POST ABORTION CARE WOULD FAIL IN NIGERIA IF COMMUNITY HEALTH PRACTITIONERS ARE NOT INCLUDED

Written by
Comrade Noah John Abbey (CHO, Pub. Health Expert)
Email: abbeyj4real@gmail.com Tel: 08035890218

Reproductive health services have eleven components and the first of those eleven is SAFE MOTHERHOOD.
Safe motherhood is an initiative that guarantees a woman’s successful completion of physiological process of pregnancy and child birth without suffering any injury or loss of her life or that of her baby, it comprises of prenatal care, clean and safe delivery, and post partum care including family planning, emergency obstetric care, Sexually Transmitted Infections (STIs)/Prevention of Mother to Child Transmission (PMTCT) and Post abortion care (Guaram, 2014 page 3). The area I am most concerned is Post Abortion Care, which is key in the reduction of maternal mortality and morbidity.

In Nigeria maternal mortality ratio remains unacceptably high at 576/100,000 live births daily (Dr. Ejike Oji, 2016) despite a high coverage of antenatal care (ANC). The driving forces behind primary health care are the Community Health Practitioners which include: - Community Health Officers (CHOs), Community Health Extension Workers (CHEWs) and Junior Community Health Extension Workers (JCHEW) and Environmental Health officers, so any policy that does not include primary health care workers (Community Health Practitioners) is bound to fail. There are three levels of care in the Nigerian health system which is the primary, secondary and tertiary levels and the desired state is where there is referral and feedback from lower to upper levels and a continuous interaction between the three tiers. But the reverse is the case because the secondary and tertiary levels always work in isolation or independently.
You can imagine a remote village without good road and basic social amenities (hard to reach). And there is need for urgent referral of a woman with severe bleeding due to abortion to a distance of about 30km. The woman in question will surely die if she did not get to the secondary facility in good time and that is because the health worker at that level is not equipped to handle such simple condition as post abortion care. The nurses and midwifes rejected the offer to work at the rural areas before and they have continued to reject going to rural areas even to date. They are not available to carry out their roles as midwifes except when such conditions get to the secondary level of care.

Community health practitioners are trained to Providing preventive, curative, health promoting and rehabilitative services at the primary level of care using their Standing Orders, by so doing minor ailments are taken care off at that level and when there is no improvement in treatment such conditions are quickly referred using the two way referral form. Considering the importance of the community health practitioner at the primary level of care it becomes necessary and mandatory to include them in the training of health practitioners.

Adequate training of these health care providers will surely lead to a gross reduction in the maternal mortality ratio because they are close to the people, they live with the people and know the problem of their people at the remote areas also they are trusted by the people. Their training will also help to reduce the work load at the secondary and tertiary level of care.

thats plane truth, my colleague in making.