Poverty reduction, not dollops, for our pregnant women

By Paul Arhewe

A Nigerian health personnel attending to pregnant women


Access to antenatal services is one sure way of uncomplicated labour and childbirth for pregnant Nigerian women. With a reputation of the second highest rate of maternal death in the world, Nigerian governments would need radical reforms in their healthcare delivery system. It is within this context I situate the recent moves by the federal government to introduce monthly stipends for our pregnant women to enable them access available antenatal services and thus bolster our healthcare service delivery system. The latest United Nations estimate puts annual global deaths during pregnancy and childbirth at 287,000 out of which India accounts for 56,000 (19 percent) and Nigeria 40,000 (14 percent). Nigeria is still miles away from plugging the loopholes and obvious gaps inherent in its ill-equipped public healthcare centres. Accessing full antenatal services at our various health centres, no doubt, would bring down drastically the problem of deaths during and after pregnancy.
 However, findings have shown that many pregnant women are still finding it difficult in accessing these essential services. The FG’s new policy of N5, 000 stipend to each pregnant woman for antenatal services and delivery comes to focus. The policy which is part of the Midwifery Service Scheme (MSS) to be funded from the N15 billion Subsidy Reinvestment and Empowerment Programme (SURE-P).
The conditions laid down before one could benefit from it, methinks, would require rigorous nationwide awareness creation else many of the pregnant women might not be able to access it out of ignorance.

Under the scheme, according to Abdullahi Mohamed, the Director for Primary Health Care Development in the National Primary Health Care Development Agency, “The woman must attend antenatal clinic at least four times.
For each of those antenatal visits, there is money attached to it, which is N1, 000. The woman must deliver at the facility; if she does, she is entitled to something; the woman must also ensure that the child is fully immunised.
The total package is about N5, 000”.
The alarming rate of death among our expectant would-be-mothers, the US Ambassador to Nigeria had this to say of the situation: “While factors like early marriage, teenage pregnancy, low contraceptive usage, unsafe and illegal abortions contribute to the high mortality rate, poverty is a major driver to this preventable situation.”
He is very correct. Many would-be-mothers shy away from available health facilities due to either the high poverty rate in the country or ignorance.
The planned policy of FG might be a welcomed development. The N5, 000 may be significantly little, it would no doubt motivate many women to embrace the antenatal practice. But will this policy address the pervasive poverty in the land?
Many pregnant women are malnourished due to their impoverished status.
During this delicate state, many are over-laboured when they engage in rigorous jobs to augment their husbands’ income, and in extreme cases, they are actually the breadwinner of the families, when their hubbies are jobless.
The situation is so messed up and complicated that government would be seen as sincere, only when the economic deficit of almost 100 million Nigerians living on less than one dollar a day is uplifted.
This could only happen through aggressive poverty reduction measures.
In a country where poverty is like a companion, paying pregnant women such stipends without addressing the poverty level is tantamount to a drop of water in the ocean. My other worry is continuity and sustenance.
It is no new tale that many attractive policies in time past only ended up as avenue for self aggrandizement by those who implement them.
Will this be an exception? It won’t come as surprise when ‘pregnant ghosts’ suddenly turn up in all parts of the country to relegate the real pregnant women beneficiaries to the background.

Some antagonists of the policy are of the view that what FG ought to do is drastically reduced the consultation delivery bills in public hospitals.
For me, this argument is more feasible and realistic than the payment of allowance that would likely end up in the pockets of ‘pregnant ghosts’.
How are we sure this policy won’t be another mirage of the many juicy promises SURE-P is programmed to render to Nigerians?
I have foreboding fear that this one might not stand the test of time, but go the way of other government redistributive and intermediation policies.
A sincere and serious government would take headlong the burgeoning and deplorable poverty status of greater number of the citizenry.
Any policy geared towards sinking the embarrassing maternal mortality rate should inevitably be thoroughly and sincerely implemented.
Anything short of this will result in the recurring rigmarole which has fast become a national identity. Time will definitely proof pessimists right or wrong.