Nigeria’s Maternal Death Burden

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A recent World Health Organisation’s report says Nigeria and nine other poor countries contribute about 60 percent of the world’s maternal health mortality burden

By Anayo Ezugwu  |  May 26, 2014 @ 01:00 GMT

THE World Health Organisation, WHO, has ranked Nigeria among 10 countries in the world that contribute about 60 percent of the world’s maternal mortality burden. The WHO report published on its website stated that Nigeria has a maternal mortality ratio of 560 deaths per 100,000 live births which is an improvement on 630 deaths per 100,000 in 2010.

According to the report, about 40,000 maternal deaths occurred in the country in 2013. This figure is second only to India, which recorded 50,000 deaths. It is still uncertain whether Nigeria will meet the Millennium Development Goal, MDG, (goal) 5. But the eleven countries that had high levels of maternal mortality in 1990s (Bhutan, Cambodia, Cape Verde, Equatorial Guinea, Eritrea, Lao People’s Democratic Republic, Maldives, Nepal, Romania, Rwanda, Timor-Leste) have already reached the MDG target of a 75 percent reduction in maternal mortality from the 1990 rate by 2015.

Another study by the WHO published in “The Lancet Global Health” confirms that most of the deaths are preventable. According to the report, more than 1 in 4, that is, 28 percent maternal deaths are caused by pre-existing medical conditions such as diabetes, HIV, malaria and obesity, which are usually aggravated by pregnancy. Other causes of maternal deaths included severe bleeding (mostly during and after childbirth) 27 percent, pregnancy-induced high blood pressure, 14 percent, infections, 11 percent, obstructed labour and other direct causes, nine percent, abortion complications, eight percent and blood clots (embolism) three percent.

On the way forward, the WHO recommends strong health systems with facilities that have adequate health workers, equipment and medicines. These recommendations are not new. The challenges facing most health facilities in Nigeria are those resulting from lack of government’s commitment and accountability to promises made. It would be recalled that the  Nigerian government, like other member countries in the African Union had agreed, during the Abuja declaration of 2001, to commit a minimum of 15 percent of total budget to health as against the 5.6 percent which was allocated in 2013.

In addition, there is a need for proper documentation of deaths in order to provide accurate information about maternal deaths and help to channel resources where they are needed most. The United Nations Commission on Information and Accountability for Women’s and Children’s Health has called for better measurement of maternal and child deaths. The commission also recommended that by 2015, all countries should have taken significant steps to establish a system for registration of births, deaths and causes of death.

“There is growing consensus worldwide that ending preventable maternal deaths can be achieved by ensuring that every woman has access to quality health care. Global and national targets beyond 2015 will be important for tracking progress in reducing maternal deaths and ensuring that maternal health continues to be a global development priority’’ WHO said.

Sub-Saharan Africa is still the riskiest region in the world for dying of complications in pregnancy and childbirth, the UN data restated. Geeta Rao Gupta, deputy executive director, United Nations Children’s Fund, UNICEF, said a 15-year-old girl living in sub-Saharan Africa faces about one in 40 risks of dying during pregnancy and childbirth during her lifetime. A girl of the same age living in Europe has a lifetime risk of one in 3300 – underscoring how uneven progress has been around the world.

Despite advances in the last 20 years, there has been too little progress in preventing adolescent pregnancies, abortions, maternal deaths, sexually-transmitted infections and HIV, and there are significant gaps in availability, quality and access to comprehensive sexuality education and services for young people, especially in low-income countries.

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