Millennium
Development Goals Beyond 2015: Improving Access to health for the mother and
child.
Although a lot has been done worldwide to
reduce child mortality and improve maternal health, mothers and children in
most parts of Africa still have a hard time accessing health care. I would
therefore propose that in the millennium development goals (MDG) beyond 2015, we should include the goal of
improving access to health care for the mother and child.
The main reason for lack of accessibility
to health care is due to lack of health facilities and the poor distribution of
these facilities hence making it difficult to reach them. In most areas of
Africa, especially the rural areas, people walk for over 5 km to access the
nearest health facility. This becomes very difficult for a pregnant woman or
for a child needing health care or basic immunization. Women in their last months
of pregnancy opt to camp near a health facility just in case the labor
commences. At the same time the facilities have no room to lodge the women who
are not in labor yet. They are asked to go back home and come when in labor.
This only leads to women walking back for the many kilometers and either deliver
on the way or when labor commences, the family decides to take the nearer
option which is the traditional birth attendant (TBAs).
Apart from the long distances, most
health facilities in rural areas lack essential medications, necessary equipment's and skilled attendants. A number of health facilities are manned by
only one nurse and a support staff. In case of a referral or a need to
accompany a client to the referred hospital, then the facility is closed for
this period. In case the health care worker gets an off or a personal
emergency, then there is no option, but for the health facility to remain
closed. The clients would not risk relying on these facilities and walking for
long distance just to meet it closed. Of course this has encouraged TBAs, home
deliveries and also self prescription and buying of the over the counter
antibiotics for those who are sick.
Another contributing factor for the lack
of access to health facilities is the poor referral system and poverty. Many
people would prefer to be locally treated due to the fact that if a client gets
some complications in the facility, it would be difficult to reach a main
hospital in the urban areas because the health facilities have no ambulances or
staffs to escort during the referral. In addition, clients are expected to pay
out of pocket for the health care. This is very difficult especially because
most of the time an illness or an emergency always strikes when people have no
money at all. Due to this, many would prefer to get services from traditional
healers and TBAs due to the believe that they are cheaper and families can pay
for the services through giving goods or farm products available.
Coupled with the above problems, there is
no adequate data collected to identify, how many mothers deliver in homes, how
many die and how many get complications. Monitoring and evaluation is poorly
done and hence no evidence is presented on the need to enhance access of health
care.
The
Political Implication of the Proposed MDGs Beyond 2015:
·
This
will can increase coverage and reduce barriers through coordinating actions and
policies across the health system
·
With
this goal in place the governments will place maternal and child health, in
particular high on its political agenda of reform.
·
The
governments will fast-track system wide reforms in maternal health
The
sub goals that may need to be put into attention are:
·
Operationalizing
the health facilities and Improve the referral system
·
Employment
and retention of skilled health care workers
·
Strengthen
monitoring and Evaluation and acting on the results
·
Free
services for the mother and children under 5 years.
·
Health
care financing
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