Children under five should not be dying from treatable diseases
Partnership for Improved Child Health (PICH) — a UK Aid Match funded project
From Christian Aid Nigeria @CAID_Nigeria
Most cases of child death in Nigeria are caused by treatable diseases like malaria, diarrhoea and pneumonia.
Child morbidity rates (the frequency with which a disease appears in a population) are significantly higher in hard-to-reach, remote, rural settlements. In these communities poverty is rife and health facilities are often too far away to reach easily.
Partnership for Improved Child Health (PICH)
The Partnership for Improved Child Health (PICH) project, run by Christian Aid Nigeria, aims to reduce morbidity and mortality rates of children under five from treatable diseases like malaria, diarrhoea and pneumonia.
The project employs the Integrated Community Case Management of childhood illnesses (iCCM) strategy, which provides timely and effective treatment to children below the age of five in hard to reach communities.
The PICH project is currently being implemented in four Local Government Areas in Benue State, Nigeria, with UK Aid Match Funding from the Department for International Development (DFID).
When the project starts, Community Resource Persons (CORPS) will be trained to manage and treat iCCM conditions — malaria, diarrhoea and pneumonia — in children below the age of five. These CORPs will reside in the hard-to-reach communities.
Mimidoo’s story
Mimidoo Avungu, a 28-year-old farmer from Benue State, Nigeria, lost her first child when the toddler was three years old. Her daughter had been sick with a fever but Mimidoo did not have the resources to get medical help. The nearest health centre was a long distance by foot and Mimidoo would have to cross a river on a makeshift bridge to get to the health facility in another community.
When the toddler’s health got worse she tried to take her to the clinic on a commercial motorcycle but the child died before they got to the Primary Healthcare Centre.
Cut off from care
Mimidoo’s second child, a boy, was two when he died during the rainy season. Commercial motorbikes did not run during the rainy season and Uno community where Mimidoo lived was cut off from the health facility by the river which was so high it washed the makeshift bridge away.
She tried to get him medical help — walking the long distance on foot and wading through the river with her son in her arms. He died in her arms before she got to the health facility and she had to walk back to her community with her dead child in her arms.
Losing hope
When Mimidoo’s third child, a boy, died at 18 months, Mimidoo did not try to visit the health facility, she had neither the resources for the visit nor the will to make the trek which could end with her baby dead in her arms.
Her son was diagnosed with pneumonia by a health practitioner resident in her community who requested payment before administering any treatment. When she was unable to pay him, he did not treat the baby, so he died.
Project offers new optimism
As part of our PICH project, Community Resource Persons (CORPS) will be trained to manage and treat iCCM conditions — malaria, diarrhoea and pneumonia — in children below the age of five. There will be a trained CORP in the Uno Community, where Mimidoo lives.
Mimidoo says this will mean help is closer to her and will have a great impact on the lives of her only surviving children — twins she had a month before Christian Aid Nigeria’s visit to her community in May 2017. In addition to accessible treatment for her twins, Mimidoo hopes a decent bridge will be constructed through the project to connect her community with the health facility.
An urgent situation
Mimidoo’s story is not an isolated incident, cases of infant mortality and morbidity are rife in Benue State, Nigeria.
When Christian Aid visited the Kwande Local Government Area of Benue State in May 2017, Sewuese Akula’s four month old son, Terkimbi, had a severe case of diarrhoea and a suspected case of pneumonia.
Sewuese got medical help for her son four days after she noticed he was sick. According to Sewuese, she waited that long because he was ‘only vomiting’ and she had bought drugs over the counter to treat this. When the diarrhoea started she took her son to a private health practitioner who recommended that the baby be admitted at the health facility. Due to financial constraints, Sewuese’s husband rejected the recommendation and purchased more drugs instead.
At the time of our visit to Kwande, Terkimbi was in very poor condition. A Christian Aid staff already trained on management of iCCM conditions recommended and bought Oral Rehydration Solution for Terkimbi. Sewuese said the treatment had not been recommended by the private health practitioner she visited.
Free and accessible treatment for children under five
Community Resource Persons (CORP) on the PICH project will be trained and armed with medicines and treatment like the Oral Rehydration Solution required for Terkimbi’s treatment.
They will also be equipped with medicines for the treatment of malaria and pneumonia, which will be available for free. Free treatment will mean mothers like Sewuese, who live in poverty, won’t have to watch their children die because they are unable to afford treatment for these conditions.
The CORPs will be trained to provide early and accurate treatment which can save lives. Trained health workers like Elizabeth, the Benue State Ministry of Health, and the Federal Ministry of Health, will oversee the activities of the CORPs in the four local governments where the project will be implemented.
Test. Diagnose. Treat!
Under-five children taken to the CORPs for treatment will be tested before treatment is administered. The CORPs will refer severe cases to primary healthcare facilities after administering palliative treatment. The tests will be useful to eliminate ‘blind’ treatment, which could have severe consequences.
Oche Oko, a blacksmith, and his wife Salome Oko, a farmer, lost their four year old to malaria after they treated him with drugs bought at a chemist without prescription. Oche and Salome did not take their son to the health facility for four days because they were afraid the bills would be too much and they thought he would get well after they administered the drugs.
When the boy’s condition did not get better, they took him to the hospital along with the drugs they purchased from the chemist. The hospital diagnosed their son with malaria but he died before treatment could be offered.
Financial support
Financial constraints are a primary reason why people in Benue State buy over the counter drugs, without testing and diagnosis, instead of visiting health facilities.
Doowuese Aondohem, a 20-year-old farmer, said women in her community use traditional medicine and often lose their children when it proves ineffective.
When Doowuese’s second child had diarrhoea at 17 months, she knew traditional medicine was not an option. However, she didn’t have the money to immediately get healthcare for her daughter. She waited until the next day when she could sell her cassava at the market to raise funds to take the child to the hospital. Her daughter is currently two years old and very healthy.
The PICH project will provide support to caregivers in remote communities where healthcare is inaccessible and will also provide relief to poor households like Doowuese’s who are unable to bear the cost of healthcare.
‘The government is overloaded so we are excited when NGOs come to help us. Your own has less protocol, there will be no moving files from table to table and you will help us within the shortest possible time.’
Zaki Nder Kuha, the traditional ruler of Agbede Community in Konshisha Local Government Authority of Benue State
