Stronger markets, increased access to essential maternal health supplies: Donors, Government Must Address Market Failures to Solve Problem.
Global health organization PATH and Nigerian NGO Association for Reproductive & Family Health (ARFH) has highlighted the fact that many Nigerian women lack access to the lifesaving medicines that can prevent postpartum haemorrhage and eclampsia – the two most deadly complications of pregnancy and childbirth. A new paper by PATH, available on the www.path.org website, titled “Stronger markets, increased access to maternal health supplies,” details how inconsistent availability and poor-quality supplies of oxytocin, misoprostol, and magnesium sulfate in the country threaten women’s lives, and what can be done to solve the problem.
More Nigerian women die due to pregnancy and childbirth-related causes than in any other country in the world – in 2015 alone, 58,000 Nigerian women lost their lives, according to the World Health Organization (WHO, 2015). Of those deaths, about half were caused by uncontrolled bleeding after childbirth, also known as post-partum hemorrhage, and a condition that causes high blood pressure and seizures during pregnancy called pre-eclampsia/eclampsia. According to a report in 2012 by the United Nations Commission on Life-Saving Commodities for Women and Children, medicines to prevent and treat these conditions – oxytocin and misoprostol for post-partum hemorrhage and magnesium sulfate for pre-eclampsia/eclampsia – are affordable, effective, and promoted for use by the global health community.
However in Nigeria, according to the Reproductive Health Supplies Coalition (RHSC), inconsistent availability and supply of products of poor or unverified quality put pregnant women at risk. For example:
- As of March 2016, 13 oxytocin products and four magnesium sulfate products registered in Nigeria have not been verified to meet international quality standards, increasing the risk that pregnant women are being administered poor-quality products.
- Despite the fact that oxytocin requires refrigeration, only 47 percent of local government authorities and health facilities in Nigeria have refrigeration capacity, meaning that many public and private drug shops are threatening product safety and efficacy by storing the drug on shelves (according to the gavi.orgNigeria Annual Progress Report 2013).
- Kaduna State, which has a maternal mortality rate that is nearly 50 percent higher than the national average, has struggled to accurately forecast and budget for needed health supplies, (according to the Kaduna State Ministry of Health Strategic Health Development Plan, 2010).
“More mothers die in pregnancy or childbirth in Nigeria than in any other country” said Mrs Kehinde Osinowo, ARFH Director of Programmes. “Fortunately, we know what to do to prevent those deaths. It’s time to work hand in hand with advocates, the government, suppliers, and donors to improve the quality and availability of maternal health medicines, reduce counterfeits, and ensure that all women receive the care they deserve.”
The paper outlines actions that advocates and decision-makers in Nigeria can take to solve persistent problems related to the availability and quality of maternal health products. These actions include:
- Increasing resources committed to the regulation of health products
- Aligning registration requirements with international quality standards
- Strengthening guidelines for proper storage and distribution of maternal health products, such as oxytocin, misoprostol, and magnesium sulfate, and
- Addressing procurement inefficiencies to improve availability of maternal health products.
While the solutions are not simple, the paper insists that these policy changes could dramatically accelerate Nigeria’s efforts to reach maternal health targets laid out in the Sustainable Development Goals. To reach these goals, the paper concludes; “it will be critical to ensure that women have reliable access to lifesaving maternal health products. Strengthening the policy environment in which markets function will be fundamental to sustaining well-functioning markets and improving access.”
The Association for Reproductive and Family Health is an indigenous non-profit, Non-governmental Organisation in Nigeria that promotes and implements sexual, reproductive and family health services and programmes including communicable, non communicable diseases, and promotes human rights in Nigeria.
PATH is the leader in global health innovation. An international nonprofit, PATH saves lives and improves health, especially among women and children. PATH accelerates innovation across five platforms–vaccines, drugs, diagnostics, devices, system and service innovations–that harness our entrepreneurial insights, scientific and public health expertise, and passion for health equity. By mobilizing partners around the world, PATH takes innovation to scale, working alongside countries primarily in Africa and Asia to tackle their greatest health needs. With these key partners, PATH delivers measureable results that disrupt the cycle of poor health. Learn more at www.path.org.