For many women in Nigeria, pregnancy and childbirth are like playing Russian roulette. Over the years, governments across all levels have paid lip service to addressing the nation’s high maternal mortality rate. To underscore how dire and unsettling the situation is, expectant mothers in war-ravaged countries like Sudan and Congo have access to better healthcare and medical services.
In 2020, about 82,000 Nigerian women died due to pregnancy-related complications, a minor improvement from the previous year. In 2023, an estimated total of 75,000 Nigerian women died in childbirth. The figure represented 29% of all maternal deaths worldwide.
According to the most recent UN estimates for Nigeria, one in 100 women die in labour or in the following days.
Causes of maternal mortality in Nigeria
According to a study by Open Access Text, an independent open-access scientific publisher, the causes of maternal mortality can be categorised as medical, socio-economic, cultural, behavioural, and political causes.
It stated that 70 per cent of maternal deaths in Nigeria are due to one of five complications: haemorrhage, infection, unsafe abortion, hypertensive diseases of pregnancy such as eclampsia, and obstructed labour. While some of the occurrences are predicted during routine prenatal care, most occur spontaneously without warning signs and constitute high-risk pregnancies
Lack of access to quality healthcare, poor infrastructure, inadequate training of healthcare providers, and socio-cultural beliefs that discourage women from seeking timely medical care also contribute to high maternal mortality rates.
Limited access to health care also contributes to the high maternal death in Nigeria. Many Nigerian women live in areas with limited access to quality healthcare facilities, trained personnel, and essential equipment. These areas, which are mostly rural and remote, are also known to lack quality infrastructure like adequate transportation, communication, and sanitation systems, which hinder access to healthcare services, particularly for women.
On the socio-cultural front, Poverty, gender inequality, and traditional beliefs can limit women’s independence and ability to make informed choices about their health, including family planning and access to care.
Effects of maternal mortality on society
The effects of maternal mortality on socioeconomic development cannot be overemphasised. Maternal mortality, which in most cases is attributed to a low level of socioeconomic status, is also a major factor hindering sustainable development. Maternal mortality remains a major indicator used in measuring the level of development of a society and the performance of the healthcare delivery system.
For a family, the death of the mother often leads to the dissolution or reconstitution of the family/household. For society, it leads to an increase in the number of one-parent households and the number of orphans.
The effect of maternal death can also be felt in the economy. It results in lost productivity of the deceased adult and reduced productivity of the sick and grieving family member and the medical expenses also take a toll on the family.
The way forward and what the government is doing
Except for a few exceptions, successive governments at all levels have not demonstrated the commitment or political will to tackle the high maternal mortality rate, let alone commit resources to the scourge. There are no incentives to address the health challenges and other contributing factors to the unsettling mortality rate because the people who are expected to fix the problems are not affected by it.
The World Health Organization’s recommendation for a functioning healthcare system is one doctor for every 600 people; in Nigeria, the ratio is one for every 4,000-5,000 patients. The federal budget for healthcare in 2024 is 5%, a record high, but far short of the 15% suggested by the UN.
In 2022, there were 121,000 midwives for a population of 218 million and less than half of all births were overseen by a skilled health worker. It is estimated that the country needs 700,000 more nurses and midwives to meet the World Health Organization’s recommended ratio.
There is also an acute shortage of doctors
Nigeria’s federal government currently spends only 5% of its budget on health – well short of the 15% target that the country committed to in a 2001 African Union treaty. This has to change.
Last November, the Nigerian government unveiled the pilot phase of the Maternal Mortality Reduction Innovation Initiative (Mamii). Eventually, this will target 172 local government areas across 33 states, which account for more than half of all childbirth-related deaths in the country.
“We identify each pregnant woman, know where she lives, and support her through pregnancy, childbirth and beyond,” Dr Sandah-Abubakar says.
So far, 400,000 pregnant women in six states have been found in a house-to-house survey, “with details of whether they are attending ante-natal [classes] or not”.
“The plan is to start to link them to services to ensure that they get the care [they need] and that they deliver safely,” Dr Nana Sandah-Abubakar, director of community health services at the country’s National Primary Health Care Development Agency (NPHCDA), said.
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