Spotlight on: Preventing maternal deaths by improving quality of care

Our third piece features insights from Imo Ude Chinasa, Evidence for Action (E4A)-MamaYe’s Niger State Advisor, on the importance of quality of care.

Why did you decide to work towards improving quality of care? And how does quality of care link to gender equality, especially in sub-Saharan Africa?

I lost my mother at an early age due to pregnancy related complications stemming from her diabetes. Her death was highly preventable. But the hospital neither had the right equipment nor the required skilled medical personal that could provide her a diabetic pregnant patient with the appropriate care. This experience inspired me to work towards improving access to quality health services so that women and children have better chances to survive than my mother. Only when women have access to quality medical services, such as maternity and antenatal care, will we be on the right path to avoiding the highly preventable deaths that are still occurring during pregnancy and childbirth.

But care also needs to be affordable and easily accessible for women, and it must be provided in a timely manner for it to be relevant. This means that ‘quality care’ requires medical experts in health facilities to be working in conditions where they can deliver time sensitive services.

Finally, there is also a satisfaction element – a woman needs to be treated with respect and dignity during such an important moment of her life. How she’s being looked after, the equipment that was used, the way health personnel talk to and treat her. These seem like very small details, but they are essential in providing good quality care.

As a woman advocating for gender equality, what were some of the challenge you encountered in your career?

Being a woman in the humanitarian or public health sector can be challenging. For example, it’s not easy for a woman to confront decision-makers and demand policy changes. While men can easily do that – in fact, it’s even seen as the norm or their duty – people always question a woman’s right to speak up and her ability to deliver in a leadership role.

But I also see this type of gender bias as an opportunity to deliver my best. Knowing that I’m going to meet people who will value me less requires me, as a woman, to build up my courage and confidence. So when lead advocacy activities, I put together a compelling ask that is supported by evidence – especially when I engage with policymakers.

How is what you do in your daily job helping to make a difference in women’s lives? What achievement are you most proud of?

What am I most proud of is working with an organisation that empowers citizens to present policymakers with the necessary evidence to enable them to make informed health decisions that improves women’s lives.

Because in my job, I help to build the advocacy capacity of diverse state-led local coalitions which are made up of a range of different stakeholders: government officials, health professionals and their associations, technical working groups, civil society networks and media representatives. These coalitions work together to track, analyse and package state owned data in a user friendly manner such as scorecards. These scorecards are used to engage policy makers to make informed health decisions that will improve the quality of health services women and children receive, thereby increasing their chances of survival.

For example, during the 2019 health budget performance review, some of the coalitions I worked with were able to identify that the allocated health funding in Niger state for 2019 was low and didn’t meet the maternal and neonatal health (MNH) commitments the government had verbally made. The coalitions began to ask government officials tough questions around why funding for maternal, newborn and child health (MNCH) activities was low, and why the small amount that had been budgeted wasn’t released in a timely manner. This has opened the door to many other important discussions with the government, for example, on supplying hospitals that offer maternity service with live-saving commodities like ambu-bags, or on getting the State Ministry of Health to create an MNCH budget line to prioritise MNCH funding.

Most importantly, it’s not me but the coalition, people from Niger state, who have been witnessing the negative impact of low health resource allocation on their mothers, wives and sisters who are asking these questions. Being able identify the bottlenecks that are hindering an MNCH budget line with them, to review the delivery of Ministry of Health MNCH programmes and attitudes of health workers to spot potential gaps, and to brainstorm ideas that can improve the quality of care in the state is a great achievement for me.