TACKLING MATERNAL MORTALITY 

 The authorities should boost Primary Health Centres for better services

The scale of maternal mortality in Nigeria has become so alarming that we call on health authorities to fashion out a blueprint that will extenuate this pressing challenge. Last week in Lagos, some stakeholders debunked most of the superstitions surrounding many of the fatalities, urging pregnant women to register early for antenatal care at skilled health facilities. “When you talk of maternal, prenatal mortality, it is not due to witchcraft or abiku. It is the structure that we put in place that determines whether we lose a woman or a child,” said the Permanent Secretary of the Lagos State Health Service Commission, Ademuyiwa Eniayewun, who posed salient questions: “Is it the woman who didn’t seek help on time and wants to deliver at home or is it that instead of going to the hospital, she registers at with a traditional birth attendant where they might be kept unnecessarily for too long? Are they able to recognise signals that portend great danger and sign the patient forward?”

Recent statistics from the World Health Organisation (WHO) reveal that Nigeria 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 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. Meanwhile, 25 per cent of all neonatal deaths are said to occur in the country on the first day of life, while 75 per cent occur within the first week.

While the challenge at hand goes beyond what the federal government can handle, it is unfortunate that many of the rural communities in the 36 states lack cottage hospitals and medical facilities. Where they exist, there is often shortage of manpower. Obsolete medical equipment and skeletal services worsen the situation. 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 in Nigeria today, especially in rural communities where insecurity has compounded their woes. 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 health care services in their domains. That many hospitals in the country are without the necessary drugs while their facilities are begging for urgent renovation is a situation that also needs to be redressed. We cannot continue to put the lives of our women at risk.

Putting an end to the agony and tears of mothers who carry pregnancy for nine months only to die at the point of delivery would require a collaboration between the federal government and authorities in the states. Doing that would also require finding ways to cushion the economic burden on 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.