NIGERIA
Attending a landmark conference on women held in Beijing, China, in 1995 led Professor Friday Ebhodaghe Okonofua, one of Africa’s top obstetrician-gynaecologists and secretary-general of the African Academy of Sciences (AAS), to a lifetime dedicated to reducing maternal mortality and advancing reproductive health policies in Africa.
That dedication culminated in the Nigerian scientist’s recent induction into the United States National Academy of Medicine. Okonofua teaches as professor emeritus of obstetrics and gynaecology at the University of Benin in southern Nigeria.
He holds a PhD in public health from Karolinska Institutet (Karolinska Institute) in Sweden, and he reviews for 20 international journals (including the British Journal of Obstetrics and Gynaecology). He is editor-in-chief of the African Journal of Reproductive Health.
Okonofua’s research has had far-reaching impact, leading to policy reforms in several African countries as well as setting the agenda of international agencies such as the World Health Organization and the United Nations Population Fund.
University World News interviewed the public health expert about his life, work and the many hats he wears.
UWN: What was your childhood like?
FEO: I was born into a not very well-endowed family. My parents were both farmers. I was the only son and had one sister. I remember very well that, despite the economic challenges we faced, my parents were determined to give me the highest level of education anyone could get.
My father didn’t go to school, but he repeatedly told me that he would ensure I got the education he did not have. So, everything he did at that time was aimed at giving me an outstanding education. I went to the best schools, primary, secondary, and university – all in Nigeria – and the fact that my parents were committed motivated me. I ate the best food, and I played the best games. I grew up in the village of Eko-Ewu, a rural community in the Esan Local Government Area of Edo State, Nigeria.
UWN: Why did you decide to become an obstetrician-gynaecologist?
FEO: I loved my mother so dearly that one of the things that I was afraid of when I was growing up was that she could die. That was the reason I decided to become a doctor: to learn how to support her medically. She was never ill; she lived 90 years, but I just had this mortal fear. I felt that, without her, life would be meaningless.
I started school early, and I was in primary school when she told me that she wanted me to be a doctor. I was four or five years old. She repeatedly said that she wanted me to be a doctor because the doctor who delivered me, Christopher Okojie, made a great impression on her.
UWN: Please elaborate on your laboratory research interests.
FEO: My research interests are focused on women’s reproductive health. Shortly after I qualified as an obstetrician and gynaecologist, the ICPD (International Conference on Population and Development) took place in Cairo, Egypt, followed by the World Conference on Women in Beijing in 1995.
The Ford Foundation sponsored my attendance at the Beijing conference. I delivered two papers at that conference: one on the inequities and adverse social consequences that women face when they are infertile, and the second on the social and clinical implications of induced abortion in Nigeria. Both papers guided the discussion at the Beijing conference. I was one of the participants who contributed significantly, drawing on my experience in the health sector.
So, that led me to form the Women’s Health & Action Research Centre (WHARC), an idea I conceived on my way back from the Beijing conference, in collaboration with a British lady who sat next to me. WHARC was founded with funding from the Ford Foundation and technical and collaborative support from the Harvard School of Public Health.
In 1997, I established the African Journal of Reproductive Health, now rated as the best journal in reproductive sciences published from the African region. The journal is published monthly and is used as a research and policy document by students worldwide, as well as by scientists, students, and policymakers from all African countries.
UWN: Given your active involvement in clinical practice and academic research, as well as teaching and training, what aspects do you find most rewarding?
FEO: I could say that I was well integrated in clinical service delivery, teaching and research. I love research and teaching a lot because of my desire to use the results of my research to teach students and to encourage them to think creatively about issues linked to the lines of research we had established.
I continue to mentor many students in research areas. Research is my most endearing part because, through research, I’m able to teach and mentor successive generations of students in research, publications, grant writing and innovation. I continue to do research. I belong to several international research networks, various think tanks focused on women’s reproductive health, and several international advisory bodies.
UWN: What is the most critical issue facing the field of obstetrics and gynaecology in Africa today?
FEO: Traditionally, we have talked about women who die during childbirth as an exclusively African problem – 70% of nearly 200,000 women who die from pregnancy and birth in the world today come from Africa. We also have additional issues – most importantly, the less-than-favourable circumstances under which women in Africa deliver. This is exacerbated by the increasing rates of poverty on the continent, which primarily affect women.
Added to this are the harmful cultural and religious beliefs and practices that prevent women from accessing available services. These are the most critical challenges in obstetrics and gynaecology in our region today. Climate change and its challenges also impact women.
UWN: You established the Women’s Health and Action Research Centre in 1995. What were your goals at the time, and to what extent have they been fulfilled?
FEO: On my way to the Beijing conference in 1995, I was the only man on a plane filled with women. The discussions and debates at the conference highly motivated me, and I became sensitive to the social challenges that African women faced.
In many ways, WHARC’s key objectives have been achieved. Our numerous research-based publications and the African Journal of Reproductive Health have led to a better understanding of reproductive health and the uptake of its principles throughout the African continent.
WHARC led the founding of the African Centre of Excellence in Reproductive Health Innovation (CERHI) at the University of Benin in Nigeria, funded by the World Bank, through which numerous PhD and masters degree candidates from several African countries have been trained.
UWN: You were once an adviser to former president Olusegun Obasanjo. What advice did you give him about research and training, and was the advice heeded?
FEO: Indeed, President Olusegun Obasanjo was a great and visionary leader and working with him was a great lesson and pleasure for me. When I became the adviser, Obasanjo asked me to conduct a study to determine why only about 10% of Nigerian women received delivery care. In the short study, which included convening a multi-stakeholder meeting, I reported that one of the major reasons was the inability of poor women to pay for maternity services.
He then made the resources available for travel to the 36 states in the country to conduct advocacy activities to encourage state governors to offer free maternal and child health services.
Eventually, 18 governors agreed to provide free maternal and child health services in their states, an outcome which I reported in the health policy journal. The second achievement was the rural midwifery services scheme, which I advised Obasanjo to establish to promote women’s access to maternity care in rural communities.
UWN: How do you relax in your free time?
FEO: I used to play football. I’m a football analyst and pundit, both on Facebook, other social media, and television. The main sport I do today, which I love, is swimming. I’m also a vegetable farmer. I grow spinach, tomatoes, bell peppers, cassava, okra, sweet potatoes, bananas and plantain. I also have an orchard where I harvest avocados, African black pears, oranges, mangoes and jugga nuts.
Most of the vegetables I eat, I produce myself. There is a better way to eat the right food, other than some genetically engineered produce.
UWN: You were inducted into the National Academy of Medicine of the United States of America. Can we say life has come full circle for you?
FEO: I think, in my own way, it has motivated me. I recognise that this was a fierce competition. Being recognised brings a lot of joy and shows me that if you continue to work hard, regardless of where you are, you will get the honour you deserve.
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