Will Nigeria’s ‘Saving-One-Million-Lives’ Initiative save a thousand?

As a growing child in my hometown, Okposi (Ebonyi State), news of a new born child in our neighborhood was always a pleasant one. My peers and I always looked forward to visiting those homes to rub a local liquid powder-mix called nzu and watch our mothers sing and dance. Our joy came from the fact that there was an additional person who would queue behind us to pick whenever gifts are shared by seniority; the new born was also a potential playmate. Okorie (not real name) was only 2years old and had many episodes of febrile convulsion. Usually while we play, we would see the mom rushing him to the clinic after applying some local herbs and palm oil, the siblings wailed while we watched with fear and apprehension. We had lost a couple of our playmates with similar condition in the past. We didn’t lose Okorie but he grew up with a very low intelligence quotient (IQ). No doubt, those convulsions caused significant brain damage.

In another development, one of our neighbors, a widow had only one daughter – Chi Chi. She got married to one spare parts dealer who used to buy biscuit for us. We loved her because she also used to shower us with gifts. We were patiently waiting for her arrival from a missionary hospital where she had gone to deliver her first baby. They came back with the baby, and everyone’s face was gloomy and eyes were red and tearful.  Chi-Chi reportedly died after child delivery. Her mother almost became psychotic.

Since then, I grew up with lots of questions on my mind. Why was Okorie’s fever always leading to seizures? What may have caused Chi-Chi who was hale and hearty to die after delivery? Could such occurrence be stopped? If yes, how? I found answers many years later during my medical training. Those childhood experiences and my desire to be part of the solution to the disaster of high maternal and child mortality in our clime influenced my decision to build a career in public health.

President Jonathan, health ministers and legislators during the launch

President Goodluck Jonathan launched an initiative to Save-one-million-lives by 2015 in Abuja a few days ago. It is a comprehensive program to scale up access to essential primary health services and commodities for Nigeria’s women and children. Nigeria accounts for about 10 per cent of the global maternal mortality and has one of the highest infant and Under-5 mortality rates in the world. This initiative builds on a growing international momentum behind maternal and child survival.

I consider this initiative laudable. Any program that can save one woman or child from dying should be applauded and supported. Perhaps if this was started much earlier, Nigeria would not have lost Mrs Ngozi Nwozor-Agbo (initiator of the Campus Life page of The Nation newspaper) to child birth 4 months ago. She was one of the most intelligent and inspiring women I’ve ever met. But am I excited about this initiative? The answer is no. But I have cautious optimism.

Nigerian health professionals are among the best one can find anywhere in the world. We have always come up with laudable health initiatives many of which have been used as a template for health programs in other countries. But the biggest problem has always been in implementation. It is depressing to know that the primary motivation for a majority of the people who would implement this initiative would be how much money they would make rather than the number of lives saved. Endemic systemic corruption in the system has led to stunted growth of our health system despite billions of naira spent annually. This is what makes me worried. My expectations have been dashed on several occasions.

I have browsed the website of the Federal Ministry of Health to find details of this initiative but it appears the last update of the site was more than a month ago. By launching this initiative, I believe government has demonstrated the political will to improve the maternal and child health situation. The Midwives Service scheme, I hope, will provide human resources for the severely under-served communities but would that be enough?  Will the government strengthen the logistics management information system to ensure those essential commodities reach the intended beneficiaries and not end up in the homes of some unscrupulous officials? Will the monitoring & evaluation system be strengthened to effectively monitor the impact being made? With this top-down approach, are the local government councils who directly oversee the primary health centers effectively engaged in this scheme? Will this initiative not end up becoming Saving-one-million-naira for the officials involved?

Will this Saving-one-million-lives initiative save up to a thousand lives by 2015? Only time will tell.

May God continue to bless Nigeria.