Experts seek proper equipping of hospitals to curb maternal deaths

A DOCTOR’S act of negligence or lack of care for women during pregnancy or childbirth can result in maternal death. However, prosecuting the medical officer will not prevent or reduce reoccurrence of maternal mortality.”

This was the view of the first National Vice President, Society of Gynaecology and Obstetrics of Nigeria (SOGON), Dr. Ireti Akintola, while delivering a lecture on Maternal Death Review (MDR) in Lagos last week. Speaking at the forum organized by Development Communications, Dr. Akintola described MDR as a kind of medical audit.

According to him, it is a process that first looks at the actions that were taken, which is then juxtapose with what should have been done so as to find out what the shortcomings are.

This he noted will help one take appropriate action to forestall future reoccurrence, adding, “If you find out a patient died because there is no blood, you make arrangement for blood to be available so that next time such death will be prevented.”

Disclosing that MDR can be an effective tool for the reduction of maternal death, Akintola said that it could only make impact when the intention is not to punish the medical officer.

“If you want to get it right in MDR, the emphasis should not be on punishing the medical doctor but on reduction of maternal death. I think it’s better for mothers not to die than finding out who made them die”, he said.

Explaining about the challenges at Lagos Primary Health Centres (PHC’s), Director of Medical Services, Lagos State Primary Health Board, Dr Fawsat Sanni said there is still no effective referral system between the PHC’s and the secondary health institutions.

Narrating a personal experience of the level of decay in the system, she said: “I have followed a patient in an ambulance, from the PHC to a general hospital for an emergency situation, only for us to reach there and discover that there is no bed space which meant she cannot be admitted.

Then again, the ambulance services at the PHC’s are not sufficiently coordinated for effective referrals.” She stated other factors militating against quality maternal care at the PHC’s such as; Ignorance, Poverty, inaccessibility and affordability of medical services, inadequate manpower especially doctors and midwives at the primary, secondary and tertiary level of care, inadequate blood transfusion services at the secondary and tertiary centres, Prevalence of traditional birth attendants at the community level, the three delays: delay in decision making, delay in transportation and delay in the facility at accessing services.

However, in other to maintain safe delivery, Dr. Sanni disclosed that the outcome of labour depend on the preparedness of the health care personnel to respond to all emergency situation.

In addition, she said the Traditional Birth Attendants remains a critical source of care for pregnant women particularly in hard to reach communities.

“There should be increased access to skilled birth attendant operating 24/7 with laid out shift for staffs. The PHCs should be equipped with Basic Emergency Obstetric care (BEOC) and must have link with facilities for Comprehensive Emergency Obstetric Care (CEOC).

There should be adequate personnel, a designated ambulance with drivers on ground who will be working shifts,” she added.