There are disturbing stories of pregnant women in distant villages with no access to healthcare or facilities for delivery. These women either give birth in their homes unattended to, or are hurried off to the nearest town, which may be several miles away in search of maternity clinics or hospitals, and that is, provided they have the right means of transportation. Good roads are also scarce in some of these places. All of these can endanger the life of a mother and her unborn baby and in severe cases, result in death.
There is the usual misconception that maternal mortality is maternal deaths as a result of child birth. However, its real definition is the number of women who die from pregnancy-related causes while pregnant. Pregnancy-related death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death, according to the World Health Organisation (WHO). Thus, it is a pregnancy-related death and not necessarily a death caused by child birth.
According to 2014 reports by WHO, every day, about 800 women die globally from causes that could have been prevented during pregnancy. Again, results of the organisation’s analysis reflect that 99 per cent of all maternal deaths occur in developing countries and are higher in women living in rural areas and poorer communities. More than half of this 99 per cent happen in sub-Saharan Africa.
Higher risks of complications and death as a result of pregnancy are faced by adolescents, when compared to older women. Girls under 15 years face a probability of eventual death from maternal cause as reflected at 1 in 160 girls in developing countries. Between 1990 and 2013, maternal mortality was reported to have dropped by almost 50 per cent worldwide, and in 2013, 289,000 women died during and following pregnancy and childbirth.
In another report by UNICEF, Nigeria is said to lose about 145 women of childbearing age every day. This matter is also disturbingly and undeniably linked to child deaths. The same report states that the country equally loses about 2,300 under five year-olds every day, which is an alarming rate. A woman’s chance of dying from pregnancy and childbirth in Nigeria is reported at 1 in 13.
A senior programme officer on the Reproductive Maternal New Born And Child Health Programme, Clinton Health Access Initiative (CHAI), Dr Onwuasor Nneka Benedicta told LEADERSHIP Weekend that, “As at 2013, it was 576/100,000 live births. This is from the Nigeria Demographic and Health Survey (NDHS) conducted in 2013. What it means is that for every 100,000 pregnant women that gives birth, about 576 of them will die. Which is not encouraging when you compare it to the 2008 NDHS data of 545/100,000 live births.
Nigeria’s case of maternal mortality when compared to the maternal mortality rate worldwide is further described as ‘worrying,’ by Dr Onwuasor as she adds, “Nigeria’s population does not help.”
When it comes to the various challenges that are faced in this field, Dr Onwuasor points out the lack of skilled health workers in this field and poor infrastructure to facilitate the work. “In the northern region, a lot of women deliver at home with no help,” she indicated.
She believes that the federal government should provide some form of incentives for healthcare workers, particularly those in rural areas, and also have a health system that works with proper infrastructure in place.
While creating public awareness and advocacy campaigns of the situation goes a long way to help in reducing maternal mortality, Dr Onwuasor indicates, “That is already ongoing to some certain extent but if there are no skilled health workers at the facility or infrastructure, then nobody will go there.”
In Nigeria, apart from WHO and UNICEF, there are quite a number of other organisations, coalitions and civil right societies, with projects designed to assist in reducing Nigeria’s maternal mortality rate. Examples are organisations such as Evidence for Action (E4A) funded by DFID, which is a five year programme targeted at improving maternal and newborn survival in six sub Saharan countries to include Nigeria, through the ‘Mama ye!’ project. It focuses on better use of information and improved advocacy and accountability to save lives.
Also important is the Mobile Alliance for Maternal Action (MAMA) a network doing a lot in rural areas. It is a Public Private Partnership (PPP) between USAID, Johnson and Johnson, the United Nations Foundation and Baby Centre. It works by delivering vital health information straight to new and expectant mothers living in poverty through their mobile phones and empowers these women to make the best decisions for themselves and their families. The MAMA programme is set to launch in Nigeria sometime this year.
Improving maternal health is vital to the society. According to UNICEF, currently, less than 20 per cent of health facilities provide emergency obstetric care and only 35 per cent of deliveries are attended to by skilled birth attendants. These are all essential information the federal government needs to look into to support maternal and child health and reduce maternal mortality in the country.
Published: Mar 7, 2015. By Bukola Ogunsina
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