In an ideal world, all women would have access to comprehensive maternal health care before, during and after pregnancy. Unfortunately, across the country, many women are unable to receive care this way, and women in rural communities can often have trouble accessing any care at all.
Unfortunately, a woman dying in pregnancy and due to a pregnancy-related cause is a significant challenge in Nigeria and changing this picture begins with maternal health programmes and services that incorporate and centre on women’s experiences and perspectives to improve the quality of maternal care.
Advocating this through different platforms, including art, to ensure women’s voices are heard for access to quality maternal care was the thrust of the second edition of the ‘Celebrating Womanhood Art Gala’ themed ‘Elevating Women’s Voices for Quality Maternal Healthcare’, by the Nigeria Health Watch in Abuja to commemorate the International Women’s Month.
Its theme acknowledges that women’s perspectives, insights, needs and experiences are frequently overlooked in decision making, policy design and implementation.
“The art pieces are to broaden the discussion around quality maternal healthcare. Often, conversations don’t bring in other sectors and stakeholders aside from those in health that play a critical role in the society to also raise awareness about elevating women’s voices for quality maternal healthcare,” said Vivianne Ihekweazu, the managing director of Nigeria Health Watch.
“Art is a unique form of expression that we can hopefully use to explain things that are complex, making them more accessible to a broader range of people in Nigeria. By positioning women and girls from their position of strength, we can create a larger collection of advocates to push for better quality maternal health.”
Ms Ihekweazu said progress in ensuring quality maternal healthcare service delivery will be impossible unless women’s voices and experiences are heard and their sight considered when developing policies.
“A woman’s perception of the care she receives is an integral part of her clinical experience and therefore, an important consideration in improving the quality of maternity care. Maternity care that focuses on women’s needs and treats women respectfully is likely to lead to greater satisfaction as well as better and more equitable health outcomes,” she declared.
The gala allowed guests to participate both physically and virtually through the Nigeria Health Watch website and social media platforms, allowing art lovers and interested stakeholders from around the world to interact with the artwork.
The art gala was organised with support from the National Gallery of Art (NGA) and Female Artists Association of Nigeria (FEAAN) who have curated art pieces from selected female artists.
Nigeria Health Watch held its first #HealthMeetsArt, Celebrating Womanhood Art Gala in 2021. Art has been used to record history, shape culture, cultivate imagination, and encourage individual and social transformation.
First lady of Kebbi State and chief executive, Medicaid Cancer Foundation, Dr. Zainab Shinkafi Bagudu, in a remark stated that across Nigeria, there are lots of maternal health issues.
“In my state, Kebbi, we are not doing so badly; we are improving some of our indices. We are using community development programmes with partners to make a difference. The maternal health clinics offer improved opportunities to get breast and cervical cancer screening. The outcomes we are seeing are enormous. Leveraging this can impact our cancer figures,” she stated.
Director of Public Health, Federal Ministry of Health (FMoH), Dr. Ngozi Azodoh, said: “Women voices are important. We must remind mothers that they are so powerful they can change the world. When we have the opportunity, we must create opportunities for other women to speak up, take them to the rightful position.”
Resident Representative of the United Nations Population Fund (UNFPA) in Nigeria, Ms. Ulla Elisabeth Mueller, said: “The power of what you are seeing today is that of voices. Today will be a reminder how many women die giving birth. I hope that we will bear that in mind and lend our voices to save our sisters, friends, mothers etc.”
Country Director PLAN International Nigeria, Dr. Charles Usie, said: “We want to celebrate womanhood in a very special way. For us, it is a connection that influences our everyday lives. Women issue is not a good thing to talk about but the right thing. We believe the issues women go through should be a thing of priority. I believe in a world where women will earn more than the men and have more days for maternity leave.”
Nigeria Director, MSD for Mothers, Iyadunni Olubode, said Nigeria needs to be intentional in elevating women’s voices regarding maternal health in support of a world where no woman dies given life.
“Two phases come to mind, ‘speak up’ and ‘loud it’. If we are to have any meaningful understanding of a woman’s clinical experience and if that is to shape how we offer women care, encourage and sustain women going into facilities to receive care, we need to understand how they perceive and receive the care. That is why it is very important that we listen to women.”
Meanwhile, Dr. Ugo Okoli, ‘Reducing Indirect Causes of Maternal Mortality and Morbidity’ (RICOM3) Project Director, emphasised the need for women’s and girls’ voices in ensuring quality maternal health care.
“In the RICOM3, a key issue that came up was health care workers were not telling them the results of their tests; when we fed that back to the quality improvement team that actually changed. It improve service uptake, too.
“The women received self-care support; they could make informed decisions about their health. Their coach supports them with notifications, raising awareness of indirect causes of maternal deaths and ill health like diabetes and hypertension; what foods to eat, where to have blood pressure measured and so on to ensure they actually look after their health.”
Dr. Uchenna Igbokwe, Programme Director, Smiles for Mothers, said making sure that the solutions are the ones addressing the problems the way the women see it was a lesson learnt in the implementation of the project to reduce maternal deaths due to postpartum hemorrhage.
“To make an impact, we needed to think from the lens of the mother. Majority of women are not delivering in the health facility. So, in working with the community to develop patient illiteracy materials to inform them about the risks they face, when they see a picture, what they understand it to mean is different. Interacting with the women, we found that the way we draw food stuff and the health facility means the same to the woman.”
Mr Emeka Okafor, Project Director, IntegratE project, which piloted the use of community pharmacists and Patent and Proprietary Medicine Vendors (PPMVs) to provide expanded family planning services in Lagos and Kaduna States, said what women want sometimes is contrary to what many people think.
“In a community dialogue to find out what women think about family planning services they are receiving from this category of providers, quite unlike what we thought initially, if the facilities are around the women, they will patronize them. It is not true for family planning.
“The women said that they prefer to go to the facilities that are a bit farther away because they don’t want to be seen in most cases. So, now talking to them, we are telling them all the options available, not only facilities close to where they live. So, we saw that patronage went up.”
In addition, the Programmes and Advocacy Manager White Ribbon Alliance, Nigeria, Jennifer Adebambo, said the idea of self-care for family planning is on the basis of many women wanting to be treated with dignity and have autonomy over their health.
“Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider to empower women to manage their sexual and reproductive health no matter their location.
“Our self-care initiative gives women the power & ability to make informed choices about their health. It gives the woman a voice and the ability to take care of her health needs where, when, and how she wants to.”
It is obvious that increased availability of maternal health services alone does not lead to better outcomes for maternal health. The services need to be utilized first and one way to increase service utilization is to plan responsive health care services by taking into account the community’s views or expressed needs.
