Inaugural lecture: Gynaecologist calls for new-born genotype screening

Prof. Afolabi

Amid statistics showing that one out of four Nigerians has the sickle cell traits, a professor of obstetrics and gynaecology, Abosede Afolabi, has called on the government to formulate a policy on universal new-born screening to enable everyone know their genotype within few weeks of birth.

Delivering her inaugural lecture recently at the University of Lagos, Akoka, Prof. Afolabi disclosed that many people are not aware of their status. According to her, a policy that ensures that people get screened as early as possible would create awareness on their sickle cell status so that they know and prepare their minds on how to further prevent the situation from escalating.

“If they are aware and decide to carry on a relationship with another person with the sickle cell trait, then at least they do so with the knowledge of the consequence and can plan for it.

“The government also needs to commit more resources to the care of people with this disorder by contributing to research and counselling and subsidising their health care expenses. This will drastically reduce the rate of maternal mortality in our country”, she said.

Afolabi in the Inaugural lecture, titled ‘Maternal Medicine; Journeys of Women in Pregnancy, Delivery and Sickle Cell Disease’ also listed factors affecting maternal mortality in the country and why it has been on the increase especially in case of people with sickle cell disorder.

These, she said, include diabetes in pregnancy, hypertension and preeclampsia, poor nutrition during pregnancy, bacterial vaginosis, and the painful consequences of women that have gone through the abhorring tradition of circumcision.

The 49 year old professor further explained that the need to drastically subsidize or even make free, antenatal and delivery health care to all is quintessential in eradicating maternal mortality.

“It is important to ensure skilled health care in pregnancy and delivery for all women by removing the barrier of cost and allowing free antenatal and delivery care for all women, either by taxing specific consumer item or by developing a mobile phone subscription based community health insurance.

“It is to make maternal health care free and this has been attempted and shown to work in Ondo state where they met the millennium Development Goal for the reduction of maternal mortality”.

She further emphasised the need for more hands to be on deck on the long aged barbaric issue of Female genital mutilation/cutting which is still prevalent in Nigeria till date. According to her, Yoruba women are reported to have the highest prevalence of female circumcision, followed by Igbo women while Osun state has the highest prevalence state in the country.

“Unlike the male circumcision, it has no medical benefit whatsoever but instead, it leads to a high incidence of complications ranging from life threatening bleedings and severe infections in the immediate period, to infertility, obstructed labour and maternal mortality in the long term.

“The reduction or lack of sexual pleasure the women are also predisposed to depending on the type of circumcision, is often ignored since we like to pretend that this aspect of life is unimportant, especially for women. On the contrary, it is very important as the derivation of sexual satisfaction denies women of their right to sexual health and psychophysical wellbeing, a fundamental art if sexual and reproductive health rights”.

“So this is a clarion call to all to help stop this abhorring act and if you know anyone still in the practice, you should help stop it.”

Afolabi also advocated the need for proper nutrition during pregnancy and stressed its importance on both the mother and child. According to her the rate of insufficiency of vitamin D, for instance, in mothers and their babies is alarmingly low despite our climate.

“Even in some mothers with some level of the vitamins, there was a challenge in transferring the vitamin D to the foetus thereby creating even more deficiency of the vitamin for the unborn child which is why some children are born with rickets and asthma”.

Afolabi also advised individuals in the reproductive age who are not ready for childbirth to embrace the family planning arrangement.

“All women and men of reproductive age should avail themselves of contraception and reduce maternal death. Limiting pregnancy also reduces deaths from pregnancy generally, as a maternal death can only occur if a woman gets pregnant.”

Prof. Afolabi’s lecture is the 4th inaugural lecture of the department of Obstetrics and Gynaecology and 341st in the University of Lagos.