Rural women

By Lola Seriki- Idahosa, Kaduna, NorthWest, Nigeria

The people of Kpoko community in Igabi local government area of Kaduna state have decried the lack of functional healthcare facilities and other basic amenities in the area since their existence about 100 years ago.

They therefore appealed to the state government to come to their aid by establishing a health facility in the community, which they said will save their pregnant women and children from dying during delivery.

During a visit to Kpoko community, an aggrerian community in
Igabi local Government Area of Kaduna State in Nigeria’s North West region, it was discovered that pregnant women were in a helpless situation as there was no single health facility to carter for the women and children.

Located thirty kilomtres from the state capital, Kpoko community has not witnessed what is often referred as ‘Dividends of Democracy ‘, as it lacks all the basic social amenities such as hospital, pipe borne water, electricity and school as seen in a nearby community, like Angwan kanti.

Predominantly dominated by the Gbagyi ethnic group and with an estimated population of about one thousand, the community has always live in Peace irrespective of their challenges.

Members of Kpoko community

Unfortunately, despite its proximity to the state capital, Kpoko community is facing the challenge of high rate maternal mortality rate, as a result of the absence of functional healthcare facilities. This situation has made consequently made pregnancy become
a nightmare rather than a blessing for their women.

Leaders of tomorrow living in Kpoko community

In an emotional laden voice, Samaila Bala “Magajain Garin Kpoko”,
(one of the traditional title holders in Gbagyi community), told tracereporter how three in every five pregnant women die or lost their unborn babies during childbirth every month.

”inaccessible road to the community is one of the greatest challenges disturbing the inhabitants of the community, also the fears of death by pregnant women due to lack of health facilities in the village makes women to be more scared of getting pregnancy”

“The lack of school, hospital and other social amenities, which
could be used to impact positively on the lives of these inhabitants
make lives very worrisome to the youth, women and elders in the
village “

‘’The absence of functional and accessible health facilities in the community is a major contributor to high rate of child and maternal mortality in the area .

‘’Many households are currently faced with the challenge and it is the women and children that mostly bear the brunt.

‘’The lingering situation dating up to a hundred years ago, has left
residents frustrated”, with many expressing their dissatisfaction with the government’s inability to attend to their health and other
socioeconomic needs all these years.

‘’The lack of functional healthcare facilities and trained medical
personnel has equally made pregnant women, become clients of
Traditional Birth Attendants (TBAs) who use head knowledge and oral traditions passed down through the ages. Usually these TBAs are the elderly women in the community who have witnessed quite a number of births and proclaim to offer the equivalent of midwife services to the laboring mothers. Many women, including those in neighboring communities, have died in the hands of these TBAs.

According to Victoria Ayuba, a 20-year-old pregnant woman, visited government owned Maternity Centre in the neighboring village to deliver her baby. However, due to the fact that there were no health personnel on ground to attend to her and decided to opt for traditional birth attendant.

She said after two days of trying to forcefully get the baby out, Victoria developed a complication after which she was taken to Igabi General Hospital around 4a.m for an operation. By then she said the Doctor in charge of the hospital, confirmed that the baby had died inside her womb due to complications arising from prolong labour. Thankfully she was saved.

Narrating how she lost her baby to TraceReporter, Victoria said women here are afraid of getting pregnancy due to the suffering they usually experience when passing through the bush to go for anti-natal, adding that there are so many risks involved when going to hospital for medical check-up.

“During my first pregnancy, I also got miscarriage while going to hospital for anti-natal and it was only God that saves me, she said, I lost the baby and it was because of the suffering I was passing through, while Trekking in the bush before reaching the major road to take Okada that could take me to hospital. Many women got miscarriage while taking long distance trekking to pass through the bush.

Victoria Ayuba and her fellow woman

Victoria’s story is just a typical experience of other pregnant women who have lost their lives, and at times their babies as a result of complications from being mishandled by non-medical practitioners’’.

Other factor responsible for maternal mortality in the community is
lack of accessible road network.

According to Samaila Zato, “The distance of this community to town is about 30 kilometers, and majority of the inhabitants are predominantly Gbagyi by tribe, who are local farmers, hunters. Most of the women in this village are into rearing little animals and selling of firewood to make some little income”.

“Indeed, this is a community where there is no single Car, no motor
cycle, as most of the settlers here use wheel Barrows, bicycles and
animals as a means of transporting their farm produce and movement of goods from one place to another due to the bad nature of the road

Mr sama’ila who lamented that despite several appeals to the state
government to come to their aid and build school and hospital,
so as to save their women and children from dying. He said no Government official has ever thought of coming to visit them or even listen to their complaints.

“Apart from pregnant women that suffer a lot while trekking far
distances to access medical care, some elderly people and other sick
ones in the community are also confronted with the challenge of
getting mobility that will convey them to hospitals.

Mrs Tabitah Babanjiga another House wife in the village told tracereorter that they have never seen a journalist in the history of the village. ‘’we are happy that God has answered our prayers as you came here’’, ‘’we are going to use you, to appeal to Kaduna state
government to remember that they promised us many things during their campaign, ”We are begging on government to help us by building health facility in our village’’ so as to reduce the health challenged confronting the settlers in the community, adding that all the neighboring villages also face the same problem”

Tabitah also spoke of insecurity in which she called on state
government for quick intervention

Other areas she said that the community needs government intervention are skilled acquisition and empowerment programs to fight poverty and create job opportunity as well as provision of motorable road to enable community transport their farm produce to the urban centre. ‘’Our food always got spoilt because of lack of means of transporting them’’

Some of the women who also spoke with tracereporter said if government does not come to their aid they might likely stop child bearing.

The development and survival of any Community depend largely on the healthy status of that Community. Although the provision of health care services is primarily vested on government, there are other stakeholders, such as NGOs that play vital role in the process.

Responding to the needs of Kpoko community, the Director Primary Health Care services and Primary Health Care Development Agency kaduna Dr. Neyu Iliyasu said that the state government is doing a lot in the health sector at the community level.

Dr. Neyu Iliasu, Director Primary Health Care Services and Primary Health Care Development Agency

According to him, “Actually a lot of things have been going on to
improve delivery to ensure it goes to doors step. ‘’There have been challenges and there are a lot of renovations that are ongoing in the health facilities.

‘’I have been going round to ensure that all projects for renovation are completed and contractors found wanting will have his contract revoked and it will be re awarded

Recently there are a lot of facilities completed about 70percent are
ready, they will soon be taken over so that they will start using
them for the community. The plan is to use 200 facilities that will
run day and night at anytime one goes to the facilities to access
health care.

For Kpoko Community, ‘’although I’ve not been to this community, we will make sure that a program called Birth preparedness which is being implemented in similar communities that have no health facilities is extended to kpoko, this means that pregnant women will get contact with community leaders to identify skilled birth attendants who could help during delivery.

“Kpoko community has a very high levels of illiteracy, the only thing
that will help such community is by educating them.

“It’s true that we also have hard to reach community and because we want health care facilities to reach everybody the government has agreed on service delivery plans because instead of doing outreach each facility goes to PHC for what we call out reach section, these people go from house to house, count from 0- 5, Where the numbers are not coming they go for outreach.

“Before it’s used to be the case of anybody within the range of 5km may have to come to the facilities now it has been reduced to 2km ranges any count outside 2km reduce from a facilities should be involved in outreach service.

“The second is the facilities health communities   and the ward development communities  have been trained to work with the facilities anything that is needed can be provided by them without waiting for government as community participation is key principles to efficient service delivery.

“The good news is the bill for the contributing state insurance scheme is now ready for assent this means the reach will take care of the poor funds for that scheme will be used to treat the individual with just little contribution of ten percent to reduced caster trophy

“Kaduna state has also been involved in free maternal and child service, It’s also possible for communities to build a structure apply for personnel in various community”.

On what the NGO is doing as regard their contribution to health,
Kaduna state Accountability Mechanism (KADMAM) a coalition of civil society working on maternal mortality and child health, the
Co-chairman kadmam Alhaji Mustapha Jumare said, “what we are doing is trying to ensure that government allocate a lot of funds in budget allocation to improve service at the health care level.

Alhaji Mustapha Jumare, Co-chairman KADMAM

According to him, “The most important thing is that we have been able to persuade the government to see that the 255 facilities rehabilitated and equipped by human resources so that they can provide 24 hours service ,

“So far we have seen government working in that direction, communities have been sorted out ward by ward.

“The government has over one thousand facilities in the state so they have only selected one in each ward of the settlement as it will take phases’’.

In conclusion, the big question then is how effective are these health services? How many Nigerians are aware of their existence and how many women in rural communities can access them?

There is no gainsaying that community people prefer the services of
unconventional community health workers, drug peddlers and traditional birth attendants because the health facilities are just not there to provide the needed services.

There is also the problem of top-bottom approach to policy
formulations. Government’s policies lack input from the citizenry. It
appears government health policies are formulated without citizens’ involvement.

It is also very crucial for the purpose of monitoring the activities of
health workers and also making informed recommendations to civil
society organizations working on legislative advocacy and policy to
feed into government’s future health policies.

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