Of the eight Millennium Development Goals (MDGs) set out in the year 2000 by the United Nations during its Millennium Sumit held at its headquarters in New York, which are to be achieved by 2015, goals 4, 5 and 6 have direct bearing on maternal and infant mortality. They are reducing child mortality rates, improving maternal health and combating HIV/AIDS, malaria and other diseases.
While most countries around the world are working round the clock to achieve the goals, less than two years to the target date, most Nigerians are skeptical that the country will achieve such a target by the year 2015 when more than half of the issues related with the identified goals are still being handled with laxity.
Maternal mortality, according to the World Health Organization (WHO), is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.
Child mortality, on the other hand, refers to the death of infants and children under the age of five. In 2011, 6.9 million children under five reportedly died down from 7.6 million in 2010, 8.1 million in 2009 and 12.4 million in 1990. Child mortality is more prevalent in the Sub-Saharan Africa with about half of child deaths being recorded there.
In Nigeria, experts said pregnancy, labour and early childhood are well recognized as being hazardous in most communities. Every now and then, women get pregnant and are delivered of their children some of whom often die from preventable diseases.
There are growing concerns about the way women and children die daily as a result of health complications in the country. According to experts, statistics on maternal deaths in the country are so shocking and unacceptable. It is said that a nation which allows her women to die in the process of bringing forth live only exists on borrowed time.
Official figures from the National Population Commission (NPC) few years ago claimed that there were 52,000 cases of maternal deaths in Nigeria annually; that is about 142 deaths daily. It also said that for every dead woman, there are 20 cases of morbidities such as obstetric fistula, infections and disabilities.
However, a recent report by the Society of Gynaecology and Obstetrics of Nigeria claimed that 11,600 maternal deaths were recorded in three months – between January and March this year – an average of 45 women died from pregnancy complications every day within the period.
According to the society, Nigeria accounts for 10% of maternal deaths in the world, ranking the second highest after India. This was made known by the Lagos State chairman of the society, Dr Oulwarotimi Akinola.
Akinola said the major causes of high maternal mortality rate in Nigeria are haemorrhage infection, hypertensive disorder of pregnancy, obstructed labour and anaemia, saying that any efforts by the government to reduce maternal mortality rates in the country must address the root cause of delays in seeking healthcare, accessing it and receiving help at any centre.
There are however other challenges that were identified by stakeholders, which are specific to rural areas. Delivering a paper recently at an event organized by the National Council of Women Societies of Nigeria (NCWS) recently, Hajiya Khadijat Mustapha Giwa of the FCT Health Department said the problems range from lack of proximity of healthcare posts to the target people at the grassroots, non-functional health centres, unqualified healthcare personnel and illiteracy among the target groups which make them to resort to traditional birth attendants (TBAs).
President of the council, Nkechi Okemini Mba, while expressing her concern on the issue stated that, “an important yardstick for measuring the development in the health sector as a nation is the level of transformation we are able to record in the grassroots.”
Worried by the development, the NCWS President said the council was partnering Faxmail Research Unit to bring up a programme called Natal Care Partnership Initiative in order to take the campaign on maternal health to all the 774 local governments in Nigeria with a view to sensitizing the rural women on their health.
She said, “Unfortunately over the years, the safety of mother and child in the local councils has been ill-attended to, especially goals 4, 5 and 6. Nigerian mothers and children residing in the villages have been most vulnerable. This is because they were largely exposed to difficult circumstances ranking first in malaria and infant mortality rates in the world.”
She added that it was the gaps and setbacks witnessed in the past that gave birth to such partnership. “To deliver on this requires the capacity to transform the way we do things to ensure plans translate into action and action into results. This programme will set up a common platform among LGAs for uniform action in reducing and enhancing delivery of Maternal and Child Healcare (MCH) and review in line of responsibility that are often blurred.”
On his part, Ambassador Boniface Anidobu, who is the managing consultant, Faxmail Research Unit, said Natal Care is based on four components which are physical care, emotional care, healthcare and spiritual care, out of which only healthcare is provided by government, while the rest are influenced either by the environment or cultural background of the people.
The programme, he said, would target reducing maternal and child deaths scourge in Nigeria, achieving MDGs 4, 5 and 6, eradicating polio and providing a reliable database necessary for evaluating healthcare service provision, planning and research duties.
As the nation marches towards 2015, experts believe that government must take the issue of maternal and child mortality seriously by matching words with actions for it to achieve the set target.
By Musa Abdullahi Krishi
28 June 2013