Framework to Combat Maternal Mortality


Maternal mortality rate remains high in the country, but the stakeholders in the health industry are not giving up to redress the situation

|  By Chinwe Okafor  |  Aug. 26, 2013 @ 01:00 GMT

EARLY this year, the whole Nollywood industry was thrown into mourning when one of the stars died suddenly. Bisi Komolafe, a popular Nollywood actress, died on January 1, of complications arising from a miscarriage of a pregnancy. Before the sad incident, the actress was on admission at the University College Hospital in Ibadan for a few days. She was said to be responding to treatment before her condition suddenly relapsed. Komolafe received more than 30 units of blood at the hospital, but she did not survive the ordeal as her health condition deteriorated leading to her death.

June 24, 2009 was an unforgettable day in the family of Ozoemena Nwoye. The latter’s wife, Ngozi, a mother of two, died in a private hospital few hours after successfully delivering her third child. She had lost so much blood in the process of child delivery and because the hospital had no blood bank to replace the lost blood, the husband had to rush out to find blood to buy, but by the time Nwoye returned, Ngozi had died. Ironically, it was the first time she would be using an orthodox hospital for child delivery. The previous births had been handled through traditional methods. It was later discovered that the hospital where Ngozi died was not fully equipped with the basic equipment needed for birth delivery process.

Solomon Okelozo had found himself in a similar situation on November 29, 2012, when he lost his wife as a result of excessive loss of blood. The wife had also been successfully delivered of her third child. Okelozo accused the management of the General Hospital, Igando, Lagos of killing his wife for refusing to attend to her while she was bleeding profusely in spite of all his pleadings.

These are a few cases among hundreds of Nigerian women that die annually of complications during and after child delivery. Health experts attribute half of Nigeria’s maternal deaths to postpartum haemorrhaging, which unskilled health workers lack the know-how or equipment to stop. Adebayo Kayode, a gynaecologist at the Lagos State University, Teaching Hospital, said Nigeria’s healthcare system still lacks facilities for emergency. He said that some of the teaching hospitals and private hospitals were trying in the area of emergency, but that a large number of healthcare systems in the country did not have the facilities to deal with emergency.

“The reason why maternal death in developed countries is low is because they have been able to take care of preventable causes of death. The unfortunate cases of maternal deaths that happen in these countries are cases they can’t handle,” Kayode said. The doctor said that until Nigeria is able to bring down preventable diseases, there would still be issues of maternal deaths.

George Ezeoke, another gynaecologist, noted that illiteracy, poverty and overconfidence have contributed to the increase in maternal deaths. “Many of our mothers still seek the help of non-professionals to assist them during labour; some pregnant women come to ante-natal clinics but they will decide to do it their own way when it is time for delivery. Some do not have the required funds to go to where there are adequate medical services. They prefer to seek assistance of local midwives. When a woman is overconfident, just because she had given birth to five other children in the past, she may rupture her womb and bleed to death if she decides to have a child on her own,” he said.

Franca Amaechi, a housewife and mother of three, said many women in Nigeria died from childbirth simply because they did not know how dangerous it could be to have babies without medical supervision. “Awareness campaigns are beginning to filter into the public consciousness, I hear it all the time and also see the advertisements on television, even if one does not have a television at home to watch, there are people walking around on the streets creating awareness and telling people that having babies at home is not good,” Amaechi said.

Speaking in the same tune Amaka Nwoye, a mother of two, said that the rate of maternal mortality was too high in the country and that pregnant women needed to be enlightened more on the risks associated with delivering at home. Nwoye said stress during pregnancy, lack of proper immunisation, poor hygiene, low standard of living, poor antenatal care are factors that could lead to death during child delivery. She blamed the government, hospitals and the ignorance of some pregnant women for some of the cases of maternal mortality.

“Government should create more awareness programmes and provide free medical care services for pregnant mothers. The authorities should also take time to go to hospitals so as to carry out the necessary checks in order to ensure that the hospital management prescribes the right drugs for the mothers because of so many fake drugs and quack doctors. Some mothers even think they know it all by going to traditional homes to take traditional medicine which are not good for their health, and this thereby put their lives at risk during and after delivery,” Nwoye said.

In September 2000, Nigeria and 146 other members of the United Nations agreed on an eight-point Millennium Development Goals, MDGs, to improve the health and socio-economic well being of the people in their countries in the 21st century. The MDG called for the reduction of maternal deaths by 75 percent by 2015. Although analyses of recent trends show that the country has been making progress in cutting down on infant and under-five mortality rates, the pace still remains too slow to achieve the MDG target of reducing child mortality by a third by 2015.

According to UNICEF, everyday, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age which makes the country the second largest contributor to the under-five and maternal mortality rate in the world. The UNICEF report said many of these deaths were preventable, but that the coverage and quality of health care services in the country have continued to fail women and children. Currently, less than 20 percent of health facilities offer emergency obstetric care and only 35 percent of deliveries are attended to by skilled birth attendants.

Susan Grant, country manager, Save the Children International, said that Nigeria has one of the highest number of maternal and newborn deaths and each year 40,000 women die during pregnancy and childbirth and more than 259,000 babies die in their first month of life.

In its bid to meet its target of reducing maternal mortality in the country, the federal government recently came up with a new initiative known as the MDG Acceleration Framework, MAF.  Onyebuchi Chukwu, minister of health, said that the framework would identify priorities in the area of interventions. He said progamme would use the model that had been tested and proven by other countries to be an accepted policy to engender progress through capacity building. This, Chukwu stated, would help refocus and fast-track the achievements of the MDGs. “It is our expectation, at the federal ministry of health, that the application of MAF will fast-track progress and performance improvement. This is in line with the existing health sector effort aimed at accelerating progress towards the MDGs by 2015. With respect to MDG 5, the health sector has made a lot of progress and expects to build urgently on these gains to meet the gaps and achieve the set target,” the minister said.

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