TBHI Blueprint


PREAMBLE

On August 20 2009, I was 25 weeks pregnant when I suffered a ruptured membrane. The proximity of my house to the hospital where I had registered for antenatal care meant that I was in the hospital within ten minutes of leaving home. I thought the situation was an emergency but on getting to the hospital, I was kept sitting for upward of two hours at the waiting area as “there was no free bed” to accommodate me. So I sat there while the amniotic fluid gushed out of me. I was anxious and visibly agitated. Yet no one attended to me. The attitude of the nurses on duty made me realize they didn’t consider my condition an emergency.  Indeed I was told it wasn’t a “big deal”, happens all the time! In essence, a situation where a woman could be losing her pregnancy and was possibly traumatized had become so common it had lost its essence. To say I was shocked will be putting it mildly; I was scandalized! Eventually I was placed on admission and ventolin amongst other medications were administered. A few hours later contractions set in, progressing in intensity and frequency as the day wore on. By 3 am it was obvious I was in labor and nothing could keep the baby in my uterus. However, I wasn’t prepared to hear what the doctor said to my husband as I walked to the delivery room. He said we should consider what “happened” as an act of God and that we were going to lose the baby as its lungs weren’t developed to breathe outside the womb. Little wonder then that after I delivered a baby girl at about 5 am, nothing was done to see if she would live. This is in spite of the fact that she cried when she was delivered. My daughter was taken for dead as she went quiet after a ‘milli-second’ of crying. An hour later she was discovered to be breathing and efforts commenced to clean her up and prepare her for referral to the National Hospital (NHA). At this time, the little girl had been moved from one point to the other; even the hospital cleaner had handled her! There was neither fuel in the ambulance to transport her down nor mobile oxygen to rest her respiratory organs. That day, I realized that it was standard to move preemies from one hospital to the other across towns even in commercial buses! The experiences gathered at the neonatal intensive care unit (NICU) of NHA for 80 days and from nurturing her to full health is the inspiration that birthed Tiny Beating Hearts Initiative (TBHI).

INTRODUCTION

Neonatal mortality arising from pre term births has become a growing concern globally accounting for 29% percent of neonatal deaths yearly around the world. To curb this trend, Nigeria along with 192 other countries signed up to  the United Nations Millennium Development Goal 4 to reduce by two third the number of child deaths from 2000 to 2015. Three years to the deadline, Nigeria still has one of the highest rates of neonatal morbidity and mortality in the world. Preterm births refer to births that occur before 37th week of gestation. Babies born prematurely are often referred to as “preemies”. Dr. E.A. Disu, a Consultant Pediatrician at the Lagos State University Teaching Hospital in “Challenges of Neonatal Care in Nigeria” stated that complications from pre term births accounted for 25% of neonatal mortality in Nigeria. In an article published in the “Punch” Newspaper on September 8 2011, Jayne Augoye wrote that in a study conducted by Save the Children UK for the World Health Organization, deaths of newborn in Nigeria “is still alarming”. We need to bear in mind that the figures that are used are those officially declared which do not reflect reality.

Antenatal care is very important to healthy pregnancies and early interventions in cases of emergencies. However, more than half of pregnant women have no access to this care. Worse still, primary health care centers and even secondary health facilities lack the personnel and equipments to keep preemies alive. Women who find themselves in such situations rely on fate for the survival of their babies. Economic hardship precipitated by the partial removal of fuel subsidy in January and its attendant consequences on prices of goods and services mean that more women will be unable to access quality medical care during pregnancy. Whilst most European countries have significantly reduced neonatal mortality rates and Latin American countries have stepped up efforts to do same, it is obvious that Nigeria will not be amongst nations that will be awarded the pass mark on the UN MDG 4.

Beyond the UN deadline however, we have a moral obligation to help the children who are born too soon in our midst. Many people don’t know much about preemies and how it is a fight for them to stay alive.

Goal:              Reduce prematurity related neonatal/infant mortality in Nigeria.

Vision:         That every premature baby has the chance to survive and live healthy.

Mission:       To reduce neonatal mortality and morbidity by harnessing available resources to help preterm babies win their fight to stay alive.

FOCAL AREAS

  1. 1. EDUCATION

Awareness is being created around care before and during pregnancy as well cost effective care methods that help in keeping more premature babies alive and healthy. Information on the prevalence of preterm births, the associated risks, and how they can be better managed in order to significantly improve chances of survival will also be disseminated regularly.

Generally, there is a dearth of information on causes and management of prematurity and TBHI is aiming to fill the knowledge and information gap by making this sort of information available to pregnant women and women of child-bearing age, healthcare personnel, and the general public, including the menfolk.

Strategies for achieving the above include leveraging on the social media, developing special programs and ad campaigns for the mass media, printed publicity materials, open-air rallies and carnival-type processions, seminars and workshops, use of the pulpit, etc

  1. ADVOCACY

Typical of Nigeria, legislation and blueprints exist that will benefit preemies and their caregivers, but their effects are barely felt out there in the real world owing to a lack of execution and implementation. TBHI seeks to prod the relevant government agencies to come alive to their responsibilities. Where implementation has been slow, TBHI will ceaselessly advocate for improved performance in that regard. Where new legislation is needed, lobby groups will be set in motion to speed up the process.

Available statistics show that more than half a million Nigerian kids could be saved annually, given proper implementation of already-existing strategies.

On its part, the National Health Bill is a beautifully crafted document with adequate provision for free medical care for children under the age of five and pregnant women. All that is holding its passage into law is the President’s assent. Using its contacts in government’s circles, we will look to hastening up that process with a view to saving the lives of as many preemies as is humanly possible.

The government will also have to step up its commitment towards putting in place more and better infrastructure. More NICUs will be needed all around the country. Healthcare institutions and personnel will need to be brought closer to the people. For the benefit of those in very remote areas, traditional birth attendants can be imbued with some basic training on how to handle preterm babies, both safer and more hygienically.

Bearing in mind that advocacy with government on legislations and more effective implementation will be cost intensive and time consuming, TBHI’s advocacy has begun to target private companies and the idea is to have them incorporate support Preemie Care into their Corporate Social Responsibilities initiative.

 

  1. SUPPORT

 

Raising a child is a cost intensive venture. For a preterm birth, it is an altogether different proposition. Because of their delicate nature, preterm babies have very special needs. In addition to requiring lots of extra care and support, their nutritional requirements are different, as well as their hygiene and clothing needs. March of Dimes, an international organisation which promotes the cause of premature babies, recently revealed that raising a premature baby cost 12 times more what it costs to take care of a healthy baby born at term

The prevalent economic situation puts most of these needs beyond the capabilities of many a parent of premature babies. This increases the likelihood that such infants would not be getting anywhere near what they need to survive already difficult-enough birth conditions.

TBHI will be concerning itself with making strategic, interventionist donations aimed at giving preemies significantly improved chances of survival.

In so doing, it will be looking beyond government circles, and at the private sector for assistance with funding as well as donation of relief materials. Corporate bodies will be encouraged to improve their Corporate Social Responsibility profile by identifying with a cause as noble as helping vulnerable infants in their fight for survival through the most difficult phase of their lives.

LEGAL STATUS

Tiny Beating Hearts Initiative has a constituted Board of Trustees which has is incorporated at the Corporate Affairs Commission under the Company and Allied Matters Act (1990).

Enquiries: Petra Akinti Onyegbule

0813 3456 557

tinybeatinghearts@gmail.com