According to studies, health outcomes differ in developing countries for mothers and infants who use formula feed compared with those who breastfeed. Lack of optimal breastfeeding is associated with infants morbidity, risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and other health risks. Breastfeeding reduces the risks of premature mortality from diseases, incidence of breast and ovarian cancer, gestational weight gain, type 2 diabetes, among others.
A number of social and cultural barriers to optimal breastfeeding have been identified as poverty, early and single motherhood, poor social and professional support, poor knowledge, myths, misconceptions and unintended pregnancies.
In Bauchi State, a women group with support of development organisation is providing empowerment support and counselling mothers about the health impact of breastfeeding and to ensure that mothers and infants receive appropriate care, starting at birth.
One of such intervention is being Implemented by a non-governmental organisation, Hasken Mata Women Group at Dot community in Dass Local Government Area of Bauchi State.
Infant and mother health burden
The latest United Nations Children’s Fund (UNICEF) report titled “Situation of Women and Children in Nigeria” states that the country records 576 maternal mortality per 100,000 live births, while approximately 262,000 babies die at birth every year.
Infant mortality currently stands at 69 per 1,000 live births, while under-five deaths is 128 per 1,000 live births, with more than 64 per cent of the deaths due to pneumonia, malaria and diarrhea.
Also, 2021 Multiple indicator Cluster Survey (MICS) and National Immunisation Coverage (NIC) survey, showed that Bauchi State has higher child mortality rate compared to other states in the North-East region.
The report indicated that the state records 153 deaths in every 1,000 live births.
Intervention
The Hasken Mata women group supported by an NGO, Breakthrough Action Nigera (BA-N), formed a cluster of 460 registered members in Dot community.
The BA-N project funded by the United States Agency for International Development (USAID) is supporting local women groups to mobilise visit to antenatal clinics, promote breastfeeding, immunisation uptake and use of treated nets at the grassroots.
The women agreed to impose a N1,000 fine for members who failed to practice exclusive breastfeeding, attend antenatal clinic and complete immunisation uptake for their children.
The Chairperson of the group, Mrs Khadija Hashim, said the women were working to raise awareness on the importance of antenatal care and immunisation in family health and child survival.
She said the N1,000 fine for immunisation defaulters was meant to complement governments efforts toward eradicating child killer diseases, improve reproductive health and wellbeing of the people.
“The fine is to encourage completion of immunisation uptake; use of treated mosquito nets and exclusive breastfeeding to reduce burden of morbidity and childhood diseases as well as improve health status of mothers.
“In 2018; BA-N project organised capacity building for our members, and in 2019, we formed a Saving and Loan Group (SLG).
“Presently, we have 23 SLG with minimun of 20 members each.
“Each group also donate N10,000 monthly to the primary healthcare center in their respective area for detergents and antiseptics, to enhance hygiene and sanitation in the facilities,” he said.
According to her, the women in Dot also provides N5,000 monthly to vulnerable households in the community to support their transportation during delivery.
The group, she said, also provide soft loans through the SLG to enable mothers to engage in productive activities to cater for their families.
Impact of health intervention on mothers
Ummu Mahmood, a nursing mother, is sitting under a roof shade in her one bedroom apartment, breastfeeding her three-months old baby.
Mahmood, just like her peers in Dot community, said she embraced exclusive breastfeeding sequel to sustained awareness creation activities by the women group in the area.
The middle-aged mother said she witnessed significant improvement in the baby’s health through practicing of exclusive breastfeeding as against her previous experience with her first child.
“I also attended routine immunisation for my child, and I’m seeing the difference in terms of his health,” she said.
Mahmood said she was encouraged by the women group to attend antenatal, practice exclusive breastfeeding and ensure proper immunisation to protect her child against child killer diseases.
Similarly, Mrs Rhoda Joseph, 29, a mother of two, said members of the group are conducting door-to-door sensitisation to improve health education, encourage exclusive breastfeeding and promote uptake of maternal and child health services.
Addressing challenges
Aeron Joseph, BA-N focal person in Dot community, said that apart from lack of awareness, poverty and poor attitude, over work has been impending effective performance of the women groups toward educating the women on child and maternal healthcare.
To address the trend, he said, the group initiated a volunteer scheme to reduce workload of the women cluster and enhance mobilisation activities at the grassroots.
He said four volunteers had been engaged for house-to-house mobilisation on maternal and child health services.
According to him, the 24 groups are contributing N500 each for payment of monthly stipend to the volunteers, adding that we had so far paid two months allowances to the volunteers.
Community and religious leaders’ engagement
Chief Imam of Dot, Malam Ibrahim Isa, said they educate their followers on importance of immunisation and exclusive breastfeeding from religious health perspective.
He said the clerics in their Friday sermons enjoin husbands to support their women towards ensuring good child, maternal and family health.
Also, Mr Iliya Jinjiri, Chairman, Ward Development Committee (WDC) in Dot, said the women are actively involved in providing useful information for safe motherhood to health agencies, partners and relevant stakeholders.
He said the women groups engaged the committee whenever they face challenges with their men on immunisation and other child health services.
The committees, therefore, invited the affected spouses in the respective communities, discussed and agreed that any sick woman in the absence of her husband should be allowed to visit health facility.
“The problem is largely on the inability of sick women to visit hospital in the absence of their spouses. No matter the sickness, a sick wife must be permitted before she is allowed to visit hospital,” he said.
Mr Ibrahim Yahya, a husband, noted that the women group use to pay medical bills for their children whenever their husbands were in financial distress.
Way forward
Mr Suleiman Umar, Health Educator, Dass Local Government Council, said the council was encouraging communities to take ownership of health programmes to enhance quality healthcare service delivery in the area.
He said that health indices in the area had improved to 75 per cent from 25 per cent at the exit of the National State Health Investment Project (NSHIP).
The health official said the feat was achieved through the BA-N training programme which developed women skills, and encouraged them to embrace best health practices as well as adhere to set guidelines for sustainability.
For his part, Mr Usman Inuwa, Programme Coordinator, BA-N project, said the programme would focus more on training of women on its priority areas to sustain the gains achieved towards improved child and maternal healthcare in the state.