Lagos, Nigeria’s bustling economic hub, is often celebrated for its vibrancy and myriad opportunities. However, beneath this dynamic surface lies a stark reality for many residents, particularly women and children, who face escalating challenges in accessing essential healthcare services.
For women like Mrs. Jumoke Sasore, an artisan in Ikorodu, the struggle is palpable. Despite her hard work, her monthly income is failing to keep pace with the relentless rise in living costs. “Every day is a battle,” she explains. “With prices soaring, I find it increasingly difficult to afford basic healthcare, let alone specialised services for my children.”
This economic strain has profound implications for maternal and child health in Lagos. Many women are forced to prioritise immediate financial needs over health interventions, leading to delayed or neglected prenatal and postnatal care. Reports indicate that the incidence of maternal and infant mortality is rising, particularly in low-income areas where access to healthcare facilities is already limited.
“There are days I just sit and wonder how everything got so expensive. Last week, I spent half of my savings on just provisions, and I still don’t know how we’ll get through the month. It’s becoming impossible to survive,” lamented Mrs. Jumoke Sasore.
Mrs. Sasore is not alone in her struggles. Across Lagos, women are bearing the brunt of the country’s harsh economic landscape, marked by soaring inflation and stagnant wages.
“The cost of foodstuffs is increasing daily. Most of us can no longer eat healthy meals. We are struggling to send our children to school and adequately provide for our families,” shared Funmilola Asa, a petty trader in Badagry LGA.
These sentiments reflect the broader challenges faced by women in Lagos, as rising prices hinder their ability to maintain not only basic living standards but also essential healthcare for themselves and their children.
As these women navigate economic challenges, the maternal and child health crisis in Lagos is reaching alarming proportions.
Recent data from the 2018 National Demographic and Health Survey (NDHS) highlights the severity of the situation: with a total fertility rate of 3.5 children per woman, a distressing 512 out of every 100,000 women succumb to pregnancy-related complications. Additionally, the state experiences significant neonatal mortality, with 35 newborns dying for every 1,000 live births.
Reversing The Trend
One effective way to address these avoidable deaths is through family planning, according to Barrister Ayo Adebusoye, chair of the Lagos Civil Society Participation for Development (LACSOP). He emphasized that “family planning is one of the highest impact interventions to reduce the risks of premature birth, low birth weight, fetal and neonatal death, and adverse maternal health outcomes.”
“It has the potential to empower women during critical times in their lives, establish healthy birth spacing practices, and ultimately reduce maternal and child morbidity and mortality. It is a key investment toward achieving many of the Sustainable Development Goals (SDGs).”
While awareness of family planning is high among women in Lagos, findings reveal that costs for consumables and other related fees are major barriers preventing access to these essential services.
For many, like Funmilola Asa, economic hardship forces difficult choices, with family planning often being one of the first services sacrificed.
“Though I am using family planning, I always struggle to find N2,000 for consumables. While family planning commodities are technically free, we still have to purchase items like pregnancy test strips,” Mrs. Asa lamented.
“The method I’m using (Implanon) will expire in a few months, and for someone grappling with daily essentials like food, housing, and school fees, prioritising reproductive health services becomes increasingly difficult. We can barely afford our house rent.”
Healthcare professionals in Lagos express concern about the widening gap in healthcare access. “Women are coming in later for check-ups or skipping them altogether,” says Dr. Adeola Olayemi, a local obstetrician. “The lack of funds means they’re unable to afford necessary tests or treatments, which can have dire consequences for both mother and child.”
Chairperson of the Ward Health Committee (WHC) at Rauf Aregbesola Primary Health Care (PHC) Centre, Mrs. Abiodun Oroja-Giwa, expressed her concerns that economic hardship may deter many women from continuing their use of family planning methods. “As the WDC chairman, I’ve heard numerous women complain about paying as much as N2,000 for consumables at public hospitals, and up to N20,000 at private facilities,” she explained. “While many come to access family planning services here, coughing up N2,000 is simply out of reach for them in this economic climate.”
Oroja-Giwa fears that the progress made in family planning uptake could diminish as women revert to traditional methods simply because they cannot afford the fees. “I know these traditional methods can fail, which is why I sometimes pay the consumable fees for some women. However, I can’t sustain this philanthropy; the government needs to address this issue.”
A recent report titled “Women’s Health Advocacy Brief” revealed that the Lagos State Ministry of Health (LSMOH) approved N227,026,558 for family planning and reproductive health in 2023, yet only N81,578,438 has been released so far. This disparity highlights the urgent need for increased investment and support in reproductive health services, especially in the face of escalating economic challenges.
Releasing essential funds for family planning has become a major hurdle, Mrs. Abiola Olabisi Adekoya, a retired nurse and family planning advocate in Kosofe LGA told the reporter, “These funds were budgeted for family planning consumables, among other needs,” she explained.
“However, the real issue lies in the release of these funds. When they are not released, nurses have no choice but to ask users to pay for consumables.”
In the current economic landscape, many women are forced to prioritise basic needs over reproductive health. “Some women would rather ignore family planning when they can’t even afford a meal for the day,” Adekoya noted. “This often leads to unwanted pregnancies, which can endanger their lives, especially if they resort to unsafe abortion methods.”
To prevent such dire situations, Adekoya emphasised the importance of government action. “The state government must ensure that funds are budgeted for procuring family planning consumables, including pregnancy test kits, so women do not have to pay a dime when accessing these vital services.” Without immediate intervention, the health of countless women and children in Lagos remains at risk.
Urgent Call For Government Action
A family planning advocate in Badagry LGA, Dr. Ajoke Sariyu Ashiru, has urged the Lagos state government to fully release the equity fund designated for health insurance aimed at the city’s most vulnerable populations. Currently, approximately 70 percent of residents live below the poverty line of $1.90 per day, making it nearly impossible for them to afford essential health interventions, including family planning services.
“Family planning is one of the many critical services included in the state health insurance package,” Ashiru explained. “The government has committed to allocating one percent of its consolidated revenue as an equity fund to provide health insurance for these vulnerable groups. I appeal to the state government to prioritise women in this initiative, allowing them to access life-saving services.”
With economic challenges worsening, the need for immediate government action has never been more pressing. Without adequate support, many women may continue to face barriers to essential reproductive health services, jeopardizing their health and well-being.
Community Leaders Take Initiative To Ensure Access
In a proactive response to the pressing maternal health crisis, Chief Hakeem Adeyemi, the first Balogun of Okunola land, has vowed to address the challenges surrounding family planning access in his community. He plans to meet with the Officer in Charge (OIC) of the Rauf Aregbesola Flagship Health Center to discuss solutions.
“As a community leader, I cannot just wait for the government to solve all our problems,” Adeyemi stated. He emphasized the need for women to have easy access to family planning services, especially in the current economic climate. “We have assigned our female chiefs to educate women on the importance of family planning. Additionally, we will work to ensure that men understand and support their wives in accessing these life-saving interventions.”
Adeyemi’s commitment extends to ensuring that the health center is stocked with enough consumables, eliminating any fees for women seeking family planning services. “No woman should have to pay for these essential services,” he asserted.
Meanwhile, the Lagos state government has also expressed its commitment to prioritizing women’s health. Mrs. Olubukola Orukotan from the Lagos State Ministry of Health assured that despite existing challenges, efforts are underway to enhance maternal and newborn health across the state.
“We have received approval for five out of eight of our proposals and have launched extensive sensitization campaigns in various communities to improve health outcomes,” Orukotan explained. This collaborative approach between community leaders and government officials aims to ensure that women in Lagos have the resources they need to make informed decisions about their reproductive health.
During a personal tour of some of the facilities, our correspondent observed that the economic challenges are compounded by inadequate healthcare infrastructure. Many facilities are under-resourced and overwhelmed, unable to provide the comprehensive care that vulnerable populations desperately need. As a result, initiatives aimed at improving maternal and child health are stymied, with limited outreach and support for those who need it most.
Community health workers play a crucial role in bridging this gap, but their efforts are hampered by insufficient funding and resources. They report increasing reluctance among women to participate in health programs due to financial burdens. “We try to offer support and education, but if a woman is struggling to put food on the table, health will naturally take a backseat,” explains Amina Bello, a community health advocate.
The situation calls for urgent intervention from both the government and non-governmental organisations. Increasing financial support for maternal and child health programs, along with community outreach initiatives, could help alleviate some of the burdens faced by these women. Providing affordable healthcare options and financial incentives for utilizing maternal health services could also encourage more women to seek the care they need.
As Lagos grapples with its economic challenges, the health of its women and children hangs in the balance. Addressing these issues is not just a matter of policy; it’s a moral imperative to ensure that all mothers and their children can thrive, regardless of their economic circumstances.