Abstract
Background: Reproductive health is a key foundation for strategies to address health security. It constitutes a vital element in the vision to achieve improved health, quality of life and well-being of individuals and families and the realisation of national economic goals. Developing a blue print for health security in reproductive health matters may contribute to closing the equity gaps in Nigeria by the year 2050.
Methods: Gaps in reproductive health were identified through situation analysis of selected reproductive health indices. SWOT analysis was also conducted to outline areas of strengths and opportunities, in addition to weaknesses and threats. Key reproductive health indicators were forecasted for 2050.
Results: Despite all efforts, gaps still exist in the country’s reproductive health indices including maternal, perinatal, contraceptive, abortion and gynaecological. Most pregnancy-related deaths are linked largely to preventable causes. If unaddressed, these challenges would undermine gains from previous interventions and responses from governmental and non-governmental organizations and pose serious threats to the nation’s health security.
Conclusions: The country must be committed to reproductive health agenda that is focused on the International Conference on Population and Development goal in its bid to achieve health security by the year 2050. Due considerations must be accorded to emerging reproductive health issues like men’s reproductive health and their involvement in their partners’ reproductive health, and the reproductive health needs of the aged, people with disabilities and those in humanitarian settings. Further in achieving health security for Nigerians by the year 2050, the principles underlying the reproductive health policy of the country must be upheld. These include equity, right based approach, gender and age responsiveness, cultural sensitivity and continuum of care amongst others.
Keywords: Health security; Reproductive health; Maternal indices; perinatal health; Nigeria.
Abstrait
Contexte : La santé reproductive est une fondation essentielle des stratégies visant à assurer la sécurité sanitaire. Elle constitue un élément essentiel de la vision pour améliorer la santé, la qualité de vie et le bien-être des individus et des familles, ainsi que la réalisation des objectifs économiques nationaux. L’élaboration d’un schéma directeur pour la sécurité sanitaire en matière de santé reproductive pourrait contribuer à combler les écarts d’équité au Nigéria d’ici à 2050.
Méthodes : Des lacunes en matière de santé reproductive ont été identifiées à l’aide d’une analyse de la situation de certains indices de santé reproductive. Une analyse SWOT a également été réalisée pour définir les zones de forces et d’opportunités, et aussi des faiblesses et des menaces. Les principaux indicateurs de la santé reproductive ont été prévus pour 2050.
Résultats : Malgré tous les efforts déployés, il y’a encore des déficiences dans les indices de la santé reproductive du pays, notamment en matière de santé maternelle, périnatale, contraceptive, avortement et gynécologique. La plupart des décès liés à la grossesse sont largement liés à des causes évitables. Si ces problèmes ne sont pas résolus, ces défis affaibliraient les gains tirés des antérieures interventions et réponses des organisations gouvernementales et non gouvernementales et menaceraient gravement la sécurité sanitaire du pays.
Conclusions : Le pays doit être commis à un programme de santé reproductive axé sur l’objectif de la Conférence Internationale sur la Population et le Développement visant à instaurer la sécurité sanitaire à l’horizon 2050. Il convient de tenir dûment compte des problèmes émergents en matière de santé reproductive, tels que la santé reproductive des hommes et leurs participations dans la santé reproductive de leurs partenaires, et les besoins en matière de santé reproductive des personnes âgées, des personnes handicapées et de ceux dans des situations humanitaires. En plus, pour garantir la sécurité sanitaire des Nigérians d’ici 2050, les principes qui sous-tendent la politique de santé reproductive du pays doivent être respectés. Ceux-ci incluent l’équité, l’approche fondée sur les droits, la réactivité au genre et à l’âge, la sensibilitéculturelle et le continuum de soins, entre autres.
Mots-clés : sécurité sanitaire ; La santé reproductive; Indices maternels; santé périnatale; Nigeria.
Correspondence: Dr. A.M. Adebayo, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan,Nigeria. E-mail: davidsonone@yahoo.com.
References
UN Population Information Network (POPIN) Report of the International Conference on Population and Development, 1995; Cairo, Sept 5 -13, 1994 Oct 18, 1994, New York: United Nations. Available at: http://www.un.org/popin/icpd/conference/offeng/poa.html (Accessed: 27 May 2018).
Omo-Aghoja, L. ‘Sexual and reproductive health: Concepts and current status among Nigerians’, African Journal of Medical and Health Sciences (2013); 12(2): pp. 103–13. doi: 10.4103/2384-5589.134906.
NPC and ICF ‘Nigeria Demographic and Health Survey 2013’, National Population Commission, Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International, 2014.
Federal Ministry of Health. Saving newborn lives in Nigeria: Newborn health in the context of the Integrated Maternal, Newborn and Child Health Strategy. 2nd edition, Federal Ministry of Health, Save the Children, Jhpiego 2011. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20498829. (Accessed: 27 May 2018).
Kassebaum N. J., Bertozzi-Villa A., Coggeshall M. S., et al. ‘Global, regional, and national levels and causes of maternal mortality during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013’, The Lancet 2014; 384 (9947): pp. 980–1004. doi: 10.1016/S0140-6736(14)60696-6.
Federal Ministry of Health. ‘Nigeria National Reproductive Health Policy 2017’, pp. 1–107.
Adetola A. O., Tongo O. O., Orimadegun A. E. and Osinusi K. ‘Neonatal mortality in an urban population in Ibadan, Nigeria’, Pediatrics and Neonatology. Elsevier Taiwan LLC (2011); 52(5): pp. 243–250. doi: 10.1016/j.pedneo.2011.06.001.
Ekure E. N., Ezeaka V. C., Iroha E. and Egri-Okwaji M. ‘Prospective audit of perinatal mortality among inborn babies in a tertiary health center in Lagos, Nigeria’, Nigerian Journal of Clinical Practice (2011); 14(1): pp. 88–94. doi: 10.4103/1119-3077.79271.
Fawole A. O., Shah A., Tongo O., et al. ‘Determinants of perinatal mortality in Nigeria’, International Journal of Gynecology and Obstetrics. Elsevier B.V. 2011; 114(1): pp. 37–42. doi: 10.1016/j.ijgo.2011.01.013.
Ibekwe P. and Ugboma H. ‘Perinatal mortality in southern Nigeria; less than half a decade to the millennium developmental goals’, Annals of medical and health sciences research (2013); 1(2): pp. 215–222.
Ezeh O. K., Agho K. E., Dibley M. J., Hall J. and Page A. N. ‘Determinants of neonatal mortality in Nigeria: Evidence from the 2008 demographic and health survey’, BMC Public Health 2014; 14(1): pp. 1–10. doi: 10.1186/1471-2458-14-521.
Bankole A., Adewole I., Hussain R., et al. ‘The Incidence of Abortion in Nigeria’, International Perspective on Sex and Reproductive Health 2015; 41(4): pp. 170–81. doi: 10.1363/4117015.
Federal Republic of Nigeria National HIV and AIDS Strategic Framework 2017-2021.
Federal Ministry of Health. National Reproductive and Health Survey Plus 2017 (NARHS PLUS) 2012.
Federal Ministry of Health (FMoH).. 2014 National HIV sero-prevalence sentinnel survey among pregnant women attending antenatal clinics in Nigeria. Abuja, 2015; FMoH.
Adetokunboh O and Oluwasanu M. Eliminating mother-to-child transmission of the human immunodeficiency virus in sub-Saharan Africa: the journey so far and what remains to be done. Journal of Infection and Public Health 2016; 9(4): 396–407.
Busolo, D. S. and Woodgate, R. L. ‘Cancer prevention in Africa: A review of the Literature’, Global Health Promotion, 2015; 22(2), pp. 31–39. doi: 10.1177/1757975914537094.
World Health Organisation. Cancer Country Profiles, Nigeria. 2014, WHO. Available at: www.who.int/cancer/country-profiles/nga_en.pdf 2014a; (Accessed: 28 May 2018)..
World Health Organization. Every Newborn: an action plan to end preventable deaths, WHO. Available at: www.who.int/about/licensing/copyright_form/en/index.html 2014b; (Accessed: 28 May 2018).
Akseer N., Lawn J. E., Keenan W., et al. ‘Ending preventable newborn deaths in a generation’, International Journal of Gynecology and Obstetrics, 2015; 131, pp. S43–S48. doi: 10.1016/j.ijgo.2015.03.017.
Mason E., McDougall L., Lawn J. E., et al. ‘From evidence to action to deliver a healthy start for the next generation’, The Lancet, 2014; 384(9941), pp. 455–467. doi: 10.1016/S0140-6736(14)60750-9.