ISSUES IN MATERNAL MORTALITY 

 The authorities must do more to stem the scourge

The scale of maternal mortality in Nigeria has become so alarming that we must call on the health authorities to fashion out a blueprint that will extenuate this pressing challenge. According to the Kaduna State Governor, Uba Sani, no fewer than 700 babies die daily in Nigeria. “This is the highest number of newborn deaths in Africa and the second highest in the world. Alarmingly, 25% of all neonatal deaths occur on the first day of life, while 75% occur within the first week,” Sani said while also noting that his state has the highest neonatal mortality rate in the Northwest.

Sani has merely confirmed the latest statistics from the World Health Organisation (WHO) which reveal that Nigeria accounts for over 34 % 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 WHO report, ‘improving maternal and newborn health and survival and reducing stillbirth: Progress Report 2023’ ranked Nigeria as accounting for the second-highest number of maternal and child deaths globally, after India.

The challenge at hand goes beyond what the federal government can handle. Many of the rural communities in the 36 states lack cottage hospitals and medical facilities that will address these challenges. Where they exist, there is shortage of manpower, and obsolete medical equipment . Instances abound of pregnant women who have had to die in the process of commuting from their homes to a medical facility.  

Yet when a pregnant woman avoids prenatal care, she puts herself under the risk of postpartum hemorrhage (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 the acute poverty that has become a major challenge, especially in the rural areas.  

However, 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. The solution 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. That many hospitals in the country are without the necessary drugs while their facilities are outmodelled and begging for urgent renovation is a situation that needs to be redressed. We cannot continue to put the lives of our women at risk.   

There is an urgent need to go beyond rhetoric and promises, to actionable plans to address all the existing gaps in the primary health sector. This will require a collaboration between the federal government and authorities in the 36 states. We must end the agony and tears of mothers who carry pregnancy for nine months only to die at the point of delivery.