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At a glance: Nigeria

A new strategy to improve primary health care in Garaku, Nigeria

© UNICEF Nigeria/2007/Adeshida
Women and children at the Primary Health Care Clinic in Garaku, Nigeria. Health Care delivered by this facility has greatly improved, thanks to the introduction of the Accelerated Child Survival and Development strategy.

UNICEF’s yearly flagship report, 'The State of the World’s Children', launched 22 January 2008, makes a call to unite for child survival. Here is one in a series of related stories.

GARAKU, Nigeria, 12 February 2008 – It is an overcast Wednesday afternoon in the town of Garaku in north-central Nigeria. Rita Jiriko, 23, dressed in a colourful blouse, patiently waits her turn on the veranda of the Garaku Primary Health Care Clinic. As she gently rocks the younger of her two children to sleep, she recalls an earlier visit to the health centre.

“When I delivered my first baby here three years ago, this clinic had only one bed for new patients,” Ms. Jiroko says. “Women who came here for antenatal care had no privacy because the same room was used for all consultations – and sometimes for male patients too. Many pregnant women stayed away from the antenatal clinic for this reason.”

A dire situation

Just a year and a half ago, the only formal health care that the town of Garaku offered its approximately 15,000 residents was two rooms in a dilapidated building with very limited staff and services. The situation was dire and the poor quality of service actually discouraged local residents from coming to the clinic.

Today, the Garaku Clinic is a five-room primary health care facility, adequately staffed and providing comprehensive health services, including maternal care, immunization, voluntary HIV testing and counseling, as well as advice on nutrition, education and childhood disease prevention.

© UNICEF Nigeria/2007/Adeshida
Rita Jiriko, 23, watches as her infant receives the oral polio vaccine at the Primary Health Care Clinic in Garaku.

Not only has the waiting time diminished, but health education sessions at the clinic are teaching Ms. Jiriko and other patients ways to protect their children from disease.

“I have learned how to prepare oral rehydration salt solution for my children when they have diarrhoea, how to protect them from mosquito bites and how important immunization is. I didn’t know about these things before,” Ms. Jiroko says.

A collaborative effort

These transformations at the Garaku Primary Health Care Clinic are due to the Accelerated Child Survival and Development strategy, more commonly referred to as ACSD.

ACSD aims to reduce the number of deaths of infants, under-five children and mothers in West and Central Africa through immunization, better nutrition, childhood illness prevention and antenatal care. Begun in 2002, the strategy had its Nigerian launch in February 2006.

In Nigeria, the strategy represents a collaborative effort by the Ministries of Health at the federal and state levels, and UNICEF. 
Critical lessons

Since the introduction of the ACSD in Garaku, the number of antenatal care consultations has increased sharply. Demand has also increased for other services, including immunization of children and voluntary HIV counseling and testing.

Justina Philip, 35, is motivated to come often to the renovated Garuku clinic because it distributes free anti-malarial, insecticide-treated mosquito nets to women who attend antenatal care classes at least four times.

“I am encouraging other women to come to the health centre, particularly the pregnant ones. Not only do we benefit from the mosquito nets, but we also learn how to prepare nutritious meals for our families,” she says.

It is difficult to argue against the picture of success painted by these numbers and the testimony of residents like Jiriko and Phillip. From the achievements of the ACSD in Garaku, critical lessons may be learned for improving maternal and child health.



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