Ebonyi, according to health reports is one of the states in Southeast Nigeria with high rate of maternal, new born and child mortality and morbidity.
Although the collaborative efforts of international partners with the State Ministry of Health are gradually yielding results, the immediate outcome has been described by many analysts as simply marginal.
Part of the reasons it has remained so is because of the general low level of antenatal care attendance and health facility delivery by pregnant women in the State.
Worried by this situation, the Ebonyi State Ministry of Health and the State Primary Health care Development Agency (SPHCDA), in collaboration with USAID-BreakThrough Action-Nigeria and its Social Behaviour Change Advocacy Core Group, organised a one-day symposium on addressing social and gender norms affecting facility delivery in the state.
The event was held Wednesday at the Osborne La Palm Hotel, Abakaliki, Ebonyi State capital.
It brought together traditional rulers, religious leaders and other key stakeholders to brainstorm on ways to address those inhibitive social and gender norms, increase facility delivery, and ultimately achieve remarkable reduction in maternal and child mortality and morbidity in the state.
Reviewing the data status of antenatal care and facility delivery in the state between January/June 2022 and 2023, the Health Management Information System officer of the State Ministry of Health, Nkechi Omaka Orji, said pregnant women recorded for ANC first visit was 43.7 percent with only 13. 6 percent completing to the 4th visit, and only about 7.9% of them attending facility for ANC up to the 8th time.
This leaves a worrisome deficit of 93.1%.
She also emphasized that of all the women who get pregnant, only about 15.3% eventually go to health facilities to deliver their babies.
Th situation leaves a big question of where the others go to deliver? Probably at home, traditional birth attendants’ places or quacks.
The State with such statistics seems to still be in a precarious situation.
Meanwhile, the Reproductive Health Coordinator, Ebonyi State Ministry of Health, Maryrose Ikechukwu, in a presentation identified limited mobility and social interaction for women resulting to poor information/ignorance on the importance of health facility delivery, poor women’s economic power and domineering posture of men and family members in health decision making as some of the socio-cultural factors limiting use of facilities by women.
She also identified some traditional and religious factors such as excessive, but uninformed belief and trust in certain spiritual masters and prayer houses; trust in Traditional Birth Attendants and local herbs as well as unbridled women’s submissiveness promoted by religious and traditional doctrines.
Ikechukwu added: “There is this issue of competition among women; a feeling that women unable to deliver at home are weak.
“Also the issue of spousal violence and withdrawn support to deliver at Health facilities from husbands because of multiple girl (one sex) birth.”
Ikechukwu enjoined the stakeholders to employ their positions and social charisma as custodians of faith and the culture of the people to stem those negative behaviours in the State.
In their separate submissions, the Chairman, Southeast Traditional Rulers Council, Eze Charles Mkpuma and his counterpart, the traditional ruler of Nkaleke Echara Unuhu autonomous Community, Ezeogo Sunday Oketa, among others, expressed grave concern over the development.
Mkpuma, also the chairman, Ebonyi State Traditional Rulers Council, decried the high level of nonchalance and laxity among the few Nurses and other health workers in the facilities as discouraging, and called for effective supervision from the Ministry of Health.
Oketa enjoined all the traditional rulers to enact a traditional law making it compulsory for all pregnant women to seek services from health facilities prescribing punishment for any man who refuses to support the wife in that regard.
The Chairman, Christian Association of Nigeria, Ebonyi State chapter, Right Reverend Scamb Nwokolo, who led the Christian religious leaders and a Methodist Cleric, Bishop Lawson Elom, as well as Alhaji Idris Datti leading the Moslem community in the State also added their voices.
Speaking, Elom suggested that more health facilities should be located in rural communities while it should be made compulsory for health workers to reside in their facilities.
Summarizing, Nwokolo expressed the commitment of CAN to collaborate with the Ministry and all partners to beef up sensitization and other supports towards reducing to the barest minimum, those negative norms leading to maternal and child mortality in the State.
All the traditional rulers and religious leaders reaffirmed their commitment to do the needful to ensure that the campaign yields desired results.
They also committed to collectively work assiduously to achieve the desired social behaviour change in health facility use by pregnant women and others across the State to save lives and improve health data of the State.
They commended Breakthrough Action-Nigeria for the initiative, pledging to take the message down to their subjects.
While declaring the symposium open, the wife of Ebonyi State Governor, Mrs Uzoamaka Nwifuru noted that the present administration in the State has positioned health and the welfare of Ebonyi people in top priority.
Nwifuru, represented by the Commissioner for Women Affairs and Social Development, Mrs Felicia Nwamkpuma, said the involvement of religious and traditional rulers who have the understanding of their communities and the subject matter is imperative for sustainability of the project in the State.
She also commended the State Ministry of Health, the BA-N and its Social Behavior Change Advocacy Core Group for their commitment which are gradually influencing positive changes in harmful social norms, beliefs and practices related to key reproductive, maternal, newborn and child health plus nutrition in the State.
Earlier, while leading participants through the activities of USAID-Breakthough Action-Nigeria, the State Coordinator, Chidimma Ukoha-Nwankwo explained that the organization is engaged in creating social behaviour change through effective health Communication in the areas of maternal/child health, malaria, family planning and nutrition among other interventions in Ebonyi State.
It is believed that the symposium would spur, enrich the knowledge and capacity of the traditional and religious leaders to do more in achieving increased facility usage by women in child delivery and care.