MATERNAL MORTALITY IN NIGERIA 

All the stakeholders could do more to address the scourge

That Nigeria accounts for the second-highest number of maternal and child deaths globally is one of the biggest challenges that should concern stakeholders in the health sector. With his experience and exposure, we believe Mohammed Pate will work with others to change the narrative contained in “Improving maternal and newborn and survival and reducing stillbirth: Progress Report 2023” by the World Health Organisation (WHO). Nigeria, according to the WHO statistics, accounts for over 34 per cent of global maternal deaths while the lifetime risk of dying during pregnancy, childbirth, postpartum, or after an abortion for a Nigerian woman is one in 22, compared to one in 4900 in developed countries. 

The scale of maternal mortality in Nigeria has become so alarming that the health authorities must fashion out a blueprint that will extenuate this pressing challenge. But the problem is there to see. Many of the rural communities in the 36 states and the Federal Capital Territory lack cottage hospitals and medical facilities that will address these challenges. Where they exist, there is shortage of manpower, while facilities are obsolete. Instances abound of pregnant women who have had to die in the process of commuting from their homes to a medical facility.

Unfortunately, when a pregnant woman avoids prenatal care, she puts herself under the risk of postpartum haemorrhage (PPH), a complication arising from childbirth, which can result in a fatal outcome. Besides, women who do not have access to healthcare are prone to unassisted delivery carried out by quack midwives in unhealthy conditions with dire consequences for both the mother and foetus. To address this serious public health issue, we must begin to examine how to mitigate acute poverty, especially in the rural areas. 

We must put the blame on the state governments and the lack of attention by many of them to primary healthcare system at the grassroots. It is even worse that most of them have rendered prostrate the local government administration in their states, leaving healthcare delivery at that level comatose. For instance, the 2018 Nigeria Demographic Health Survey revealed that just about 43 per cent of births in rural areas across the country were assisted by a skilled healthcare provider. That means more than 50 per cent are aided by unskilled traditional birth attendants (TBAs), community-based birth attendants (CBAs) and other alternative healthcare providers. The solution therefore goes beyond mere formulation of some policies by the federal government. There should be a framework where states and local governments are held accountable for maternal child healthcare services in their domains. 

The authorities, at both the federal and the states, should also find ways to cushion the economic burden on most of the women who dwell in the rural areas, as that has been identified as the reason for their inability to afford quality prenatal and post-natal care. There should be a special focus on maternal, newborn and child health. We cannot continue to put the lives of our women at risk. 

The need to go beyond rhetoric and promises to actionable plans that will help in addressing all existing gaps in the primary health sector is urgent. This requires the collaboration of all stakeholders in both the private and public sectors. We must end the agony and tears of mothers who carry pregnancy for nine months only to die at the point of delivery.