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Mothers in Lokoto adopt key household practices

Zainab and her child
© UNICEF Nigeria/2007/Okey-Amechi
Zainab holds her baby boy as she narrates the story of her difficult first pregnancy

By Somto Okey-Amechi and Oluseyi Abdulmalik

Zainab Ali is 32 and a mother of five. She lives in Lokoto, a traditional community in Chachanga Local Government Area of Niger State. She got married at the age of 26 and for her, married life has been somewhat of a challenging experience, especially as she recalls how she struggled with a lot of illnesses through a very difficult first pregnancy and then a child birth at home with a Traditional Birth Attendant (TBA) at hand to help her through the delivery.

“It was a very difficult time for me. After some time I just learnt to cope with all the illnesses and somehow, my child survived”.

Though somewhat traumatised by her previous experience, Zainab says those days and her hard times are over.  Not too long ago, a maternal and child health clinic, the only health centre in their community, was established.

The clinic is strategically located within the community at less than a kilometre away from most homes and it has five Community Health Extension Workers (CHEW). It has become a refuge not only for Zainab but for the rest of the community as well.

Pregnant with her second child, Zainab was introduced to antenatal care through the UNICEF sensitisation program that was continued by the community health workers at the health centre. She was glad to obtain such enlightenment. Her implementation of the information she received made her second pregnancy a much easier experience for her.

“That time round, when I felt sick, I went to the health centre, they give me drugs and advice and I felt much better. During delivery there was no problem; everything went much more smoothly”.

Experiencing the proven benefits

UNICEF supported sensitisation in this community, providing information on how to ensure the survival and development of especially, children under-five and mothers during pregnancy. This has led to the adoption of various key household practices, such as antenatal care by most of the women in this tight knit community of Lokoto.

Hitherto, basic practices such as  exclusive breastfeeding, intake of adequate micronutrients through diet or supplementation, growth monitoring and promotion and even birth registration were unknown and non-existent in this traditional society.

Under the Accelerated Child Survival and Development strategy, the community was introduced to various key household practices (KHHPs) through advocacy and sensitisation; and within a short time, changes were evident. At the inception of the promotion of the key household practices, a baseline survey showed practice of exclusive breastfeeding in the community to be at 4%. Four years after implementation, the level of knowledge and practice  has risen to 97%.

At present, 96% of pregnant women now take iron supplement while 95% of children aged between 6-59 months receive Vitamin A supplements. There have also been marked improvements in stunting, wasting and underweight levels of children under-five in the community.

Most of these women are gathered here during our visit and the interview with Zainab soon develops into something of a group discussion. Many of the women here know each other and share similar experiences and they are all eager to talk about the lessons they have learnt and how their lives and the lives of their children have changed for the better since the implementation of the Accelerated Child Survival and Development initiative in their community.

Zainab’s friend, Aishatu, speaks up next and tells of how she shares her friend’s appreciation of antenatal care. Aishatu is a 28-year-old mother of two and she considers herself fortunate enough to have first encountered the UNICEF supported programme four years ago when she was pregnant with her first child. She says that she has had no regrets since.

“They take care of me at the health centre when I am pregnant and they taught me how to take care of my children when they are sick”, says Aishatu. According to her, she successfully manages diarrhoea in her children with the oral rehydration salt solution.

Apart from antenatal care and home management of diarrhoea and other childhood illnesses, the social consciousness of the people of Lokoto has improved tremendously and this is evident during our visit there. Walking into some of their rooms reveals the use of Insecticide Treated Nets (ITNs) by many households. In addition, families have also learnt the importance of immunising their children and ensuring their children get all the routine vaccinations they require.

Aishatu Siraju, 28, mother of 2, prepares oral rehydration solution which she uses to effectively manage diarrhoea in her children.

During the interview sessions, many mothers are openly breastfeeding their children. One of the women, Hauwa Basiru, a 30-year-old mother of five, says that she exclusively breastfed the last three of her five children. When asked why she didn’t breastfeed the first two exclusively, she said that at that time it was considered inhumane to do so because it was thought that breast milk could not possibly be enough nutrition for the child. She said that husbands never supported their wives then because they believed that exclusive breastfeeding was not healthy and it meant starving the child.

But now, Hauwa says all that kind of thinking is history as both husbands and wives have received adequate information to help them acknowledge the benefits of exclusive breastfeeding. “With exclusive breastfeeding, my babies are healthier, don’t fall sick often and have better mental development”, says Hauwa. With dissemination of proper knowledge, the community has come to realise that breast milk contains all of their children’s nutritional requirements and is superior to any substitute.

Hauwa’s positive experience with breastfeeding has rubbed off on her 27-year-old neighbour, Mariam Ibrahim, who seeing the obvious benefits breastfeeding had on Hauwa’s children, adopted the practice with her own children. “I noticed changes in the rate of growth of my children since I started breastfeeding them, their physical appearance is better and I am even comfortable doing this”, Mariam said.

The women discuss the difference in the quality of care they have received from trained health workers and the traditional birth attendants. Zainab says that their women no longer use the traditional birth attendants in the community because they are not trained to deliver quality health services. She said the mothers feel that they and their babies are safer with the care they get from trained staff at the health centre.

Consolidating change

“But we still have a little way to go”, says Zainab. We need to ensure there is an improvement in our sanitary condition too. She pointed out that although they have water, it isn’t enough as there is just one functional borehole serving the entire community.

The implementation of the Accelerated Child Survival and Development initiative in Lokoto community has produced obvious results. There has been a significant decrease in the rate of infections among children under-five and there has been a major shift from mortality to stability.

An operational health facility with trained staff contributed in large part to bringing much needed healthcare services to the women and children of this community, but many here are amazed that most of what it took to effect such a turn around from the way things used to be was just getting access to the right kind of information.

Mother breastfeeds
© UNICEF Nigeria/2007/Okey-Amechi
Mariam Ibrahim, 27, breastfeeds her baby. She was encouraged to adopt exclusive breastfeeding after seeing the positive impact it had on other children.



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