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Gynaecologists fear reduction in antenatal attendance over fuel price hike

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By Francesca Hangeior

Gynaecologists have expressed concern that the recent hike in fuel prices could significantly reduce antenatal attendance among pregnant women across the country.

The maternal health experts have warned that low antenatal attendance could lead to poor pregnancy outcomes due to a lack of supervision and specialist care.

The physicians further expressed worry that the hike in fuel prices could exacerbate Nigeria’s already troubling maternal health indices, highlighting that effective antenatal, intrapartum, and postpartum care were crucial in averting maternal mortality.

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The hardship, which started after the removal of fuel subsidy and devaluation of the naira, was exacerbated on Wednesday when the pump price of fuel jumped from around N800 to N1,150 per litre.

This has led to increased transport fares nationwide and worsening the hardships faced by Nigerians.

The gynaecologists disclosed that the new fuel pump price would certainly impact antenatal attendance, stating that pregnant women with low income would not be regular with their appointments due to high transport fares.

The World Health Organisation’s new guidelines recommend at least eight antenatal visits during pregnancy, emphasising that care should begin within the first trimester.

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According to the 2018 National Demographic and Health Survey, Nigeria has a worrisome maternal mortality ratio of 512 deaths per 100,000 live births.

Speaking exclusively with PUNCH Healthwise in different interviews, the gynaecologists expressed concern that reduced antenatal attendance would prevent many expectant mothers from receiving necessary interventions.

Dr Chukwuneme Okpala
A Consultant Obstetrician and Gynaecologist at Nnamdi Azikiwe University Teaching Hospital in Nnewi, Anambra State, Dr Chukwuneme Okpala, warned that the recent fuel price hike would lead to decreased antenatal attendance.

He explained that the initial increase in fuel prices had already raised transportation costs, and the latest hike had further worsened the situation, making it difficult for many pregnant women to keep to their appointments.

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Okpala stated, “Hospitals will see a decline in antenatal care attendance in Nigeria due to the rising fuel cost. High transportation costs will have a ripple effect on people’s living standards, reducing the purchasing power of pregnant women.

“Many will struggle to afford basic needs, which will inevitably affect their ability to attend appointments. When finances are tight, families will have to prioritise essentials like food over healthcare, leading to fewer women attending routine antenatal services.

“Many women will not visit the hospital regularly for antenatal care due to financial constraints, regardless of their proximity to healthcare facilities.”

Okpala stressed that irregular attendance at antenatal clinics could lead to poor quality care, significantly impacting pregnancy outcomes.

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“Without regular visits, those who need interventions may not receive them. Attending antenatal clinics frequently increases the chances of detecting and managing potential complications.

“Only through hospital visits can healthcare providers assess and identify any issues, whether maternal or foetal. When women do not present or arrive late, it often results in more severe problems that could have been addressed earlier”, he said.

Okpala lamented that decreased antenatal attendance will exacerbate Nigeria’s maternal health indices.

“If the current hardships persist, our maternal health statistics will suffer. In 2023, the WHO reported that Nigeria has the second highest rates of maternal, stillbirth, and neonatal deaths in the world, following India,” he said.

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The expert explained that maternal mortality serves as an indirect measure of a country’s Gross Domestic Product, adding, “If our GDP declines, healthcare will be adversely affected. Preventing maternal mortality relies on proper antenatal, intrapartum, and postpartum care.

“If women begin to seek alternative care due to high transportation costs, our maternal mortality rates will undoubtedly rise. While the effects may not be immediately visible, they will become apparent if the current trend continues without intervention.”

Offering recommendations, Okpala stated that the government was aware of the necessary actions to take, as many professionals have provided potential solutions.

He said, “The government has two options: either reinstate the fuel subsidy and tackle corruption or refine our fuel and sell it reasonably. Alternatively, they could establish an affordable public transport system for antenatal mothers, enabling them to attend their appointments.”

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He emphasised that such measures could lead to positive pregnancy outcomes, asserting, “The responsibility lies with the government, not individuals. If they implement these changes, it would help, but I remain sceptical about their willingness to do so.

“Our government travels abroad and observes how things work there. If we can enhance purchasing power, we will access quality care; if purchasing power decreases, the outcomes will suffer.”

He said, “If a person earns N100,000 and that amount remains unchanged over time, their quality of care, as well as the quality of food they can afford, will decline.

“Consequently, the amount they can allocate for healthcare will also decrease. The government knows what needs to be done, but corruption often hinders these efforts.”

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Corroborating Okpala’s statement, a Consultant Obstetrician and Gynaecologist at the Niger Delta University Teaching Hospital in Bayelsa State, Dr Judiet Ugbechie, emphasised that reduced antenatal attendance increases the risk of pregnancy complications.

She noted that higher numbers of antenatal visits are crucial for decreasing the likelihood of stillbirths and improving pregnancy outcomes.

Ugbechie said, “Having eight or more contacts for antenatal care can significantly reduce perinatal deaths compared to having only four visits or none at all.

“A woman’s visit to her antenatal care provider should encompass more than just a routine check-up; it should involve comprehensive care and support throughout the pregnancy.”

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She highlighted that more frequent and higher-quality visits between women and their healthcare providers facilitate the uptake of preventive measures, timely detection of risks, and address health inequalities.

“Antenatal care is particularly vital for first-time mothers, as it sets the foundation for how they will engage with antenatal care in future pregnancies,” she said.

She recommended that pregnant women schedule their first antenatal visit within the first 12 weeks of gestation, followed by subsequent visits at 20, 26, 30, 34, 36, 38, and 40 weeks.

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US Congress Certifies Trump Win Four Years After Capitol Riot

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By Kayode Sanni-Arewa

Donald Trump capped a historic political comeback on Monday as Congress certified his election victory, in a remarkable turn from four years ago, when a mob he had summoned to Washington ransacked the US Capitol.

The president-elect spent much of his campaign facing prosecution over the 2021 insurrection, when his supporters — fueled by his false claims of voter fraud — rioted to halt the certification of his defeat to Joe Biden

But Trump, 78, was voted back into office in November and Monday’s ceremony went much more smoothly, even with a major winter storm blanketing the capital and much of the country in snow.

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“Donald J Trump of the state of Florida, has received 312 votes. Kamala D Harris of the state of California has received 226 votes,” Harris herself declared to assembled lawmakers after the counting was complete.

Harris — who oversaw the certification as part of her vice-presidential duties — said the official count “shall be deemed a sufficient declaration” for Trump and Vice President-elect JD Vance to take their oaths of office on January 20.

The ceremony marked the final blow to efforts to have the Republican leader face justice over the riot, the culmination of a multi-pronged alleged criminal conspiracy that prosecutors said Trump led — before they dropped all charges upon his election.

Trump has vowed to pardon an unspecified number of the rioters — around 900 of whom have admitted federal charges from trespassing and vandalism to assaulting police — describing them as “hostages.”

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In a Washington Post op-ed, Biden slammed Trump’s allies for downplaying the violence of 2021 and urged Americans to be “proud that our democracy withstood this assault.”

“We cannot accept a repeat of what occurred four years ago,” he said. “An unrelenting effort has been underway to rewrite — even erase — the history of that day.”

Indiana conservative Mike Pence had Harris’s job — certifying his own defeat alongside Trump — in 2021 when, in a desperate bid to cling to power, the then-president demanded that he reject Biden’s victory.

Lawmakers in both parties have occasionally used the certification process to challenge elections, but more than half of House Republicans rejected the results in 2021.

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– ‘Emotional trauma’

No Democratic leaders followed the Republican example this time around and there were no objections to certifying Trump’s victory — a process that took barely half an hour.

The former reality TV star was impeached for inciting the 2021 insurrection after delivering a raucous speech outside the White House early in the day, demanding that supporters march on the Capitol and “fight like hell.”

Thousands attacked the citadel of American democracy — battering police with metal bars and flag poles, smashing windows, sending lawmakers running in fear and chanting “Hang Mike Pence!”

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Four people died — two from heart attacks, one from a potential overdose, and a rioter fatally shot by police as she tried to force her way into the House chamber. Four police officers committed suicide subsequently.

Republican Speaker Mike Johnson has vowed to investigate the House committee that probed the riot and found that Trump had instigated it after the failure of a host of other schemes to overturn an election he knew he had lost.

US Attorney General Merrick Garland said in a statement the Justice Department had over the last four years charged more than 1,500 people suspected of involvement in the “unprecedented attack on a cornerstone of our system of government.”

The certification — which launches a two-week countdown towards Trump’s January 20 inauguration — was designated for the first time as a national security special event, with 500 National Guard personnel on standby.

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But the federal government and Washington public schools were closed Monday with up to a foot (30 centimeters) of snow expected.

“Four years ago today, our nation watched in horror as a terrorist mob stormed the Capitol grounds and desecrated our temple of Democracy in a violent attempt to subvert the peaceful transfer of power,” Democrat Nancy Pelosi, who was House speaker at the time of the rebellion, said in a statement.

“The January 6th insurrection shook our Republic to its core — and left behind physical scars and emotional trauma on members of our congressional community and our country that endure to this day.”

AFP

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Senate Sets Jan 31 For Passage of N49.7trn 2025 Budget

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By Kayode Sanni-Arewa

The Chairman of the Senate Committee on Appropriations, Adeola Olamilekan, has affirmed January 31, 2025, as a provisional date for the passage of the 2025 ₦49.7tn budget as the committee prepares to begin budget defence on Tuesday.

He made this disclosure on Monday during a meeting with the chairmen of relevant committees on the template for the 2025 Budget Defence Session to guide the budget process towards its eventual signing into law.

Olamilekan further revealed that upon the resumption of plenary by the 14th of January 2025, the Senate would immediately commence a two-week break for the seamless continuation of the budget defence process.

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He equally revealed a planned retreat on Thursday on the budget consideration which will involve ministries, departments and agencies, civil society organisations, and other stakeholders in the polity for further consultation and insight into the content of the budget proposal

According to the timetable, from the 15th to the 18th of January, it is expected that the committees would report back on their documents, after which collation and tiding of documents by the Appropriation Committee.

Acknowledging the limited timeframe, Olamilekan emphasised the need for lawmakers to intensify their efforts. He also urged his colleagues to forgo their holidays and begin immediate work on the proposed budget estimate, underscoring the importance of timely and efficient handling of the budget process within the stipulated timeframe.

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My life now under heavy threat after my new year message – Obi alleges

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By Kayode Sanni-Arewa

The Labour Party (LP) presidential candidate in the 2023 elections, Peter Obi, has alleged threat to his life following his criticism of President Bola Tinubu’s administration in his new year message.

Obi’s allegation follows a statement credited to the national spokesperson of the All Progressives Congress (APC), Felix Morka, in a recent interview.

Morka was quoted to have said that “Peter Obi has crossed the line so many times and has it coming to him whatever he gets”.

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In his new year press conference on Thursday, Obi had lamented the political, economic and security, healthcare situation in the country.

The former Anambra State governor said that the political, economic and security situation of Nigeria is worsening daily, despite government’s contrary positions and claims of improvement in different spheres of human endeavour.

“Our national challenges are visibly worsening. Our nation and its fortunes are in clear reverse. The indices are clearly indicative of our decline; thus our national indices tell a disconcerting story,” Obi said.

“Nigeria remains one of the poverty capitals of the world, with over 100 million people living in extreme poverty and more than 150 million in multidimensional poverty. The situation has deteriorated significantly over the past 18 months under the current administration.

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“As a nation, we have fallen from being the largest economy in Africa, with a GDP of $574 billion and a per capita income of over $3,500 in 2014, to now ranking fourth on the continent. Our current GDP is less than 50% of what it was a decade ago, standing at approximately $200 billion, with a per capita income of barely $1,000.”

Reacting to Morka’s statement in a post on his X handle on Monday, Obi asked if he has “really crossed the line” after receiving threats against his life, family, and associates following his New Year’s message.

He challenged anyone who thinks he has crossed the line to point it out to him where he did, expressing his commitment to upholding decorum.

The former governor also vowed not to be silenced in his resolve to speak truthfully, especially as the country “drift toward undemocratic practices.”

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His post reads, “I ask the question because my New Year message has now led to threats against my life, my family, and those around me. While I have received all sorts of messages, one Mr. Felix Morka has gone further to accuse me of “crossing the line” and has warned that I will face the consequences.

“If I have truly crossed the line, I invite anyone to point it out, as I remain committed to upholding decorum. However, I will not be silenced in my resolve to speak truthfully, especially as our nation continues to drift toward undemocratic practices.

“We are increasingly transforming into an authoritarian and repressive regime, where freedom of expression is being systematically suppressed. May God help us create a better and freer society for the sake of our children.”

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