DFID supported midwives decry neglect by government

Access to quality care for expectant mothers has been one of the developmental concerns in many rural communities across the country. This problem, however, is more pronounced in the north where culture of the peoples forbids a male health worker from attending to women especially during child delivery.

This problem hinges largely on lack of deserved priority to girl-child education, which translates in the dearth of professional midwives in the available primary healthcare centres within the region thereby forcing expectant mothers to depend on traditional birth attendants for deliveries despite the consequences.

Besides this, findings further revealed that majority of health workers in most of the northern states live in urban areas even when their places of assignment are in rural communities. This lopsided concentration of health workforce within the urban centres has deprived rural women of adequate care during pregnancy and child-birth especially when the need arises during odd hours.

Concerned with these problems, a DFID-funded project, Woman4Health, came up with an initiative aimed at encouraging young rural women to take up the challenges in their respective communities through its Foundation Year Programme where young women with passion and requisite qualification are supported to enroll into schools of nursing and midwifery to become professional nurses and birth attendants.

The idea is to raise professionals that can serve rural women irrespective of hour or time of need.

Hadiza Abdullahi Yunus is one of the pioneer products of W4H’s health workers training scheme, currently working as a professional midwife at Primary Healthcare Centre Kuchi, Kunchi local government area of Kano state.

Hadiza said she was inspired into the profession because of the difficulties her people had been facing over the years when it comes to child delivery, adding that anytime a woman is in labour especially during late hours it used to be very difficult for her to access professional caregivers as most of the birth attendants live in the city.

‘’Before I came here as a midwife after my training, the people that were working in this facility attend to women in labour only during working hours. After this they would go because they do not live in Kunchi. So, you can imagine how difficult it could be if a woman starts labour in the night. But since I came here anytime there is a problem irrespective of the hour of the day I would come and attend to the woman,’’ Hadiza said.

Hadiza was 19 years old when she got married after her secondary school education.

She said though she had interest to further her studies financial constraints couldn’t permit her to pursue her dream career in nursing and thus decided to get married immediately she finished secondary school.

“It is like work of divine destiny that I find myself in this position today rendering services to my kith and kin here in Kunchi local government area because when I finished my secondary school there was no hope for me to further my education as my parents were financially handicapped, and could not support me to a higher institution.

“Having lost all hopes, I decided to get married immediately, until the NGO came along with its foundation year programme.

“When they came looking for candidates with requisite qualifications for midwifery, many young women presented their credentials including myself and I was lucky I got picked. I then went and did the Foundation Year Programme for three-and-a-half years. Six months in preparatory and three years on the training,” she added.

She noted that there was a lot of apathy by the residents towards the health facility before she joined due to lack of female birth attendants to receive deliveries at the PHC.

“Long before I came there was very low patronage to this facility especially for deliveries. Most of the women then give birth at home in the hands of traditional birth attendants in the process of which some of them ended up with some com plications like post-partum tears and because the traditional birth attendants are not trained in suturing these tears and the person that could do it at that time was a man, most women would prefer to live with their conditions than approaching the healthcare givers for better management.

“However, since I assumed duty in this PHC the people’s mindset about giving birth in the facility has changed,” she noted, adding that even the women that give birth at home are coming to the PHC for better management of their afterbirth complications.

She said severe cases that could not be managed at the Primary Healthcare Centre are referred to Kazaure General Hospital in Jigawa state.

When our reporter visited the PHC recently it was discovered that though Hadiza was on maternity leave the demand for her services could not allow her take care of her two-month-old baby as she was seen busy attending to expectant women who had visited the facility for ante-natal services.

Hadiza advised the women to always seek assistance of professionals while in labour, stressing that “prolonged labour at home under the care of traditional birth attendant is very dangerous because in some cases you have issues of retained placenta and if this happens the traditional birth attendants cannot handle it and if it is not managed within the shortest possible time and the hose (mouth of the womb) closes the woman may have excessive bleeding that may result to her death’’.

She said there had been incidences of retained placenta. “It happened many times in the past where a woman would give birth in the evening and has retained placenta and they waited until the following day after the hose had closed.
She said failure to access care in an event of retained placenta can result to profuse bleeding and eventual death of the woman. “Many women had died in that process but since I came here I have been able to manage the situation and changed the narrative.”

Some of the women, who spoke to our reporter, lauded the sacrifice Hadiza has made in giving succour and hope to expectant mothers in the community.

“Hadiza is the best thing that has ever happened in Kunchi, because she has been very active and responsive any time the need arises for her services, in the night, in the daytime, or in the evening she is always there for us and she has helped in stopping preventable maternal death in this community,” Kadija Jibrin said.

Aisha Mohammed described Hadiza as a committed and reliable midwife, whose contributions can never be measured by the residents.

In spite these testimonies, our reporter gathered that for over the past two years, Hadiza has been working as a voluntary staff at the Primary Healthcare Centre with no any form of incentive either from the local government she serves, or the state government.

She described the lack of support as the major setback to the foundation year initiative which was conceived to alleviate concerns of rural women.

It could be recalled that the programme was built on an agreement with the state government that it would absorb the young women into the mainstream primary healthcare management system on completion of their studies for sustainability.

Hadiza however, said: “Since I started this work over two years now I have been responsible for my upkeep and everything. My transportation and other basic needs relating to my duty all rest on my shoulders and my family. I never received a kobo from government in form of salary, allowances or anything similar to it as I am yet to be absorbed into the main system. The only assistance I receive is from the person in charge of ANC who, out her own magnanimity, always shares her meagre salary with me and some other cleaners in the clinic.”

Though worried about her predicaments, Malam Nura Aminu, Hadiza’s husband, however reiterated his resolve to continue to support his wife in her quest to giving her best to the society.

“As her husband I am very proud of Hadiza, her resilience in the face of all these challenges and zeal to help her fellow women out of this longstanding issue has inspired many young women in Kunchi, today. Many women have been encouraged to go back to school simply because of the precedence she has led.

“All I can say is Alhamdullilah. After our wedding I had plans to get her back to school because of the interest she had been showing towards education, and when this NGO came with its initiative I had no difficulty or any reason to grudge about than to allow her to go to school.

“Today as she serves the community I am very happy and the credit for her services is coming directly to me because people have been thanking me for giving them my wife to serve humanity and base on that even though she is yet to get absorbed by the government as some of her colleagues, I will never falter to support her in any way, even if the work should take her out of Kunchi today I am not only willing to allow her but I will fervently pray for her to succeed there ” he added.

Our reporter gathered that on several occasions, anytime need arises for Hadiza’s services at the PHC in the night, Aminu usually accompanies her to the facility and stands by her in prayers until she is able to successfully address the situation before he goes home.

Superior officer in charge of Ante-Natal Unit, PHC Kunchi, Hajia Firdausi Bello, lauded Hadiza’s contribution in mitigating maternal death in the local government, appealing to the government to formalise her employment so as to sustain the feat so far achieved.