The United States Agency for International Development (USAID) disclosed recently that about 35,000 Nigerian women died during childbirth in 2014, accounting for 13 per cent of the global maternal deaths. This statistics tally with that of other agencies which have raised alarm over the high maternal mortality ratio (MMR) in the country. The MMR is the indicator used in measuring the number of women who die during pregnancy, childbirth and within 42 days after childbirth per 100,000.
The Nigerian Demographic Health Survey (2013), which was published in June 2014, indicates an MMR of 576 deaths per 100,000 live births in 2013 while the World Health Organisation (WHO), in its 2014 report on maternal mortality, put Nigeria’s MMR at 560 deaths per 100,000 live births. The United Nations Children’s Fund (UNICEF) had earlier said about 145 women of childbearing age die in Nigeria every day, adding that Nigeria is the second largest contributor to maternal mortality rate in the world.
We consider these statistics outrageous and unacceptable. Over 80 per cent of maternal mortality in the country have been attributed to conditions such as haemorrhage, malaria, pregnancy- induced high blood pressure, eclampsia, HIV/AIDS, diabetes, and unsafe abortion; deaths from all these are preventable with proper healthcare, skilled supervision and interventions for preventing or treating complications that could arise during pregnancy, at childbirth or after. So it beats our imagination that maternal mortality is still a burden.
For a country that has only two per cent of the world’s population, accounting for 13 per cent of the global maternal deaths is mind-boggling. What this means is that Nigeria is still far from meeting the Millennium Development Goal five which targets a 75 per cent reduction in maternal health and attainment of universal access to reproductive health by 2015. For Nigeria to achieve this target, her MMR must be less than 250 women per 100,000 live births as against the current 576 with only a few months to the end of 2015.
Since it is obvious we cannot meet the MDG goal on maternal mortality, we recommend that governments at all levels should set new achievable targets and adopt drastic measures to achieve result. A good starting point in this post-2015 campaign to curb maternal mortality should be to bringing healthcare closer to the people. It is instructive to note that at least two-thirds of maternal deaths in Nigeria occur outside a health facility mainly due to lack of access to healthcare facilities and resources. Women residing in some rural communities have to travel on bad roads several kilometres in search of maternity clinics or hospitals. Confronted with these challenges, most of them are made to give birth in their homes with the assistance of untrained traditional birth attendants, thus endangering the lives of such women and their unborn babies.
Since maternal related deaths are preponderant among low income and rural dwellers, government must devote substantial resources towards ensuring unhindered access to adequate and affordable quality healthcare and training of skilled community-based birth attendants to increase maternal coverage in areas required. The provision of non-medical interventions such as physical infrastructure, improvement in women education and empowerment should also be considered.
One crucial factor that should also be addressed is the entrenched traditional and cultural practices which contribute to maternal mortality. For instance studies have shown that a significant percentage of maternal deaths in the country are among teenage mothers and this is not surprising as Nigeria has one of the highest child marriage prevalence rates in the world. Some other long-held beliefs prevent women from attending ante-natal clinics or adopting family planning. All these should be dealt with as they are borne out of ignorance. In tackling these, the involvement of the traditional, community and religious leadership in various communities is imperative.
High mortality in a country is a strong index of poverty. With Nigeria’s status as the largest economy in Africa, one of the fastest growing in the world and a major oil producing country, it is shameful that her citizens do not have access to basic healthcare. We therefore urge government to deploy resources in addressing maternal mortality in the country. We also call on Nigerians to be vigilant to prevent criminal diversion of funds meant for the development of healthcare system in the country if our target of curbing maternal mortality is to be achieved.
The health conditions of women through which society is constantly regenerated should not be toyed with in any way. Therefore, there should be a conscientious planning and execution of programmes as well as multi-level collaboration in dealing with the problem of maternal mortality. We believe that there is need for a complete overhaul of the nation’s healthcare delivery system to enable women have access to skilled healthcare before, during and after they give birth. This will go a long way in curbing the unacceptably high rate of maternal mortality.