Maternal mortality is defined as the number of women who die from pregnancy-related conditions during pregnancy or most often within 42 days of ending a pregnancy. And this health experts say includes incidental causes. Maternal Mortality often depicts the health status of a community or a nation. It basically has a direct correlation.
According to a report from the World Health Organisation (WHO), approximately 830 women die from preventable causes related to pregnancy and childbirth every day and a high percentage of all maternal deaths occur in developing countries, including Nigeria. It is indeed worrisome that the rate in Nigeria, according to WHO statistics in 2015, stands at about 814 per 100,000 pregnancies. Most health experts have lamented that Nigeria’s current statistics of very high deaths per year during childbirth is indicative of inherent lapses in the critical aspects of the healthcare delivery system of the country.
In some Scandinavian countries like Norway, Denmark and Sweden, the rate is about less than 10 per 100,000. So the trend in Nigeria is indeed alarming. Even though, there are some areas in the country where the maternal mortality rate seems to be diminishing, however, in general the situation raises serious concerns.
Some of the main causes of high deaths or child mortality in Nigeria have been attributed to illiteracy, and other related problems.
“We have issues of haemorrhage, sepsis and infections like HIV and AIDS. Of course, there are other common problems such as cases of high blood pressure during pregnancy and incidental causes such as road traffic accidents. Other factors that are related include poverty, unorthodox beliefs and cultural practices including religion, ignorance, inappropriate nutrition and accessibility to good facility including good road or waterways transportation during emergencies” said Prof. Akin Bamigboye, a Lagos-based specialist Gynaecologist and Obstetrician.
Recent studies have revealed that, a Nigerian woman faces a one in 24 chances of dying from complications arising from pregnancy or childbirth. And even more specific representation is provided by the United Nations Children’s Emergency Fund (UNICEF). The reports states that “every single day, Nigeria loses about 2,300 children under five, and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.
Yet, even though a considerable amount of efforts have been expended by the government in some states in the country especially in respect to the improvement and availability of skilled birth attendant. However, the impact of the insurgency in the north-east is an issue. Also, the economic downturn in the country has impacted on this as well. Health experts are of the view that the current government actions which are not enough especially to meet the Millennium Development Goal 4 (MDG) – to reduce child mortality by two-third by 2015 which has since elapsed calls for more concerns.
While Prof. Bamigboye insists that some states in the country have improved on the availability and training of birth attendants, more still needs to be done. “Take for instance, the case of Ondo State where the traditional unskilled birth attendants have been offered free training in different areas of their choice as incentive to give up the trade. They have a health policy called “Tracking”, which they use to monitor pregnant women in the state by provision of mobile communication to all pregnant women. They monitor the woman during pregnancy and after child delivery.
And in case of an emergency, the health care services can get to them on time. There is also free medical care given to the women during pregnancy and after child delivery. This has really helped to reduce the maternal mortality in the state. So, I think that this model in Ondo State can be adopted across Nigeria”.
Basically, three major challenges have been identified to enable the country surmount the problem. They include availability of quality service, accessibility to that service and affordability of the service. Again, the government and stakeholders have been urged to address the poor access to health facilities, poverty, illiteracy and unwillingness of pregnant women to access healthcare services.
Furthermore, providing greater access to healthcare, building the capacity of health care workers, as well as ensuring that other measures are put in place by government and stakeholders to educate families on what best to do during pregnancy, childbirth and caring for infants and children under age five is also of paramount importance.
It is worthy of note that budgetary allocation set aside by successive administrations for healthcare services in Nigeria have been criticised by stakeholders for being inadequate. In other developed countries, governments commit a huge chunk of their budgetary allocations to the health sector. In some countries like South-Africa, the governments allocate 15% or more of their national budgets to health. However, this is not the case in Nigeria.
Indeed, while most of the vulnerable women are poor and disadvantaged, their deaths have been often ignored. Reports reveal that they happen every day, which ordinarily should make the country scale up interventions to achieve the targets of reducing maternal and mortality rates.
Another issue has to do with family planning. Studies have revealed that closely spaced pregnancies is one of the greatest factors in both maternal and especially child deaths, regardless of whether a woman has access to healthcare. Recent reports have shown that only 6% of women use modern methods of contraception in developing countries, according to Save the Children. In some parts of Africa like Congo, birth control has become more widely available and more widely used. This practice can be employed in Nigeria, health experts say.