The thematic panel discussion is a way for MamaYe to assess availability of maternal healthcare commodities and human resources in a health centre before such a health centre could be referred to as safe for pregnant women and newborns.
Topic 1:To what extent is health financing on Maternal, Newborn and Child Health based on priorities and state strategic plans (needs and challenges)?Presenter: Director General, Gunduma Health System Board, Pharmacist Usman TahirJigawa State Government is doing its best with the allocation of more than 14% to the health sector. With the help of development partners, there is an operational plan in the State, a basket fund to reach women at the grassroots.However, there is a dire need to overhaul systems, improve implementation of services and strengthen the referral system.2014 is planned to be a different story. There will be more routine immunization and more women accessing health facilities. With routine immunization, over 70% of maternal, newborn and child health issues will be solved. The government is also doing its best to ensure that services reach women in the rural areas. And if more women are enlightened and they go to facilities to access healthcare services, the more the government will be committed to providing the services.Topic 2:Availability of live saving drugs 24hrs a day, 7days a week including; Oxytocin, Antibiotics, Mistoprostol, Magnesium sulphate among othersPresenter: Chairman, Free MNCH Partners in Jigawa State, Baffa NayayaAmong the most effective medicines to prevent postpartum haemorrhage are Oxytocin and Misoprostol, while Magnesium Sulphate has been identified as the most effective medicine for preventing and treating deadly seizures caused by pre-eclampsia and eclampsia.The need for these medicines is great and its presence is needed at every level of the health care system where pregnancy deliveries occur, from urban hospitals to rural clinics. There’s a huge challenge, however, with distribution, access, quality, lack of skill among health providers and storage of these drugs.Government and other stakeholders should ensure that these medicines are made available, while the supply chain needs to be strengthened. An effective monitoring and evaluation system is also a requirement.Topic 3:Functional blood banks and services in secondary health care centres: availability, challenges and opportunitiesPresenter: Assistant Director, Medical Lab Scientists, Lawan S. Yakubu (represented by Ali Usaman)Blood banking is the cornerstone of emergency and surgical medicine and over six million transfusions are administered to seriously ill patients in Sub Saharan Africa each year.In Jigawa State, there are about 13 facilities with some level of blood banking capacity, while only a few provide some basic facility based blood banking system. As such, blood transfusion services is fragmented, hence the need for a national blood banking policy as well as capable human resource to achieve set goals.Cross-section of panelists at the discussionTopic 4:Availability of midwives 24hrs a day, 7 days a week in health facilities (employment, remuneration and retention)Presenter: Coordinator, NPHCDA, Dr AkusoFrom 2009 when the Midwives Service Scheme was launched in the State, there has been no single midwife serving who is an indigene of the State. With the support of the present administration, there is now a school of midwifery in the State and Jigawa State will soon be graduating its first set of midwives.The federal government, through the NPHCDA, pays N40, 000 per month to midwives and N25, 000 per month to Chews while the State Government pays N30, 000 per month to midwives and N20, 000 per month to Chews.Jigawa State is the best State in terms of payment from November 2009 till date while Sure - P has also been paying.The State gives automatic appointment to midwives who choose to stay and serve, so the government is willing to retain midwives who choose to stay.However, there are challenges: instability of midwives in rural areas, unavailability of indigenous midwives in the State, which causes communication gap between midwives and patients, resulting in attaching midwives to community health extension workers who are from the community and can speak the language of the people, lack of accommodation and lack of ambulance for referral. Factors preventing mothers from attending healthcare facilities still remain culture and religion, among others. The Sure – P program could help bridge the gap and ensure more midwives are working in the state.Responses to discussionDr Ashiru Abubakar: there is the need for political commitment on the part of the government. Government needs to be receptive to change while there is also a need for attitudinal change on the part of the people. For example, there’s a MamaYe poster on blood donation that says you can’t get blood on the road side or anywhere, a human being needs to donate the blood before it can be used.There is a need for behaviour change communication for people in the State and there is a need for change agents to go and voice out as well as speak to the people in order to solve the problem of lack of blood in the State. The Midwives Service Scheme must be sustainable, because without sustainability it will be difficult to continue. Our women prefer their own children to look after them but indigenous children need to go to school and the issue of girl child education needs to be emphasised.Sale Yusuf Burnin Kudu, Community Enlightenment Initiative: information is about sharing and caring. We need to be up and doing, going from top to bottom in the community. Attitudinal change in our people is important, and the Midwives Service Scheme in the State is very touching and as community mobilisers, we don't have to wait, for the government alone cannot do it.Rashida Abdullahi: the grassroots will appreciate explanations on blood donation and see reasons to donate to save other people’s lives. People are asking questions and their curiosities must be encouraged. Tunde Segun: we need to mobilize people and also ensure that our facilities meet demand of the people, which is a great challenge, hence we need to work on ourselves to meet them and ensure facilities are up to standard.Usman Tahir's closing remark: the Jigawa State Government is willing to work hand in hand with CSOs to move the state forward. Success recorded in the health sector is based on good governance and leadership, and there is an innovative ambulance service which has just started in some secondary health facilities including Hadejia, Jahun and Kafin Hausa. We also have a close user group using Airtel and the state is working towards having more. The government also gives pregnant women delivery kits, wrapper and allowances when they attend antenatal care.