As Nigeria marks 2018 International Day to End Obstetric Fistula, President, International Society of Fistula Surgeons, Professor Oladosu Ojendegbe said if Nigeria will prevent its yearly 12,000 new VVF cases, ensuring pregnant women have access to effective and efficient care through such interventions as the Midwife service scheme was core.
Professor Ojendegbe said despite many interventions like the Rapid Response Initiateive (RRI) repairing about 5,000 VVF cases every year, more cases still occur every year because Nigeria’s health system is not provided free and accessible access for pregnant women that require skilled attendants during childbirth.
The expert, who remarked that ending fistula is faced with many challenges that drive its course, declared that Nigeria had a backlog of 200,000 VVF cases, adding “while we are trying to pluck and reduce the number, the clearance rate is lower than the filling rate as it were.”
While government and its many partners, including fistula surgeons, continues to work increase awareness on fistula, he stated that about 2.2 million deliveries occur yearly in Nigeria and about 12 facilities have the capability to attend efficiently and effectively to patients who have a fistula.
He declared, “We should allow them to get pregnant when they are fit to get pregnant and when they do get pregnant that they are well looked after. We should not be discouraging them accessing skill birth deliveries.”
The don, however, said this would require strengthening the primary healthcare delivery.
He added, “at PHC, the critical healthcare cadre are the midwives to be assisted by CHEWs. The government had a policy which was to strengthen PHC and ensure that they work effectively; that is the midwives service scheme.
“These midwives, where TBAs still work, can link those PHCs to TBAs. They can actually visit them as part of their work. So there is no way, cases of fistula will increase since the chances of harbouring or keeping pregnant women in labour unnecessarily will be diminished.
“But here is a situation where the engaged retired and young midwives for rural areas by the midwife service scheme are not paid, and so they left.
“If you earmark, say N10, 000 for average spending on a pregnant woman to ensure safe delivery and there are about 2.2 or 2.3 million deliveries in Nigeria throughout the year, if you multiply this, it is just N2.5 billion. What is N2.5 billion to make every delivery safe in this country? So it is like penny wise pound foolish.
“We know what we should do to prevent women from dying, to prevent babies from dying and families from being sad, but we fail to do it. Indeed, it is possible to prevent maternal mortality.”
Professor Ojendegbe said ensuring women do not develop fistula was a right issue, adding “these women are trying to procreate for mankind, it is almost like saying soldiers who have gone to war and are wounded, leave them. Do not worry.
“They are human soldiers as it were. We already know that there is danger in it and we still push them through it. So if they get wounded in the process, the responsibility is more on us more than anybody to come to their help,” he concluded.