When Barr. Sullivan Chime of Enugu State took over as Governor in 2007, one of the programmes which attracted public accolade for his administration is the free maternal and child health scheme.
The scheme raised the hope of the high population of poor women in the state, especially those in rural areas, who can hardly afford two-square meal, let alone, medicare.
Before Governor Chime introduced the programme, these women were solely at the mercy of local midwives and road-side drug sellers. When eventually the child is born, the road-side drug seller, usually called chemist, continues the task of treating the child of any ailment that comes up, most times without any form of diagnosis. All these, put the state at the high risk of maternal and child mortality.
As part of efforts to reduce child and maternal death, Chime’s government introduced free maternal and child health scheme, including the distribution of long lasting insecticide treated mosquito nets to all households in the state, de – worming of children twice every year and intensified childhood immunization.
The programme, no doubt yielded results within the first two years, as pregnant women and nursing mothers, took advantage of this and thronged the hitherto deserted health centres scattered across the 17 local government areas in the state.
However, all that has changed as the once bubbling health centres and rapidly going back to the old days owing to government’s tax policy with relation to the free health services.
The State government introduced policy that mandates pregnant women in the state to provide evidence of tax payment by them or their husbands before accessing the Free Maternal and Child Healthcare (FMCH) policy of the state.
Ever since the policy came on board, the citizens of the state have been seriously lamenting over the situation, insisting that the free maternal healthcare was out in place to reduce infant and maternal mortality rate in the state.
Concerned stakeholders in the health sector have prevailed on the Government to review the tax policy, which is seen as a serious impediment towards the realization of the MDGs in 2015.
Beyond the issue of tax policy, the stakeholders monitoring the implementation of the programme in Enugu said that certain other issues including lack of drugs have greatly hampered the project, stressing that it was not available in several health institutions in the state.
Nevertheless, citizens of the state lamented that they want free medical care, as most of the women affected are jobless and widows.
According to the Women’s Health and Action Research Centre, WHARC, maternal mortality still remains high in Enugu State, raising serious doubts on whether the state would realize the Goal 5 of the MGDs in 2015.
If the current statistics are not reversed, it is evident that Enugu State will likely not achieve the global objective of reducing the rate of maternal mortality. Available statistics indicate that the maternal mortality in the state ranges between 772 and 998 per 100,000 women.
Speaking recently on behalf of Civil Society Organizations in the State, Deacon Jerry Nwanna observed that the tax policy was a great impediment towards government’s realization of the free maternal and child health.
He noted that the intended beneficiaries of the free health policy were vulnerable groups, who should ordinarily be exempted from paying tax.
“We are not saying that people should not pay tax because we know that government needs revenue, but what we are saying is that the issue of free maternal and child health involves a small segment of the society, which ordinarily would hardly have the means of paying tax.
“Our experiences have shown that the free health policy is not yielding the expected result because of the tax policy.
“We appreciate the government’s policy of free maternal and child health, but we are appealing that the issue of taxation as a condition should be completely removed”, he stated.
He was, however, quick to add that “government could also consider the option of allowing a joint community tax, where every community pays tax and gets a certificate that covers all these vulnerable groups, especially those in the rural areas.
“In such case, it will be the duty of traditional rulers to identify every pregnant woman in his community. This measure will check influx of people from other states”.
Nwanna equally stressed on the need for adequate security to be provided across all the public health facilities in the state.
According to him, “most of these facilities are so isolated and unsecured that the life of the woman, her child and even that of the health workers is at stake”.
Similarly, representatives of the various communities called on the government to adequately equip the health facilities.
A resident of the state, Mrs. Njideka Onu lamented that despite the free health policy, pregnant women were still charged certain money when they visit the facilities.
“Most times, they will say they don’t have drugs from government; the woman will be required to pay for the drugs. So, I am appealing to the government to ensure regular supply of drugs to the facilities.
“We are also worried about this issue of tax, we don’t even know what to pay and where to pay. Please, let this be free indeed”, she appealed.
Another concerned rural dweller, Mr. James Eze lamented that some of the health centres were in bad shape.
He said: “you can imagine a situation where a woman is delivered of her baby at the full glare of every other person. It is not ideal; so we are calling on government to provide us with better structures”.
A widow, Mrs. Ngozi Okenyi urged government to consider the plight of poor women in the rural areas, who are intended to benefit from the programme.
According to her, “I heard that government introduced tax policy because people were trooping into the health centres from other states. I want to plead with government to find another way out; let traditional rulers or councilors be used to identify any body that wants to benefit from the scheme.
“Those of us who are widows and we do not have any serious means of livelihood, where are we going to get tax clearance. I plead with Governor Chime to make it free as before”.
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