Rotary`s Contribution to the Strengthening of the Nigerian Health System

At the public presentation of the results of the Rotary Maternal and Child Health Project in Abuja in May 2015 Professor Hadiza Galadanci, one of the leading experts on maternal health in Nigeria, enumerates the achievements of the project which has now been successfully established in 20 hospitals in Nigeria, and points out the challenges that are still lying ahead of the Nigerian health system. … more

Professor Galadanci how do you assess the progress that Nigeria has achieved with regard to the reduction of maternal and child mortality in the past few years?
"In the project hospitals we have made significant progress. But even though the maternal mortality rate in Nigeria is still unacceptably high, we have not achieved the Millennium Development Goals four (reduce child mortality) and five (improving maternal health). With regard to maternal health, therefore, there is a number of challenges in Nigeria. "

What challenges do you think of?
"First, the infrastructure has to be mentioned .This begins in the hospitals. And when I talk about infrastructure, I mean not only to improve water, electricity and the purely external, material things in the hospitals, but the entire technical equipment that must operate. The second challenge is to provide the health care of high quality. We need sufficient and adequately skilled staff. Personnel who are trained to use the medical devices. The third challenge is the monitoring. We need to ensure that every pregnant woman is recorded, that every Death is registered and also that the cause is investigated. From this we can draw our conclusions and learn what to do, improve the system so that in future less mothers die due to poor medical conditions. "

So everything is a question of infrastructure and education ?
"Of course there are other reasons for poor maternal health. We must involve the communities to inform people and raise awareness of health care. It is particularly important to educate young girls and women. What we do together with Rotary: We do community dialogue in order to tackle this aspect. For example, in anemia, an anemia of pregnant women, which should not be detrimental to the child and can be treated by better diet or tablets . We inform the women about the causes, prevention as well as the way to access the health care system. All together we call that the quality care cycle. "

Does “self-determined family planning” belong to the subjects that you together with Rotary address?
"Family planning can reduce maternal mortality by up to 30 percent. A key issue is to prevent high-risk pregnancies, so too early pregnancies and too many pregnancies. They are the most common causes of maternal mortality. There are also too late pregnancies, if women are forty years or older. Family planning can help to ensure that we reach the Millennium Development Goal five better, but also the Millennium Development Goal four because if a woman can not adequately take care of a child, e.g. if she can not breastfeed for long enough (or if the mother dies in childbirth), then the risk for the child is high, to die young. "

What role does Rotary play in improving medical care for birthing mothers?
" With the help of Rotary , we have supplied the hospitals with equipment , e.g with suction cups, instruments for determining the child's heart rate, ambulance suitcases etc. If we realize that a hospital does not have magnesium sulfate, we provide them with it. Magnesium sulfate is key in fighting against eclampsia ,a disorder which causes severe cramps that may occur in the last trimester of pregnancy. And we train the staff how the funds are to be applied. "

What are the factors that make the project a success?
"The Rotary project is therefore a success, because it considers more than just an aspect of maternal health. We have improved the structures in the hospitals, we have improved the training and thereby optimized the processes in the clinics. We also ensure that every single birth is documented in the project hospitals. Over the past six years, 150 869 cases were reported in this way. The collected data we feed back into the system so that we can achieve further improvements there. In addition, the project works, through the dialogue we run there, even in the villages. So we have created an entire cycle. If that will continue as planned and will be expanded, we can actually still achieve the Millennium Development Goals four and five. But the Rotary project for quality assurance in obstetrics also makes a great contribution to strengthening the Nigerian health system in general. And Nigeria's intention is to improve its health system. It already takes part in the network MDSR (Maternal Death Surveillance & Response). But quality assurance by the Rotary model goes far beyond. I do not know any NGO in the world that makes such a significant contribution to the strengthening of a national health system such as Rotary with this project for quality assurance. "

What happens next when the second scaling-up is completed in June?
"We have tried from the beginning to involve the state in the project so that it can be taken over at the end, of what has already been done in 20 hospitals. Because what is this about? It's about sustainability. If the project maternal health will be integrated into the Nigerian health system, if in all hospitals it will be worked according to the quality criteria of the Rotary project, we have achieved our goal. We want that the National Health System takes the project over. It has to become a routine. "

 The interview was conducted by Prof. Dr. Robert Zinser, RFPD CEO (Email: robert.zinser@t-online.de); recorded by Mark Zdunnek