Healthcare and general living conditions in Nigeria are poor especially for children and women. Infant and under-five mortality rates are high. Over 70 per cent of people seeks care from informal health care providers and 62 per cent of those health providers practicing modern medicine have little or no formal schooling. Two third of births take place at home, mostly assisted by unsupervised, untrained birth attendants. The weakened Public Health Care (PHC) system with low coverage of key interventions have resulted in the persistence of high disease burden. With accessibility to comprehensive reproductive health services, women are less likely to die in pregnancy, more likely to have healthier children and better able to balance their family and work life but unfortunately, majority of Nigerian people, especially women, are poor and very vulnerable to illness, disability and even death due to lack of access to comprehensive health services. LAPO recognizes this fact and therefore implements a well structured health education and service provision programme with special focus on maternal and child health, malaria and other tropical diseases, and HIV/AIDS.
IMPROVING REPRODUCTIVE, MATERNAL AND CHILD HEALTH IN NIGERIA
Nigeria has a high disease burden due to a weak healthcare system with maternal and child mortality rated the highest in the world. For every woman who dies during childbirth, more others suffer debilitating complications and chronic ill health. Infant and child mortality rates are unacceptably high with about 1 out of 5 mortality before the age of five.
Reproductive health indices are also lamentable; the modern contraceptive prevalence is very low at less than 10%, with a very low uptake of contraceptive services due to lack of sexual health information which also makes young people vulnerable to sexually transmitted infections (STIs) and unintended pregnancy. HIV/AIDS remains a major issue of concern among children, young people and women in Nigeria with an average prevalence rate of 3% and an estimated 3.7 million Nigerians (mostly females) living with the virus. Overall life expectancy at birth is currently put at about 52 years for males and 54 years for females; infant mortality rate is 86 per 1000 live birth while maternal mortality ratio is 840 per 100,000 live births.
The organisation is convinced that with better access to child survival initiatives and reproductive health services (such as child immunization and nutrition, family planning, safe pregnancy and delivery, care, treatment and prevention of common ailments, women are less likely to die during pregnancy and more likely to have healthier children and better able to balance their family and work life.
KEY PROGRAMMES AND ACTIVITIES
Reproductive Health Improvement in Target Communities
LAPO is engaged in the provision of reproductive health education and referral services to community members and clients of LAPO Microfinance Bank in Edo and Delta States in collaboration with the Partners for Development (PFD/Nigeria). Enlightenment handbills and stickers on Safe Motherhood and Family Planning, Pregnancy Care, Reproductive health and Cancer prevention have been printed and distributed to beneficiaries including clients of LAPO Microfinance Bank They are also referred to health facilities for uptake of antenatal, family planning and HIV counselling and testing services. The programme has generally enhanced their uptake of child survival and safe motherhood services in standard hospitals.
Preventing the Spread of HIV/AIDS
HIV/AIDS is a major issue of concern in children, young people and women in Nigeria. In 2015, an estimated 36.7 million people worldwide were infected with HIV. The HIV epidemic is most severe in Sub-Saharan Africa. Nigeria ranked second after South Africa as countries with the highest HIV/AIDS prevalence with 7.1 million and 3.2 million respectively in 2016.
LAPO actively promotes HIV prevention practices, knowledge of HIV status and provide care and support for people living with the ailment through its HIV/AIDS project. The organisation has partnered with the Society for Family Health (SFH) and the Global Fund to implement HIV/AIDS intervention projects which has significantly reduced the vulnerability of target beneficiaries to the ailment.
Amongst the projects are:
- Preventing HIV Amongst Female Sex Workers in Edo State
In 2017, LAPO partnered the Society for Family Health (SFH) to implement the Global Fund (GF) supported-HIV Prevention Project targeting Female Sex Workers (FSWs) and general population in Edo State. The Minimum Prevention Package of Intervention (MPPI) consisting of structural, behavioural and bio-medical services was the strategy adopted in the implementation.
Under the project, LAPO trained 24 FSWs as peer educators (PE) in selected local government areas of Edo state. Each PE formed a group of about 10 – 15 cohort members to discuss issues including safer sex practices, assertiveness, self-value, safer sex negotiation, correct and consistent condom use, sexually transmitted infections (STI), drug abuse, rape and gender-based violence (GBV).
A total of 868 FSWs in 14 brothels in Edo State benefited from regular STI screening and treatment for tuberculosis and other skin infections. Also, 277 FSWs received peer education which enhanced their knowledge of HIV prevention and safer sex practices while 928 beneficiaries with STIs were promptly referred for treatment.
A peer educator in Suzy Guest House, Aviele in Edo State, Mama Baby confirmed that the project has helped her peers to see beyond their current occupation and think more about other business ventures. “Some of my peers now have daily savings to enable them save enough money for business start-up. The girls are now more confident with enhanced sex negotiation skills.” Another peer educator from Easy Guest House, Aviele, Clara O. said consistent and correct use of condom is now being practiced by her peers, adding that her cohort members are now aware of the risks involved in unprotected sex such as STI and HIV infection. She said the consumption of hard drugs and alcohol has also reduced.
In a similar vein, Chichi Michael, a peer educator at Iyaro Parliament in Benin City said “condom usage during sex is not negotiable for me anymore” as the project has made her realize the importance of consistent condom usage with clients, partners or special boyfriends.
On the whole, the project has enhanced safer sex practices among FSWs through the promotion of consistent condom usage, improved knowledge of HIV status, reduction in self-medication and psychoactive drug abuse.
- Promoting ‘Right to Health’ in the fight against HIV/AIDS
LAPO joins forces with the global community yearly on World AIDS Day to reduce HIV-related stigma and deprivation. In 2017, LAPO joined the global campaign to reduce HIV-related stigma and deprivation under the theme “Right to Health.” Seminars were organized simultaneously in Edo, Delta, Rivers, Enugu, Oyo and the Federal Capital Territory, Abuja with community leaders, groups, local government health personnel and social development officials numbering 929 (239 M, 690 F) in attendance. Messages at the seminar were centered on promoting the right of people to prevention and impact mitigation services irrespective of their HIV status in Nigeria, where over 3.2 million people living with HIV and AIDS live. Issues around confidentiality, cost, availability and other forms of stigma and discrimination hindering access to HIV/AIDS services were discussed.
- Promoting Preventive Healthcare Amongst Microfinance Clients
Those who live in extreme poverty, especially women bear a hugely disproportionate burden of poor health and inequality. LAPO is not unaware of this challenge. In 2017, the organization reduced the economic burden of ill health among clients of LAPO Microfinance Bank and their communities through the promotion of preventive healthcare practices. Health information and screening services including education on malaria, blood sugar and blood pressure, cancer, hepatitis, maternal and child health, HIV and hygiene were freely provided to them under the integration of health and microcredit programme. The integration programme makes it possible for microcredit clients to receive health sensitization and screening services during weekly union meetings. The services increased the health knowledge and health-seeking behaviour of the clients.
Funke Oluwaseyi, a hairdresser in Prosper union, Isolo Branch shares her experience about the LAPO health integration programme, “I never knew that my Blood Pressure (BP) was high until a LAPO staff came to our union to educate and screen us. When she checked my BP, it was high and right there she gave me a paper (referral form) for hospital check-up. I went to the hospital and the doctor confirmed that my BP was actually high. I was treated and became fine. That same month, the staff called to ask if l had gone to the hospital and enquire about my health. I really thank God for using LAPO to save me. Before the test, l was not sleeping fine, but now l sleep like a baby after the test and treatment. She also told us the implication of having hypertension and the need to check our BP regularly because Hypertension is a silent killer.”
A joyous Mrs Simbiat Dairo of Prosper Union, Isolo branch has this to say, “I joined LAPO since year 2000 and now the leader of the union. A staff of LAPO checked my BP during a union meeting and said it was very high. She gave me a referral letter to the hospital and l wasted no time in running to the hospital for treatment. l am taking my drugs and l check my BP regularly as advised by LAPO. I have really gained a lot from LAPO health training. They have taught us the signs of hypertension and how to prevent it.”
On her part, Mrs. Ohuekere Juliet of God’s Own Union said she has learnt how to prevent HIV/AIDs from the LAPO health training she has attended while Mr Isreal Okafor said he was taught how to keep his environment clean to prevent malaria. In Chidima union, also in Lagos state, Mrs Chioma Aniagwu acknowledged lessons acquired from training on hygiene, adding that clean environment can save people from deadly diseases. She noted that her children are no longer vulnerable to diarrheal unlike before.
IMPROVING COMMUNITY HEALTH
The public healthcare system in Nigeria has deteriorated since the last two decades especially in the rural areas. The sector is marred by gross mismanagement, service fragmentation, personnel deficiency including drugs, decaying infrastructure, imbalance in resource allocation and access to quality care. The Primary Health Care (PHC) system has been undermined and therefore unable to combat the numerous health challenges facing the Nigerian population. Many Nigerians are still patronising traditional healers and local birth attendants due to rising cost of medical treatment and dearth of health personnel.
KEY PROGRAMMES AND ACTIVITIES
Promoting Universal Health Coverage
In her determination to improve access to health services, LAPO hasis currently collaborating with AICCO Multishield Health Maintenance Organization (HMO) to provide micro-health insurance services to clients and underserved low-income households. The scheme prevents out-of-pocket healthcare expenses as well as improve access to health services including full antenatal care at no additional cost. This year, 13,218 clients were enrolled in the scheme with full implementation and uptake of services scheduled to commence in February, 2018.
- Improving Community Health
As a part of its commitment to community health improvement, the organization instituted the LAPO Community Health Outreach in 2015. The scheme enhances access of poor, vulnerable members of remote rural communities to quality health care services. In the year 2017, the organization conducted four outreach sessions in Egba and Oregbeni communities (Ikpoba-Okha Local Government Area) and in Ogbido and Ibienafe communities (Etsako West Local Government Area), Edo State.
A total of 4,288 (1,537 M; 2,751 F) community members including children were provided free medical treatment including child care, gynaecological care, dental care, ear, nose and throat care, body and joint pains, malaria treatment, high blood sugar and blood pressure check, eye care and provision of eye glasses during the outreach. Some of them could not afford hospital bills before the intervention. The beneficiaries expressed gratitude to LAPO for the intervention.
Mr. Gaius O. is one of the beneficiaries in Egba community. He was treated for diabetes and high blood pressure and referred to the Central Hospital, Benin City for further medical intervention at the expense of LAPO. He described the LAPO medical outreach as “timely and life-saving.”
In Ogbido community in Etsako West Local Government Area of Edo State, Mrs. Victoria M. and two of her children were down with malaria and unable to access treatment due to financial constraints. They received free treatment, drugs and long lasting insecticidal nets during the health outreach. In her words: “We had malaria but did not go to the hospital because we had no money. I was using herbs to treat it without success. I thank LAPO for the free malaria drugs and insecticide-treated nets which l think will end malaria scourge in my family.”
Ms. Roseline O. was one of those treated at the Oregbeni centre of the LAPO Health Outreach in Ikpoba-Okha Local Government Area of Edo State. She was excited over the free eye treatment and provision of recommended eye glasses at the event, which now enables her see clearly. “I was unable to recharge my phone due to my poor eyesight but with the eye glasses given to me by LAPO, I can now do it myself even at night.”
- Pushing for Malaria Prevention among Vulnerable Population
World Malaria Day is a global event commemorated yearly on April 25th. In 2017, LAPO took advantage of the programme to raise awareness about malaria and its devastating effect on people, especially pregnant women and children below age five. Rallies, advocacy visits and seminars were organized at community and local government levels in Lagos, Oyo, Edo, Rivers, Enugu and Abuja under the theme “A Push for Prevention.” Community members were sensitized on malaria prevention and control strategies including the distribution of treated mosquito nets to 946 persons.
- Promoting Hygiene Through Regular Handwashing
“Our hand, our future” was the theme of this year’s Global Hand Washing Day celebrated worldwide on October 15th to create awareness on the importance of handwashing. LAPO used the opportunity to inculcate the habit of regular handwashing in primary and junior secondary school pupils in Edo, Delta, Rivers, Enugu, Oyo and the Federal Capital Territory Abuja. The messages were aimed at reducing the incidence of diarrhea and respiratory infections among children thereby enhancing school attendance. 5,724 (2,348 M, 3,376 F) pupils were taught the necessity of proper handwashing with soap, while their schools provided handwashing items.
The Acting Principal of Kingdom Heritage Model School, Asaba, Delta State, Mr. Kalusi admitted that the pupils now cautiously wash their hands after using the toilet and before eating as a result of the enlightenment programme.
- Reaching People with Health Information via Mobile Phone
LAPO disseminates preventive health information monthly to 25,000 clients of LAPO Microfinance Bank in remote communities across Nigeria through mobile phone. During the year, 300,000 (67,800 M, 232,200 F) clients and staff were enlightened on cancer prevention, eye care, meningitis, pregnancy care, food hygiene, post-natal depression, monkey pox, HIV/AIDS and medication adherence.
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