This is a very exciting era. We are witnessing improved citizens’ participation in decision making for maternal and newborn health (MNH).
Specifically, in Bauchi State, MamaYe Nigeria is working with CSOs and the media, through its State-Led Accountability Mechanism approach (SLAM) called Bauchi State Accountability Mechanism for Maternal and Newborn Health (BaSAM). This has given a wider inclusion of CSOs and the media in MNH governance and budget process.
What MamaYe is doing differently is helping policy makers make decisions that are more beneficial to the governed by ensuring that such decisions are backed by evidence.
The Bauchi State Accountability Mechanism (BaSAM), is made of CSOs, the media and government. BaSAM consists of sub-committees on evidence generation, advocacy, knowledge management and communication. These committees produce evidence materials and advocacy briefs that are communicated to the government to influence decisions on MNH.
While BaSAM engages the government, the media is showing an ever-growing support for the MNH cause. In one of such cases, the General Manager of Globe FM, Bauchi, provided one free hour of engaging with the Chairman, Budget Appropriation Committee of the Bauchi State House of Assembly, Yakubu Abdullahi. Mr. Abdullahi is also a member of the State’s Health Committee.
BaSAM Co-chair, Hajiya Maryam Garba, and MamaYe State Coordinator in Bauchi, Ahmed Mohammed Ahmed, were in the Globe FM studio with Mr. Abdullahi. They wanted to find out, among other issues, the level of involvement of CSOs in the State’s budget process, and how, through the accountability mechanism, CSOs can contribute to the Bauchi State 2016 budget process to ensure that adequate and evidence-based allocation is accorded to the health of pregnant women and newborns.
In the 2015 budget of Bauchi State Commission of Youth and Women Rehabilitation and Development, for 6 local governments, 22 million Naira was budgeted for the purchase of medical kits for pregnant women. Women of childbearing age in the 6 Local Government Areas combined are 694,554.
If you divide 22 million Naira among 694,554 pregnant women, how much would a pregnant woman get?That is less than 32 Naira! So, this analysis may come to mind if you are wondering why, in spite of many interventions, the high level of advocacy and the involvement of the media, maternal and newborn mortality is still on the high side.
It is true that not the entire population would become pregnant at the same time. But this is why the government needs to determine the poorest quintile (who will not be able to afford birth kits) of the total population and base its budgeting on that information.
Nomso Ibe of Traffina Foundation, who is into production and sales of clean birth kits for pregnant women said a bag containing essential materials like delivery mat, cotton wool, sanitary pad, olive oil, baby receiver, hand gloves, razor blade, soap, chlorhexidine gel, apron (for the midwife) and placenta disposable bag, goes for 2,500 Naira regular and 4,000 Naira super pack.
The super pack contains misoprostol, which helps stop women from excessive bleeding (the leading cause of maternal death in Nigeria), and chlorhexidine gel, to prevent umbilical cord infection in the newborn. The bag containing these items can also be used to carry baby things.
The interesting part is that Traffina Foundation partners with sponsors who pay for the kits so that the pregnant women may get them for free.
UNFPA also provides birthing kit at a subsidised rate of 3,000 Naira.
Given the fact that misoprostol and chlorhexidine are quite vital to the safety of the woman in labour and her newborn, it makes enough sense to budget for a super pack birth kit and not leave anything to chance. Therefore, a pregnant woman in any of the 6 LGAs quoted above will need 4,000 Naira budgeted for her.
It means that instead of 22 million Naira, the government should be looking at 694, 554 women of child bearing age, multiplied by 4,000 Naira, which gives 2,778,216,000 (two billion, 778 million, two hundred and sixteen thousand Naira).
The government can make an appropriate budget that covers a reasonable percentage of the total childbearing population if it bases its process on evidence. Anything short of that evidently amounts to underutilisation of the little money available to the government, and a continuous high rate of maternal and newborn mortality.
The MamaYe budget tracking and analysis training, which was conducted in Bauchi for lawmakers and other stakeholders, was to help the government see such gaps as described above.
It was thus exciting to hear Mr. Abdullahi say during the radio show that the budget training was one that he learned from, which he said would inform the 2016 budgeting process.
Luckily for Bauchi State, the new government is cooperative and responsive. Supported by the MamaYe accountability mechanism and advocacy endeavours, the game has started changing. For instance, it is very unusual to get a live radio airtime for free, and the government’s representatives see MamaYe as a partner in progress.
With MamaYe’s intervention in Bauchi State, the media has come to terms with the reality that if maternal mortality must be reduced from 1,549/100,000, it (the media) must contribute to developing issues in the interest of the public.
Mr. Abdullahi also said during the radio engagement that with the revised 2015 budget, the health sector has received tremendous attention from the current government. He gave the governor's 5-point health agenda and the commitment to give 15% of the State’s budget to the health sector as examples of the government’s seriousness. He expressed optimism that the executive is also going to give priority to the health sector in its 2016 budget. The good news is that the optimism has yielded, the governor proposed 15%!
The MamaYe Bauchi State coordinator then touched on MamaYe’s support to the State Ministry of Health and its agencies on the use of their own evidences to develop their plans so that they could adequately address the real gaps in health budgeting. The result of that is the 15% that the governor has proposed!