Abstract
This chapter examines the use of indigenous languages during antenatal care (ANC) sessions among mothers in Lagos state. Authors investigate factors that influence the use of indigenous languages, the most preferred mode of presentation, and how the languages affect reception, participation, and knowledge of mothers on safe motherhood practices. Using in-depth interviews with nurses and observations during the ANC sessions, the study found that indigenous languages engender participation and are effective in building self-esteem, trust, and confidence of mothers. Songs in the indigenous language, particularly Yoruba language, help mothers retain and recall safe motherhood messages easily. Mothers generally demonstrate their understanding during the question and answer sessions, while also serving as agents of information reinforcement among themselves using indigenous languages. In view of the occasional need for interpreters, the study recommends that health workers should be encouraged to take courses in indigenous languages within their region as a second language.
TopIntroduction
Since the 1990’s, Nigeria has made efforts and recorded some progress at reducing maternal and child mortality. Nigeria’s Maternal Mortality Ratio dropped from 1,200 deaths in 1990 to 540 deaths in 2013 per 100,000 live births. Similarly, under five Mortality Ratio dropped from 191 deaths in 1990 to 94 deaths in 2012 per 1,000 live births. Despite this progress, Nigeria still occupies the unenviable position as a leading contributor to the regional and global burden of women and children’s death. Furthermore, child survival in Nigeria is threatened largely by nutritional deficiencies and illnesses, particularly malaria, diarrheal diseases, acute respiratory infections (ARI), and vaccine-preventable diseases (VPD), which account for the majority of morbidity and mortality in childhood (Society for Family Health, 2019).
In its bid to address this challenge, the Lagos State Government in 2008 inaugurated a committee to offer technical guidance on the various modalities needed for the reduction of the maternal mortality. The committee recommended a 5-year work-plan developed for the implementation of the Maternal and Child Mortality Reduction Programme (MCMR) to reduce the maternal and child mortality rates in line with the United Nations Millennium Development Goals 4, 5 and 6. An earlier study in the state gave the maternal mortality ratio in Lagos State as 555/100,000 live births. This figure was higher than the national average of 545/100,000 live births (Lagos State Ministry of Health, 2017). Hence, critical to safe motherhood is effective health communication, particularly during antenatal care sessions.
According to the World Health Organisation (2016), antenatal care (ANC) is the care provided by skilled health-care professionals to pregnant women and adolescent girls in order to ensure the best health conditions for both mother and baby during pregnancy. At the ANC, pregnant women want to have a “positive pregnancy experience”. A positive pregnancy experience is defined as maintaining physical and sociocultural normality; maintaining a healthy pregnancy for mother and baby (including preventing and treating risks, illness and death); having an effective transition to positive labour and birth; and achieving positive motherhood (including maternal self-esteem, competence and autonomy). To achieve these, the midwives check the health of the pregnant mother and the baby; give the pregnant mother useful information to help her have a healthy pregnancy, including advice about healthy eating and exercise; discuss options and choices for care during pregnancy, labour and birth; and answer any other question which the pregnant mother may have. Thus, the components of ANC include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. (WHO, 2016; NHS, 2017)
Consequently, miscommunication in this regard can be life threatening. Essentially, effective health communication remains significant in mitigating mother and child morbidity and mortality because mothers must be able to understand what is being communicated. Amuseghan, Ayenigbara and Orimogunje (2010) agree that health communication has developed to turn its focus on enabling informed individual choice and reduce miscommunication or misrepresentation that could lead to morbidity or fatality. The need for such intervention crystallises the need to communicate in a language that would be easily understood by the mothers.
In agreement, Flood and Rohloff (2018) note that language is a key feature of models of health that is used by the indigenous people themselves. More so, global health programmes conceived and delivered using indigenous languages are likely to be successful. As an intervention, Mphasha and Lebese (2017) state that tackling health issues with the languages that people understand is essential in improving the lives and prospects of the people. In addition, Amery (2017) notes that “miscommunication is not just about languages, some of these difficulties also arise from the interface of communication and culture which are often derived from differences in world view”. In effect, it is all about the totality of the presentations and approaches to how such indigenous languages are used by the health care providers when engaging with the mothers during antenatal services.
Key Terms in this Chapter
Safe Motherhood: These are all activities, programmes, campaign and communication purposely designed to provide mothers with relevant information to guide them before pregnancy, during pregnancy and after childbirth and ensure the safety of the mother and child. They are all clinical activities and programmes targeted at reducing maternal and child morbidity and mortality in society.
Health Communication: All forms of messages, written, verbal or visual that are deliberately designed to influence and stimulate behaviours that will enhance healthy living and conditions in a society.
Health Literacy: It is the basic and extensive knowledge acquired by an individual on matters relating to healthy behaviours, making positive health choices and engendering healthy living.
Pre/Antenatal Care: The care given to pregnant women during pregnancy by health care providers at a recognised health centre. It involves giving routine health talks, information, guidance and conducting routine health checks on the pregnant women to ensure that the mother and the unborn child are in good health, and mitigate or reduce potential medical challenges that may impede safe delivery for the mother and child.
Yoruba: A common indigenous language originally spoken by people living in south-west Nigeria.
Primary Healthcare Centres: These are healthcare facilities provided by the state and federal government to cater and provide quick and easy access to healthcare services for people at the grassroots.
Postnatal Care: It is the continuation of care given to pregnant women from pregnancy up until the first eight weeks after childbirth.
Child Mortality: This refers to the state of death of a child, which may be caused by an illness, lack or poor pre/postnatal care, a congenital condition or an accident.
Child Morbidity: This refers to the state of illness in a child, which may be due to lack or poor pre/postnatal care, a congenital condition or an accident.
Information Reinforcement: The process of sharing and strengthening health information among individuals to facilitate positive health decisions.
Nursing Mother: A woman who is breastfeeding a day to two-year old child, although such care may extend beyond two years in certain conditions.
Public Health: The organized efforts to achieve wellbeing among the people by promoting healthy living through health education and literacy largely facilitated by government regulations and policies.