Maternal death rate in Nigeria maybe worse than we imagined

Every single day, Nigeria loses about 2,300 children under five and 145 women of childbearing age. Nigeria is the second largest contributor to the under-five and maternal mortality rate in the world accounting for 14% of the world’s maternal mortality deaths (the highest in West and Central Africa). Maternal mortality is the death of a woman while pregnant irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management. While infant mortality rate is the rate children die at birth or shortly after birth.

Maternal and infant mortality is a critical indicator of global development, and decreasing its severity has been a challenge in low-income countries for decades despite the presence of effective interventions. The co-chair of the Bill and Melinda Gates Foundation, Bill Gates, named Nigeria as one of the most precarious places in the world to give birth and also the 4th country with worst maternal mortality rate after Sierra Leone, Central African Republic and Chad.

Poverty indisputably contributes to the dastardly statistics. Many women especially those in rural areas due to low income and limited hardly have access to quality prenatal and postnatal care. Report by the World Health Organisation (WHO) shows that 40% of women in low-income countries visit antenatal care units. The resultant effects are not far-fetched, Nigeria’s maternal mortality statistics at 814 deaths per 100,000 live births stands at 14% of the world’s maternal mortality deaths.

A UNICEF report, 2016 shows that an estimate of 2,600 children died within the first 24 hours every day of the year, while 2.6 million children died before the end of their first month.  More than 80 per cent of these children died from preventable and treatable causes such as premature birth, complications during delivery, and infections like sepsis and pneumonia. In 2018, the United Nations Children’s Fund (UNICEF) launched the “Every Child Alive” global campaign to demand and deliver solutions on behalf of the world’s newborns.

The major strategy for decreasing maternal and child morbidity and mortality is ensuring that every baby is delivered with the assistance of a trained birth attendant which generally includes a medical doctor, nurse or midwife. The Sustainable Development Goals (SDG) aims to curtail global maternal mortality to less than 79 per 100,000 live births by the year 2020. However for Nigeria, this target seems almost unattainable, rather the rate continues surging upwards.

The Nigerian government have continuously paid lip service to the system of healthcare delivery; especially as it affects maternal and child welfare. Though, states such as Lagos have done an impressive job of creating healthcare centres in keys areas to support women, but it is not enough. Lagos is not effectively representative of Nigeria, considering that about 62% of her population are based in the rural areas.

The complications women suffer from during and after pregnancy and child-bearing contribute to the high rate of mortality. Most of these problems arise during pregnancy and they can be deterred. While others may be present before pregnancy but worsen during pregnancy. Often when mothers are malnourished or do not receive adequate maternity care, their children also face high risks of disease and death.

Also reliance on traditional birth attendants (TBAs) who often employ traditional and untested practice which may have harmful effects on the mother. They are also not effective in decreasing mortality during childbirth because of the paucity of knowledge and training in managing deliveries, understanding complications, and referring patients with complications. Many people still opt for traditional birth attendants because it resonates with their social and cultural beliefs. Traditional birth attendants should not be substitute for a doctor, midwife and/or nurse rather they ought to provide support for the skilled personnel on duty.  

Terminating preventable mother and child deaths can be achieved by improving access to skilled health-personnel during pregnancy and at the time of child birth. Also providing lifesaving interventions, such as immunization, breastfeeding and affordable medicines. Ensuring rural communities have basic amenities, enhanced hygiene and sanitation thereby risk of disease outbreak.