Dr Makinde Akinlemibola, the chairperson, Lagos State chapter of the Association of Nigerian Private Medical Practitioners (ANPMP), an affiliate of the Nigerian Medical Association (NMA) tells TOBI AWODIPE some of the challenges in managing the health of women and girls in Lagos State, and how the dearth of health workers is affecting women’s reproductive health.
What are the challenges in managing the reproductive health of women in Lagos State
Regarding reproductive health in Lagos, we have quite a number of challenges and a major one is ignorance. Many women are ignorant of their reproductive health and are not abreast of what to do before starting sexual activities. Someone ignorantly initiates them into these activities and before you know it, they are dealing with a couple of sexually transmitted diseases (STDs), unwanted pregnancy and other factors.
How much influence does this aspect (reproductive health) have on the general well-being of the woman and family?
It has a lot of influence. When women contract STDs, some are mild while others can be very severe and become a lifelong disease and can quickly become life-threatening. When girls or women run into these kinds of challenges or are dealing with unwanted pregnancy, it can cut short their education or life ambition.
There is also the issue of economic liability in the sense that pregnancy sometimes affects the earning abilities of some women. When the child is eventually born, there is an extra mouth to feed and making ends meet can become a problem. If the girl or woman was pursuing academic programme or was into trading, that might be put on hold for a while.
There is also the problem of stigma or shame with many girls that have children out of wedlock, what we call single motherhood. It is a serious problem these days.
What is the private sector contribution to tackling the challenges in this aspect of women health in Lagos state?
Many women usually come to us as the first point of call and we try to educate them on what to do and how to take care of themselves and their health. Also, if when they come to us they are not pregnant yet, we teach them how to take care of their reproductive health by preventing pregnancy and how to stay safe from contracting STDs.
Being the first point of contact means we must educate them medically so they don’t get the wrong information outside. We help them maintain good health.
What are the benefits or link of family planning to the health and well being of women?
If you link the issue of family planning to reproductive health, the benefits are enormous.
We know it is not possible to prevent women from being sexually active but we want them to take full responsibility for their health by preventing unwanted pregnancies, reducing the risks of contracting STDs, taking charge of their future and protecting their general health and well being. We want to improve the quality of life of women and this is the first step in achieving this goal.
How is the private sector helping the clients to get these benefits?
There are a number of non-governmental bodies working in this space with us and providing us with needed materials to help us in propagating this message. Organisations like The Challenge Initiative (TCI) have been very instrumental to us in the private sector and their assistance has gone a long way in helping us reach our set goals in the state.
Are there ways you recommend for the inclusion and involvement of men in achieving these goals?
When women come to us, we encourage them to bring their partners along and it becomes easier to educate them then on how they should be involved and what is required from them. Most men don’t want family planning because they believe women would become promiscuous which is not true.
But when they hear it from us and the benefits are explained to them, they tend to receive the message better. We need to encourage more men to come and get educated on what needs to be done and how they can support women in their lives. Involving men actively also helps them realize the need for child spacing, keeping the number of children a woman has under control and even improving the family’s finances.
Planning the family properly not only helps the woman’s well-being and health, it also helps their finances and when they are told this, they tend to appreciate their role and cooperate better.
What do public and private sectors do in common to empower women and improve upon their health?
There are so many things both sectors do in common. Because we are the largest group of government-recognised private doctors, most organisations tend to relate with us and when we look at the collective care and health services we give in the country, it is over 60 percent.
Outside Lagos, the number is even higher. Whatever the public sector is embarking on, we’re usually privy to it and we come together to discuss it and reach a collective solution.
So, whether you go to public or private healthcare, the tendency that you will get almost the same service is very high because there is a collective benchmark below which we cannot go. When training are organized, for instance, we are involved, helping us to keep abreast of latest happenings and reproductive health practices.
How do you think the government can engage the private sector better?
I think I would just reiterate again that whatever government is doing, they should involve and inform us as key stakeholders. We know how to get in touch with all our members easily and whatever information they need us to be aware of, it is easy to get everyone on board with best and latest practices.
Many health workers have left the country in the last couple of years. How would you say this factor is affecting reproductive health provision in the state?
Obviously, it is having a lot of negative impact as the number of health workers that is supposed to attend to the general populace is reducing. Nigeria’s population is increasing but the number of people that are supposed to attend to their healthcare is reducing daily, both in terms of quantity and quality.
We need to keep encouraging those that are still here to get them to stay back. The government needs to encourage health workers to stay back with not just improved remuneration but also better conditions of service.
Is there any existing support for the private sector engagement in critical areas such as reproductive health and family planning?
I’ll be honest and say that most support we get now is from NGOs like TCI that I mentioned earlier on. They are doing a lot in reproductive health and it is greatly appreciated. I would rate their assistance highly as they have been very supportive in so many areas, especially regarding follow-ups.
It is one thing to organise a seminar, it is another to provide the needed tools to practise with and another thing entirely to get feedback.
These are just some things they have been doing that are very commendable. I would rate them very highly, especially for us in the private sector. However, our main problem right now in this sector is that young people are leaving in droves and those of us left are not getting younger. Because of this fact, the number of people we can impact is reducing.
What advice can you give the people regarding sourcing quality health services in the private sector?
We can only encourage them as quality comes over a period of time. We need the government and NGOs to keep impacting and helping us. We also need lots of encouragement, which can come in different ways to enable us keep doing our best.
We can bring semi-retired health workers back into the system; they have a lot of knowledge and experience. Even after they have retired, for those that can, they can be encouraged to be a part of stakeholders and participate. This would help to boost the quality of workers in this space and boost capacity building for younger ones.
Education is also important, we need to keep improving the knowledge of workers in this sector, organise seminars, trainings and so on. All these would go a long way in improving the quality and quantity of talents we have at this time.
