Sunday, 22 May 2011

MALARIA: Nigeria: maternal mortality

From: William Brieger
Subject: [malaria] Nigeria - maternal mortality and malaria
To: "Malaria Update"
Date: Thursday, May 19, 2011, 5:09 AM
Maternal deaths still high in Nigeria - Expert •Malaria kills 4,500 pregnant women in Nigeria yearly -Ogun Health Commissioner
Written by Olayinka Olukoya with News AgencyThursday, 19 May 2011
A reproductive health expert, Dr Ejike Oji, says maternal mortality rate is still high in Nigeria and requires urgent attention to check the trend.
Oji is the Country Director of IPAS Nigeria, a non-governmental organisation that protects women's health and advances women's reproductive rights.
He told the News Agency of Nigeria (NAN) in Port Harcourt, on Wednesday, that in spite of efforts made by government and stakeholders, maternal mortality rate was still high in Nigeria.
He said that Nigeria was second to India in maternal deaths in the world.
Meanwhile, Ogun State Commissioner for Health, Dr Isiaq Salako, has disclosed that about 4,500 pregnant women die of malaria in the country annually.

William Brieger
Senior Malaria Specialist, JHPIEGO -
I think very important question has been posed here 'what are being done to reduce these problems?' For Malaria the high impact interventions include 1) use of Long Lasting Insecticide Treated Nets (LLINs), 2) Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp), and 3) effective case management of malaria using appropriate anti-malarial drugs (ACTs). We are aware LLINs have been distributed in most States in Nigeria through local and international efforts and supports, but appropriate usage especially amongst those at risk remains a huge challenge. I am not sure that we will be able to say that those that received the nets are actually using it as prescribed. Furthermore, Malaria in pregnancy (MIP) prevention and control still remains a component of Focus Ante Natal Care (ANC) in our National Guideline while we are quite aware from available research evidence that ANC attendance among pregnant women in most parts of Nigeria remains very low. While there is an on-going efforts to pilot new approach, obviously, a huge number of pregnant women (those that ordinarily will not attend ANC) are missed-out at baseline given the current national MIP guideline. More importantly is the on-going pilot efforts to improve case management of malaria at all levels through the roll out of the 'use of rapid diagnostic test kits for parasitological diagnosis of malaria, dispensing of appropriate anti-malarial drugs (ACTs) and availability of cheap ACTs through the Affordable Medicines Initiative (AmFm) that is expected to crowd-out the use of wrong anti-malarial drugs and high costly ACTs.

However, the delay in rolling out this important initiative across the country is a challenge that may have compromised our on-going efforts. Addressing these challenges affecting each of the high impact interventions using the GFATM and other donor funds most appropriately, scale-up of the interventions and sustainability. On sustainability, our government at all levels must rise up to spend substantially on health. Good enough the National Health Bill has been finally passed, much kudos to those that fought for it but the battle is far from being won. let us remember that we have always had good policies with poor implementations. It is my sincere wish that all hands must be on deck till the battle against malaria is finally won, Hope to see it come to pass in my life time.
Jhpiego - Innovating to Save Lives
Orji Bright
Jhpiego - An Affiliate of Johns Hopkins University, Baltimore 2/6 Akpakpan Street, CPD BuildingUyo, Akwa Ibom State. Nigeria Country Office, 3rd Floor, Labour House, Central Area, Garki.
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From: Emmanuel Otolorin
To: Malaria Update
Sent: Sat, May 21, 2011 2:06:47 PM
Subject: [malaria] RE: Nigeria - maternal mortality and malaria

The Nigeria 2008 NDHS showed Nigeria’s Maternal Mortality Ratio (MMR) to be 545 deaths per 100,000. That translates to 33,000 maternal deaths every year. Since we know that malaria is responsible for 11% of these deaths, we can therefore estimate that malaria kills 3630 pregnant women every year which is not too different from what was reported in the news below. I think it’s better for us to begin to ask questions about what is being done to reduce this problem. We should thank the Global Funds for AIDS, TB and Malaria (GFATM) for its very generous grant of over $500m to tackle the problem of malaria in Nigeria. Other donors who have supported Nigeria include the World Bank, DfID, USAID, ExxonMobil etc. The Nigerian government, through the MDG office, has also chipped in. We just need to see that the interventions being implemented (use of insecticide treated bed-nets, intermittent preventive treatment with Sulphadoxine-Pyrimethamine and case management with an Artemisinin-Combination Therapy (ACT) are sustained sufficiently over a long period to ensure a satisfactory impact.

From: Ali Gambo []  Friday, May 20, 2011 10:57 AM
To: Malaria Update Subject: [malaria] Nigeria - maternal mortality and malaria
The statistics is quite shocking, to say the least. But I do hope somebody is not playing politics with Statistics. Come to think of it, whose responsibility is it?
Inundating the public with such shocking Statistics will not serve the purpose of gingering people into action.
What happened to the "roll malaria back" plans and campaigns after the launching fanfare?
Ali.I.Gambo (Applied Statistician)
....Education is our passport to the future, for tomorrow belongs to those who prepare for it.......Malcolm X.

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