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Lagos Govt. equips 40 health workers against maternal mortality

By Monsurudeen Olowoopejo

In a continued effort to combat maternal mortality, the Lagos State Government has trained 40 health workers on new skills to aid their effective management of pregnant women during their third stage of labour.

The health workers selected from different primary, secondary, and tertiary healthcare facilities across the state were put through necessary skills to manage childbirth and postpartum complications which pregnant women may encounter.

The three-day training organized in collaboration with the United Nations Population Fund (UNFPA) and the Saving One Million Lives Programme for Results (SOMLPforR) in Ikeja afforded the government the opportunity to aid the workers with skills that could assist them prevent excessive bleeding, which remains a leading cause of maternal deaths in Nigeria.

Speaking on the importance of the training, the Director of Family Health and Nutrition at the Lagos State Ministry of Health, Dr. Folasade Oludara noted that the training aimed to bridge the knowledge gap among newly recruited healthcare workers and update the skills of existing staff.

According to her, the training addressed one of the primary causes of maternal mortality—postpartum hemorrhage, or excessive bleeding after delivery.

“This training is critical for reducing maternal mortality in the state. It will equip our healthcare workers with the skills to manage postpartum hemorrhage effectively and ensure safe delivery,” Dr. Oludara said.

She explained that Postpartum hemorrhage is responsible for a significant portion of maternal deaths, both globally and in Nigeria, adding that the training focused on teaching participants the proper use of uterotonic drugs such as oxytocin and misoprostol, which help the uterus contract after childbirth to prevent excessive bleeding.

The Director said that participants were also introduced to new techniques like delayed cord clamping, which allows blood from the placenta to flow back into the newborn, reducing the risk of neonatal anaemia.

“In addition to medical interventions, the training also emphasised the use of innovative devices like the non-pneumatic anti-shock garment (NASG), which can stabilise a woman experiencing hemorrhage while awaiting further medical care”, she said.

Oludara noted that these devices are crucial in emergency situations, particularly in low-resource settings where access to blood and blood products might be delayed.

“The anti-shock garment buys time for women until blood transfusions or other definitive interventions can be arranged,” she explained.

Oludara disclosed that the training also addressed the proper use of the partograph, a simple yet critical tool used to monitor labour and predict potential complications.

“Many healthcare workers were familiar with the partograph but had not been using it effectively. The participants were re-trained on how to utilise it properly to improve maternal outcomes. The partograph is a life-saving tool. If used correctly, it can help prevent complications during labour,” Oludara stressed.

She added that the training also prioritised the interpersonal skills of healthcare workers noting that the training focused on improving communication and empathy between healthcare workers and patients to enhance the overall birthing experience.

The medical expert expressed optimism that the new skills acquired by healthcare workers would lead to a significant reduction in maternal mortality across the state. “We are hopeful that this training will change the narrative for us. Skilled healthcare workers are the key to reducing maternal deaths and ensuring safe deliveries,” she concluded.

One of the facilitators at the training, Prof. Yusuf Oshodi, a renowned obstetrician and gynaecologist from the Lagos State University Teaching Hospital (LASUTH), highlighted that the training was designed to reduce Nigeria’s high maternal mortality rate, which has remained unchanged for decades.

He noted that excessive bleeding and hypertensive disorders in pregnancy are the two leading causes of maternal deaths, and addressing these issues could reduce maternal mortality by 40 percent.

“Our goal is to face these two monsters—postpartum hemorrhage and hypertensive disorders in pregnancy—which account for a large portion of maternal deaths,” Oshodi stated.

During the event, the Director and Reproductive Health Coordinator of the Lagos State Ministry of Health, Dr. Victoria Omoera delivered a comprehensive presentation titled “Proposal to Improve Maternal Care, Reduce Maternal Mortality, and Strengthen Systems for Safer Childbirth.”

In her address, Dr. Omoera highlighted the need for improved maternal healthcare services in low-resource settings like Lagos, where healthcare workers often lack the tools, capacity, and training needed to provide high-quality services.

She identified the main causes of these deaths as obstetric hemorrhage, hypertensive disorders, unsafe abortions, obstructed labor, and infections, noting that two-thirds of these cases involve women with no identifiable risk factors.

“These deaths are preventable if we take the right steps,” she stated, urging for increased investment in maternal health interventions.

One of the solutions, Omoera advocated for was the adoption of low-cost, high-impact interventions such as the Active Management of the Third Stage of Labour (AMTSL), which the World Health Organization (WHO) introduced in 2012. She pointed out that AMTSL, along with the use of non-pneumatic anti-shock garments (NASG) and newer drugs like Carbetocin and Tranexamic Acid, could reduce maternal mortality by up to 60%. She stated that these measures have already been piloted in Lagos State, with significant improvements in maternal outcomes.

She emphasised the need for continued capacity building for healthcare workers. She noted that the Lagos State Ministry of Health had trained 160 healthcare workers between 2019 and 2020, which contributed to a slight reduction in the state’s maternal mortality ratio. However, she acknowledged that more work needed to be done to meet key targets for intrapartum care.

“Our goal is to ensure that every healthcare facility in Lagos is fully equipped and that all healthcare workers have the necessary skills to prevent maternal deaths,” she concluded.

The training, which brought together about 40 healthcare workers from primary, secondary, and tertiary healthcare facilities, was a blend of theoretical and practical sessions. Participants were exposed to clinical demonstrations using mannequins and hands-on practice with anti-shock garments and uterotonic drugs.

The training is part of a larger initiative to strengthen maternal and child health services in Lagos State.

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