REPOSITIONING MATERNAL AND NEONATAL MORTALITY REDUCTION AS A NATIONAL PRIORITY

COMMUNIQUE ISSUED AT A ONE-DAY NATIONAL SEMINAR / CONSULTATIVE MEETING ORGANISED BY FEDERAL MINISTRY OF HEALTH IN COLLABORATION WITH THE HOUSE COMMITTEE ON HEALTH AND THE CENTER FOR DEVELOPMENT AND POPULATION ACTIVITIES (CEDPA) ON THE 24TH OF MAY 2006 TO MARK THE NATIONAL SAFE MOTHERHOOD DAY AT THE SHERATON HOTEL AND TOWERS, ABUJA ON THE THEME: REPOSITIONING MATERNAL AND NEONATAL MORTALITY REDUCTION AS A NATIONAL PRIORITY

PREAMBLE
Maternal and neonatal health concerns have emerged as the most important issues that determine global and national well-being. This is because every individual, family and community is at some point intimately involved in pregnancy and the success of childbirth (WHO 2006).  With an alarming rate of about 800 maternal deaths per 100,000 live births, this issue is indeed a National emergency. According to the President of the Federal Republic of Nigeria, Chief Olusegun Obasanjo, current rates are unacceptable and must be reversed. The Federal Ministry of Health in collaboration with the House Committee on Health and the Centre for Development and Population Activities (CEDPA) organized a one-day seminar/consultative meeting on Repositioning Maternal and Neonatal Mortality Reduction as a National Priority. The event was supported by the David and Lucille Packard Foundation and the MacArthur Foundation.
            The Moderator, Mrs Eugenia Abu, Manager NEWS, Nigerian Television Authority (NTA) called the house to order at 9.55 a.m. The occasion chaired by Honourable Dr Aminu Safana, Chair, House of Representatives Committee on Health,  attracted a lot of dignatories including Mrs Sarah Jubril, Nigeria’s first Presidential Candidate, Senator Daisy Danjuma, Chair, Senate Committee on Women Affairs, Honourable Saudatu Sani, Chair, House Committee on Women Affairs, Honourable Wale Okediran, President,  Association of Nigeria Authors (ANA), Dr Adeyemi, FMOH, Prof Emmanuel Otolorin , Senior Regional Technical Officer, JHPIEGO, Hon Dr. Gyang D. Dantong, Member, House of Representatives Committee on Health, Chief (Mrs) Kolade, a CEDPA Alumnus and the Iyalode of Osogbo, the Donor Community, Directors and staff of Development Organisations and the UN, CEDPA partners from all over the country and the media. Participants numbered over 300.
 
Papers Presented included:
 
Situation Report on Maternal Mortality and Neonatal Mortality - FMOH: Dr. Moji Odeku, FMOH
Situation Report on Neonatal Mortality - Dr. Esther Obinya, UNICEF
Key Note Address:  Repositioning Maternal and Neonatal Reduction as a National Priority - Prof. Oladapo Ladipo, President/CEO, ARFH and Dr. Mairo  Mandara, Senior Country Advisor, David and Lucille Packard Foundation
Making Pregnancy and Child Birth Safe: The WHO Initiative -  Dr. Sola Odujinrin, RH Advisor, WHO
Accelerating Maternal and Neonatal Mortality Reduction through Good Governance   Mr. Jimi Agbaje, Gubernatorial Aspirant, Lagos State
Protecting Women and Children’s Right to Life: The Role of Parliamentarians  - Hajiya Bilkisu Yusuf, Executive Secretary, AdvocacyNigeria
 
Defending Women and Children’s Right to Life through Political Participation - Lady Ime Udom, NEC Member, Peoples Democratic Party (PDP)
Budget Tracking and access to Maternal and Neonatal Healthcare: Exploring the Linkages - Hilary Ogbonna, Budget Advocacy Coordinator, ActionAid International NigeriaHarnessing the Power of Communities to hold Elected Officers Accountable for Maternal and Child Health - Ejiro Joyce Otive-Igbuzor, Director, CEDPA NIGERIA
 
The Consultative Meeting observed as follows:
The problem of maternal deaths (death of a woman while pregnant or within 42 days of termination of pregnancy) in Nigeria at 800 maternal deaths per 100,000 live births is a national emergency. The position of Nigeria as the second largest contributor to maternal deaths in the world after India demands urgent action.
The fact that one out of every five Nigerian child dies before his/her fifth birthday is unacceptable.
The HIV/AIDS pandemic has further worsened the state of maternal and neonatal mortality in Nigeria.
Maternal deaths in Nigeria result from preventable causes including ignorance, myths, cultural barriers, poor road networks, lack of access to health services and skilled attendants, mismanagement of pregnancy, illiteracy and poverty.
Inadequate functional utilities especially electricity, potable water and transportation system contribute to the high maternal and neo-natal deaths.
Nigeria’s failure to address preventable causes of maternal mortality is a tragic symptom of the social injustices that manifest as discrimination against women and denial of women’s human rights. Men often make ill-informed reproductive health decisions on behalf women which usually put the women and children (under 5 years) at the risks of ill-health and death.
Male involvement in reproductive health issues as well as pregnancy, child nurturing and domestic affairs is desirable and beneficial to the entire family, communities and society. 
Reduction in maternal mortality will not only improve the quality of life for individuals and families but also contribute to economic growth, societal and gender equity and democratic governance.
Adequate funding of programmes enabling young people to avoid unwanted pregnancy, unsafe child birth and sexually transmitted infections (STIs) would produce a significant benefit to development and slow the spread of HIV/AIDS.
Unless there is political priority for safe motherhood and child health as indicated in the Millennium Development Goals 4 and 5, it is impossible to achieve the other development goals.
 
The meeting called on governments at all levels:
To declare maternal and neonatal deaths a national emergency and design an emergency action plan to address them.
To increase budgetary allocation to health to at least 15 percent in line with the Abuja Declaration of 2001 by the African Union.
To specifically dedicate budget lines to reproductive health programmes including safe motherhood.
To ensure that every part of the country especially rural areas and urban slums is covered with health facilities with adequate infrastructure and skilled staff.
Remove user fees for antenatal, delivery and postpartum services in all public health facilities.
Prioritize girl-child education because of its direct relationship with reduction of maternal mortality.
Since most maternal and neo-natal deaths occur outside the health facilities, health services should be taken to the people by training and recruiting community midwives who would undertake home deliveries in addition to the usual antenatal care and information dissemination.
Invest in data collection and evidence-based planning, implementation, monitoring, evaluation and impact assessment.
 
The meeting called on the legislature to:
Legislate in favour of free antenatal care and delivery and family planning services for every woman.
Allocate more money to health, education and other social services.
Exercise its oversight function to monitor the strict implementation of the health budget and the national health sector reforms.
To serve as advocates for safe motherhood at all levels.
 
The meeting called on Civil Society to:
bullet Equip and mobilize women and men to achieve gender equity and reduce maternal and neonatal mortality
bullet Prioritize the issues of maternal and neonatal mortality reduction in their programming.
bullet Monitor the health budget and strict implementation of the health sector reform.
 
The meeting called on Nigerian citizens to:
bullet Vote for only those who will work for safe motherhood and neonatal health in the 2007 elections
bullet Strengthen partnerships and networks at community levels to hold elected officials accountable.
 
The meeting also called on:
bullet Religious and traditional leaders to be actively involved in addressing the Maternal and Neo-natal issues in their communities.
bullet Political parties to make safe motherhood and neonatal health core elements in their manifestoes and an election campaign issue in 2007 and beyond.
bullet The media to draw attention to the high rates of maternal and neonatal deaths and give visibility to politicians that prioritise these issues in the 2007 elections.
 
COMMUNIQUE COMMITTEE
 
Ms. Ejiro Otive-Igbuzor                                        Dr. Omokhudu Idogho
Country Director, CEDPA                                     ActionAid Nigeria
 
Hajia Fatima Shagari                                             Dr. Moji Odeku
ENHANSE                                                           FMOH
 
Ms. Raheemat Momodu                                  Hon. Dr. Gyang D. Dantong
UNFPA                                                       House of Reps Committee on Health
 
Dr. Zipporah Kpamor                                       Yahaya Taidi and Patrick Otoro
DCD, CEDPA                                                   Rappouteur team

Ejiro J. Otive-Igbuzor
Country Director
Centre for Development and Population Activities (CEDPA)
Plot 223, Adetokunbo Ademola Crescent
Wuse II, Abuja. Nigeria
TEL: +234-(0)9-5234652
FAX: +234-(0)9-5234592
MOBILE:+234-(0)-8033077400
http://www.cedpa.org