Growing up in Bunkpurugu is the greatest blessing the Good Lord has given me aside my life and person. Anytime my cognitive processes play back some of the childhood events and I juxtaposed to today’s social environment, I see a real social detachment. One such important remembrance is the issue of childbirth and how we received it, spontaneous joy. It was time to enjoy free and continuous meals for three or four days depending on the sex of the new arrival (neonate). I recall with admiration how I walked with pride into my mother’s room to have a relook at an innocent brother or sister while my peers waited for briefing. Great I felt.
The final arrival of a neonate and the afterbirth churns out spontaneous excitement, and instant disappearance of the labour pain, insults, utterances, anxiety, fatigue, and suspicions. The next chapter is nutritious diet including high protein and vitamin doped combinations organized to go with TZ of millet origin, prepared with support from peers of the post-partum mother. I still imagine that soup –full of pepper, eaten hot, and competed for. Those were the days when Traditional Birth Attendance demonstrated their skill with alacrity.
The expansion of health care facilities including health centres and CHPS compounds have helped to bring health closure to the people. Unfortunately we are battling the available of skill manpower to handle certain specific areas including conducting labour. We have few Midwives who are fast ageing (most have celebrated their 50th anniversary of arriving in this universe).
Child birth which is meant to bring joy to the family and community at large has turn out to be the source of pain and anguish to families of today. The Ministry of Health and its agencies especially the Ghana Health Service continue to promote facility based skilled delivery, because it ensures safety, prevents complication, and ensures early detection of complication, and prompt referral for better care. However, the health care facilities have become detention camps for expectant mothers. Day in and out we hear of mothers and babies being detained at some health facilities for non-payment of bills. The question that a radio serial caller asked recently was-have the hospitals been turn to remand camps? Yes a relevant question that requires public answer.
Indeed, I can’t answer the question myself, especially when I work with the National Health Insurance Authority and also have a solid background in the healthcare delivery industry. The easier answer we often hear has always been attributed to delays or nonpayment of bills by the NHIS. We wake up to newspaper headlines such as; Blind Nursing Mother Detained over GHc40, Despite New Health Scheme New Babies Detained in hospital pending Payment, Korle-Bu Teaching Hospital Detained 12 nursing mothers, and Surfline Communications pay bill of detained medical patients. Meanwhile, under no circumstance should a mother be detained post-partum.
Nonpayment of bills, and detention of the postpartum mothers and neonates; which of them is backed by law? I think none. We have been hit by an outbreak of disrespect for the rules by first the client on one hand, then both the managers of the economy and health care managers. The current operations of the NHIS provides for free registration and immediate benefit of all expectant mothers irrespective of social status. An expectant mother needs to just walk to the NHIS office with proof of pregnancy and you are registered. Further, it accommodates free medical care for expectant mothers and covers the child for the first 90 days of life. It is rather unfortunate that this free service is often not accessed before going for delivery. Fortunately, the operations allow for emergencies to be treated which includes labour/delivery.
Health care providers are well aware since 2008 that government had implemented free maternal health care for all expectant mothers to support the achievement of MDG 4&5. Fortunately most NHIS offices are close to the health care facilities especially the public and CHAG health facilities. So why detain somebody for performing her biological duties as ascribed in the Holy Book. We as health workers are repeating what happened during the Fee for Services regime of the 1990s. We had exemptions for children under five years and pregnant women as well. However there was conspicuous disrespect for the policy where those vulnerable groups were charged to pay and yet claims were forwarded to ministry of health for payment.
Anytime I hear or read about mothers being detained, the first suspicion is that the managers of the finances of the state might not be sharing in the President’s vision of improving Maternal and child health. If I am wrong, why will we detain mothers after delivery when funds have been earmarked for that? How can we dare to call that prudent financial management? Yes there will always be delays in payment as the disease burden does not respect the state of revenue generation in the country, but that is the more reason we should priortise maternal and child care especially delivery and its associated challenges for we call that cohort the Vulnerable group.
Mothers who are only responding to their biological duties including childbirth should not be made to suffer because the Ministries of Finance and Health have not performed their duties of making funds available. It is the children we deliver who will bring in future revenue. Civil society organizations and especially human rights groups should not occlude their visions to such abuses. This illegal detentions must stop. Hospitals are not detention centres, but rather healthcare given facilities.