Reducing maternal mortality in Nigeria
As the 2015 target date draws nearer, Nigeria is still not listed among the 10 countries seen to have made rapid progress to meet the goals. The World Health Organisation (WHO) says: “Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. “While motherhood is often a positive and fulfilling […]
As the 2015 target date draws nearer, Nigeria is still not listed among the 10 countries seen to have made rapid progress to meet the goals.
The World Health Organisation (WHO) says: “Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period.
“While motherhood is often a positive and fulfilling experience, for too many women, it is associated with suffering, ill-health and even death.
The WHO defines a maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes”.
It adds that maternal death or maternal mortality also referred to as “obstetrical death” is the death of a woman during or shortly after a pregnancy.
Mr Olu Fatile, a Clinical Nurse with the Planned Parenthood Federation of Nigeria (PPFN) in Lagos, adds: “infant mortality is the number of children dying under a year of life per 1000 live births”.
According to Who, the major direct causes of maternal morbidity and mortality include: haemorrhage, infections, high blood pressure, unsafe abortion and obstructed labour.
WHO is also blaming “bacterial infection, variants of gestational hypertension — including pre-eclampsia and HELLP syndrome, obstetrical hemorrhage, ectopic pregnancy, puerperal sepsis (childbed fever), amniotic fluid embolism, and complications of unsafe or unsanitary abortions”.
In 2000, the United Nations put global maternal mortality at 529,000. Less than 1 per cent of this occurred in the developed world, showing that most of these deaths are medically preventable.
Reducing maternal mortality by three quarters between 1990 and 2015 is a specific part of Goal 5 of the MDGs.
WHO says over 90 per cent of maternal deaths occur in developing countries, while 45 per cent of postpartum deaths occur within 24 hours of delivery.
Medical experts have also identified malaria in pregnancy as a contributor to increasing maternal mortality.
According to experts, Malaria infection in pregnant women leads to increased morbidity and mortality and the delivery of premature infants with low birth weights due to intrauterine growth retardation that may have been as a result of placental parasitisation.
Malaria, they say, also contributes to mental anaemia (shortage of blood in the brain) and other implications such as abortion, stillbirth and pre-term delivery.
“At present, Nigeria ranks as one of the 13 countries in the world with the highest maternal mortality ratio (MMR),” “Media Partnership for (MP4) Women and Children”, a publication on unreported development in maternal, newborn and children health in Nigeria, reported in its May-July 2009 edition.
Toward arresting this worrisome development, governments at the three tiers and various non-governmental organisations (NGOs) have set machineries in motion.
Recently, a workshop on “Nigerian NGOs Workshop: Toward a Consolidated Role as Maternal, Newborn and Child Health advocates” was held in Abuja as one of such intervention programmes.
It was organised by ACCESS (Access to Clinical and Community Maternal, Neonatal and Women’s Health Services) and JHPIEGO (John Hopkins Programme for International Education in Gynaecology and Obstetrics), in partnership with the Nigerian Government.
It afforded experts the opportunity to brainstorm on best strategies to address the issue of maternal mortality.
They agreed that the nation’s primary health services must be improved upon in that “once there are adequate and well equipped primary health centres across the country, maternal mortality and child health issues will be a walkover”.
The workshop called for adequate funding of the health sector and the harmonisation of health programmes by all tiers of government.
Mrs Oluwatoyin Saraki, Wife of Kwara State Governor, urged NGOs at the state level to work closely with wives of the governors to confront the menace.
“It takes passion and commitment to fight this menace. There is need for Nigeria to have a home grown donor agency where funds are made available, devoid of international agencies all the time,” she added.
In the same vein, Gov. Mahmuda Shinkafi of Zamfara recently expressed worry over the increasing rate of maternal and child mortality in Northern Nigeria.
Shinkafi, speaking at a three-day retreat on leadership development in reproductive health in Gusau, said the region was still leading on the table of maternal and child mortality rate.
According to him, it is worrisome to note that statistics available had shown that the North-West has the highest maternal mortality rate, closely trailed by the North-East.
Shinkafi urged local governments, being the closest to the grassroots, to double their efforts on awareness campaigns and increase funding of primary healthcare facilities to reverse the trend.
On its part, the Kaduna State Government recently commenced the distribution of drugs worth N239.9 million — under its free medical programme — to children and pregnant women. The gesture is to curb high maternal and infant mortality.
Dr Peter Everton-Yari, Kaduna State Commissioner for Health, said the drugs were customised with the picture of Gov. Namadi Sambo, map and symbol of the state, to check abuse and pilferage.
He said they would be given free to pregnant women and children below the age of five, through public health institutions.
“The primary objective is to reduce maternal and child mortality rate in our state and it is part of Gov. Namadi’s electoral pledges”, the commissioner said.
Everton-Yari explained that over 960,000 pregnant women and 1.4 million children benefited from the pilot scheme of the programme earlier in July.
He said items given free included: treated mosquito nets, vector chemicals, anti-septics, sanitary pads, cotton wools, needles, syringes and detergents.
Similarly, the Chairman, Coalition of Civil Society Organisations in Yobe, Malam Musa Mohammed, said the European Union (EU), 20 NGOs and Civil Society Organisations, were set to fight maternal and infant mortality in the state.
Mohammed spoke in Damaturu, added that the coalition was prepared to carry out different projects including HIV/AIDS and poverty reduction.
Also, recently, Nigerian journalists at a two-day capacity building training programme, organised by Development Communications Networks (DEVCOMS), in Lagos, decried the persisting high maternal and child mortality in Nigeria.
The journalists mourned the state of neglect of the nation’s health institutions and urged government at all tiers to buckle up.
They called on the government to create more awareness about maternal and child health, saying this would tackle the issue of ignorance that had been a major challenge to healthcare delivery.
Similarly, Development Communications (DEVCOMS) Network, an NGO on maternal and child health issues in Nigeria, is set to provide grants to the best investigative reports on maternal, newborn and child health.
Mr Akin Jimoh, DEVCOMS Network Programme Director, said the initiative was in collaboration with The Well-Being Foundation (WBF), who will give awards to the most outstanding set of stories on maternal, newborn and child health.
The grant, worth N75,000, is field trip funding for unreported or ongoing investigative stories on the issue. It is to encourage journalists to report health related issues.
Apart from realising that maternal mortality remains a problem in Nigeria, the relevant bodies – from government, through to NGOs and corporate organisations — are aware that it needs to be tackled headlong.
Experts call for adequate use of family planning methods to ensure effective child spacing.
They also want legislation to discourage early marriage as it is known to have contributed immensely to high maternal and child mortality in Nigeria.
Poverty means undernourishment in a pregnant woman that needs to be well fed because of her delicate condition.
In the final analysis, observers and analysts believe that Nigeria can meet the objectives of MDGs 4 and 5 before 2015, if the government at all tiers, exercise the needed political will to give health care facilities the desired priority attention. (NANFeatures)