Blessing Taiwo is a first-time mother who has never experienced pregnancy before. Like many women, she had heard several frightening stories of mothers who died after childbirth due to complications and inadequate care. Determined not to become part of such statistics, she began making enquiries about the cost of antenatal care in her neighbourhood a few months after her marriage.
The first hospital she visited presented her with a bill of ₦200,000 for five to seven antenatal visits. The second facility, located close to the first, quoted an even higher amount of ₦250,000.
“It is unimaginable that the cost of antenatal care could be this high,” Taiwo said to herself as she took the bills home for discussion with her husband.
Essence of antenatal care
The United Nations Children’s Fund (UNICEF) describes antenatal care as a form of preventive care in which pregnant women receive social, emotional and psychological support at this critical period in their lives.
Yet, access remains uneven. Sub-Saharan Africa continues to record low levels of antenatal coverage, with many women unable to complete the minimum recommended visits, while a significant proportion receive no care at all.
Antenatal care affords pregnant women access to micronutrient supplementation and treatment for hypertension to prevent eclampsia, as well as immunisation against tetanus. It also helps prevent mother-to-child transmission of HIV through the provision of HIV testing and medication.
In malaria-endemic areas, health personnel can provide pregnant women with medications and insecticide-treated mosquito nets to help prevent this debilitating and sometimes deadly disease.
Maternal deaths and limited access
Inaccessible antenatal care has been attributed to the increase in maternal deaths in Sub-Saharan Africa, as records show that many pregnant women die as a result of complications during and after pregnancy and childbirth.
The World Health Organisation (WHO), in a recent update, stated that over 90 per cent of all maternal deaths occurred in low- and lower-middle-income countries in 2023, a category in which Nigeria falls, with most of the complications both preventable and treatable.
Some of the issues linked to maternal mortality, according to the WHO, include severe postpartum haemorrhage, infections – usually after childbirth – pre-eclampsia and eclampsia, complications during delivery, and unsafe abortion, among others.
The apex health agency’s statistics indicate that a maternal death occurred almost every two minutes in 2023, while over 700 women died daily from preventable causes related to pregnancy and childbirth.
Affordable care through Ilera Eko
However, to reduce the high burden of maternal and child mortality, the WHO some years ago adopted the focused antenatal care model, which recommends a minimum of four antenatal visits during pregnancy. For many women, however, meeting this requirement remains difficult due to financial constraints.
While her husband was still contemplating which hospital to settle for, a neighbour fortunately introduced Taiwo to the idea of health insurance, explaining the benefits she could derive as a newly married woman. She then began searching for health insurance schemes available in her vicinity and came across the Lagos State Social Health Insurance Scheme, popularly known as Ilera Eko.
After obtaining detailed information about the provisions of the scheme, her family decided to subscribe to the Standard Jaara plan, which offers five antenatal visits along with other medical services for just ₦ 55,000, instead of the ₦250,000 she had initially been quoted by the private hospital.
“Although it was my first pregnancy, the information and care I received from the clinics each time I visited made the journey easier for me, as it gave me access to doctors and midwives for consultation and guidance on issues I was not clear about during the period,” Taiwo narrated.
She eventually had a safe and successful delivery, giving birth to a healthy baby boy without any complications.
Benefits for mothers and newborns
The Permanent Secretary of the Lagos State Health Management Agency (LASHMA), Dr Emmanuella Zamba, in an exclusive interview with Pharmanews, further highlighted the benefits of the Lagos State Health Insurance Scheme for mothers and their babies.
She noted that the scheme prioritises the health of mothers and babies through a robust package.
“So, you can even have your caesarean section free, which we know normally costs up to ₦500,000 or ₦1 million, depending on the facility. These services are heavily subsidised by the plan. Once you subscribe, it definitely helps families,” she said.
“One of the things we have also introduced is that a woman must have attended antenatal care for at least five months. This helps us identify high-risk mothers early and allows doctors to monitor them properly. In the end, it improves health outcomes in terms of having healthy babies and healthy mothers.”
The LASHMA chief urged Lagos residents to take advantage of the scheme to better protect their families.
“This will allow you to send your children to better schools, build a house, buy a car, and improve your quality of life. If you leave your family’s health to chance, it can impoverish your household overnight,” she warned.
Reflecting on her experience, Taiwo concluded: “I will confidently recommend the health insurance scheme to every pregnant woman. I am a bona fide enrollee who has experienced the quality antenatal care needed to reduce maternal and child mortality in the country.”
