According to the World Health Organisation, an estimated 536,000 women die of pregnancy-related caused annually, leaving babies behind. VERA ONANA writes about the effect of maternal mortality on babies and how it may be curbed.
Ajayi held the baby in his hands as tears from his face fell gently on the baby’s cheeks… “It wasn’t supposed to be so,” he sobbed and interrogated the doctor “what will happen to this baby, what am I supposed to do with this child without its mother?” In Nigeria, several men have been in this dilemma and sadly, several more may end up in the same situation.
On the flip side, there is another situation. While pregnancy and child birth may be the most arduous journey a woman may be exposed to in her lifetime, women joyfully endure the pain, changes and challenges that come with it just to behold the smile of their babies but what happens when they never see that smile?
Recently, Nigeria’s National Centre for Women Development (NCWD) decried the high maternal mortality rate in Nigeria. According to the NCWD’s acting director, Malam Sadeeq Omar, who spoke at a two-day peer review meeting on a report of the 2016 update on maternal health indicators in Nigeria, maternal deaths ratio, was 243 deaths per a 100,000 live births at the time of the review.
However, a more recent statistic on Nigeria’s high maternal mortality rate was confirmed in a new report which revealed that about 400,000 women die every year in the country from childbirth related complications. This report was presented in December, 2016 by the Chairman of the Association for the Advancement of Family Planning (AAFP), Dr. Ejike Oji and it indicated that the nation’s maternal mortality ratio has hit 576 deaths out of every 100,000 live births daily making Nigeria the country with the second highest cases of maternal mortality in the world after India.
In the same vein, a 2015 report from the World Health Organisation (WHO), stated that approximately 830 women die from preventable causes related to pregnancy and childbirth every day and a high percentage of all maternal deaths occur in developing countries, including Nigeria.
An even more specific representation is provided by the United Nations Children’s Emergency Fund, UNICEF, which reports that “Every single day, Nigeria loses about 2,300 children under five and 145 women of childbearing age. This makes the country the second largest contributor to the under–five child and maternal mortality rate respectively in the world.”
Another recent UNICEF report states that in every 10 minutes, one woman dies on account of pregnancy or childbirth in Nigeria. These perplexing statistics reveal the extent of the problem of child and maternal mortality in Nigeria and the dire need to curb this worrisome negative trend.
In his 2014 paper, “Informed Community Participation is Essential in Reducing Maternal Mortality In Nigeria,” published in the International Journal of Health and Psychology Research by the European Centre for Research Training and Development in the United Kingdom, Dr Antor Ndep of the Department of Public Health, University of Calabar, stated that “the current implementation of free health care to pregnant women and under-five children seem to be yielding some positive results but Nigeria’s maternal mortality rate (MMR), however, is yet to reach the reduction rates as recommended by the MDGs.”
Ndep added that “although Nigeria saw a 27 per cent decline in MMR between 2005 (820 per 100,000 live births) and 2010 (630 per 100,000 live births), the country is still among the top 13 highest MMR in the world.”
The World Health Organisation (WHO) estimates that over a million children worldwide lose their mothers annually and the children who lose their mothers are 10 times more likely to die prematurely. This shows that countries with high maternal mortality ratios, record high infant and child mortality rates as well. Due to the crucial role a mother plays in the life of a child, Nigeria’s high maternal mortality rate is indicative that critical aspects of the healthcare delivery system like financial and geographic access to care and good quality healthcare delivery services in Nigeria continue to fail women and children.
Causes of maternal mortality in Nigeria
According to a United Nations Children’s Fund (UNICEF) report, some of the major causes of high MMR in Nigeria include haemorrage, obstructed labour, postpartum infection also known as puerperal infection which is any bacterial infection of the female reproductive tract following childbirth, malaria and complicated abortions. Ndep also noted that “researchers in Nigeria have reported that puerperal sepsis accounts for 12 per cent of maternal deaths in Nigeria and that till date, little is known about the background hospital factors that predispose pregnant women to post partum infection that leads to mortality.”
The expert explained further that high maternal mortality has been attributed to a combination of individual level factors such as attending ante natal clinics but choosing to deliver at home, at a church or by a traditional birth attendant. Other causes he as well as some other Nigerian researchers, identified as women who never attended antenatal clinics but showed up at the hospital as emergency cases with varied degrees of complications.
Omar explained, while giving an update on maternal health indicators in Nigeria, in the reports of one of the national dailies, that while it is difficult to collect data in Nigeria because most significant births and deaths occurred at home or outside health centres, a lot of factors hinder women from accessing care, thus resulting into mortality.
“The barriers to accessing quality maternal health services are created by many factors including poverty, women’s limited access to education and income, nutritional problems and poor or non-existent transport, road and communications infrastructure in conflict or post- conflict situations.”
Reducing MMR in Nigeria
In his paper, Dr Ndep proposed a Primary Health Care (PHC) model called informed community participation in other to mitigate maternal mortality in Nigeria. According to Ndep, people learn when they are involved based on the quote “tell me and I forget, teach me and I remember, involve me and I learn,” by Benjamin Franklin. The proposed informed community participatory model of the PHC places emphasis on the community’s involvement in their needs/assets assessments.
“For the reduction of high maternal mortality rates, the proposed community participatory model would engage women (women of child bearing age, mothers, grandmothers and mother-in-laws) in the health decision making at the grassroots level, addressing their concerns and expectations, for the protection of their physical, mental, psychosocial wellbeing and above all securing their health outcomes before, during and after pregnancy and childbirth, thereby reducing maternal mortality in Nigeria.”