects men and women disproportionately, with women being more exposed and vulnerable due to some cultural and socio–economic factors. Women tend to bear the heaviest burden of environmental degradation, especially pregnant women who are often considered a vulnerable population during disasters, both natural and chemical.

Oil pollution is known to be a predictor of several conditions such as cancer, neurotoxicity, high blood pressure; and could lead to adverse maternal outcomes such as increased rate of miscarriage, intrauterine growth restriction, preterm birth, birth defect, low birth weight. More research revealed that oil pollution increases the risk of preterm birth, miscarriage, birth defects and gestational diabetes among women in oil polluted communities.

This is more crucial and a double burden to us in the Niger Delta as Nigeria remains one of the leading contributors to maternal deaths globally, contributing to around 20% of maternal deaths worldwide. In Nigeria, the current maternal mortality ratio is 512 per 100,000 live births with noncommunicable diseases (NCDs) including cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases accounting for 24% of total deaths during pregnancy.

In 2022, the CMADI embarked on a baseline audit that consisted of how best to support our primary health facilities in 2 primary health care facility in Warri South Local Government Area in Delta State. The audit was required to understand the state of the health centre using observation and qualitative interviews of staff members.

The following questions were asked during the audit:

  • Birth rate: Number of births recorded from 2015 to 2022.
  • Mortality rate: Number of deaths recorded (adults, women, young people, children). This includes age and gender.
  • Prevalent illnesses and diseases treated in the health centre.
  • Antenatal care: Attendance
  • Questions were subjected to further probing were necessary.

Findings showed that the primary health centres are in operation with limited capacity and human resources. Health workers’ attitudes might be due to known factors such as limited exposure to training on empathy, customer service and community engagement. Immunisation of children seems to be slow progress and with positive impact. Malaria and upper respiratory diseases have been identified as prevalent illnesses, especially among those under 5s. Based on CMADI’s work in environmental health, we believe the upper respiratory illnesses are due to the air quality of the environment as the health centres are situated near the Warri refinery.

We proposed a collaborative approach to supporting the primary health centres to improve the health and wellbeing of the community residents. This included working with health centres on a volunteer basis to support the work within the community. To offer staff in the health centres training opportunities in risk, safety, WASH, community engagement, patient care etc.

We sought to support the health centres in identifying other common diseases and ways to raise awareness for preventable diseases and illnesses. A baseline community health assessment was conducted in January 2023 across 4 local communities.

CMADI is currently supporting the Ubeji Primary Health Centre every Tuesday with their antenatal sessions. Our project co-ordinators alongside nurses deliver sessions that cover the different trimesters in pregnancy, nutrition, post-partum care and depression, medicines during pregnancy, immunisation, sex after pregnancy, exclusive breastfeeding and lots more.

Conversations are challenging the status quo and gives room for discussions about issues such as post exclusive breastfeeding, what next? Women raised questions like, “I did exclusive breastfeeding for my first daughter and after six months she refused eating and it has been so till date, so I am sceptical about this one”. “What kind of meals should I give me child after breastfeeding?”

As CMADI continues working with the health centres, we would keep working with the ideas we have as the year unfolds to improve the maternal and child health outcomes.

If you are interested in working with us on this project for health centres in coastal communities, do reach out to us.

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