Maternal mortality is a key indicator of population health and social economic development.
In African communities especially the sub-Saharan region, the rate is quite high. In fact, Africa has the highest maternal mortality rate in the world and Nigeria is one of the countries with the highest rate in the region. One of the major contributing factors to this prevalence is the slow progress being made in the region in solving this problem.
Maternal Mortality Rate in Nigeria: Past & Present Figures
As of 2015, the maternal mortality rate in Nigeria was 814 deaths per 100,000 live births. Fifteen years earlier, the figure was slightly lower at 800 deaths per 100,000.
Currently, Nigeria has the second highest burden of maternal mortality in the world and contributes about 15 percent of the annual total global deaths which represent two percent of the global population.
In this post, we will take a look at figures over the last few decades. But first, let’s define the maternal mortality ratio (MMR).
MMR is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by the pregnancy or its management (excluding accidental or incidental causes). This ratio includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year.
Generally, maternal mortality reflects the status of the country’s population and quality of life and the factors affecting this parameter are often sociocultural, economic and logistics coupled with the poor healthcare delivery.
The rural communities where functional health care services are scarce is responsible for the high mortality rate because a large percentage (about two-thirds) of the births in this area still occurs at home. In fact, only a little over a third of the births in the country are attended by doctors, nurses, or midwives.
The major cause of this high MMR has been linked to the lack of access to quality delivery services. Some of the prevailing factors leading to poor accessibility to healthcare are lack of funds for treatment and distance to health facility.
Also, the lack of trained health care attendants in births and the fact that only six in ten mothers receive antenatal care from a trained medical professional are other causes of the high MMR in Nigeria.
Accessing antenatal care can prevent neonatal mortality arising from neonatal tetanus, malaria, and maternal anaemia. Unfortunately, over half of the pregnant women in Nigeria receive iron supplements and only 39 receive drugs to prevent malaria.
Most maternal deaths arise from heavy bleeding after birth. It was revealed by Bill Gates, the founder of the Bill and Melinda Gates Foundation that one of the most dangerous places in the world to give birth. In fact is the fourth country with the worst maternal mortality rate only surpassing Sierra Leone, Central African Republic, and Chad.
Overall, the low level of care received by pregnant women in the country is one of the major contributors to the high infant and maternal mortality ratio.
In 2015, of the 303,000 women that died globally due to complications of pregnancy and childbirths in 2015, 58,000 women died in Nigeria. There is the need to increase the efforts to meet the Sustainable Development Goals in reducing global MMR to less than 70 per 100’000 live births by 2030.
Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. This means the country has a lifetime risk of maternal death of 4.62 percent. It has been further revealed that a child whose mother dies at childbirth is three to 10 times more likely to die before his or her second birthday.
Postpartum hemorrhage is severe bleeding experienced by women following the birth of a baby. It is preventable through the administration of an effective uterotonic to the mother immediately after the birth of her baby. The uterotonic which include the likes of oxytocin, misoprostol, ergometrine, syntometrine, and carbetocin causes the uterus to contract.
But the problem is the quality and effectiveness of these uterotonics in developing countries is quite low which has led to the inability of the uterotonic to prevent PPH due to the poor state of medicines.
In 2018, it was revealed that 74.2 percent of oxytocin samples failed the quality test in Nigeria. Oxytocin must be stored in cold storage to remain potent in temperature of between 2°C- 8°C. Short of that, the drug will not work.
Oxytocin is recommended by W.H.O as the first-line medicine for prevention and treatment of postpartum hemorrhage, is temperature-sensitive medicine and requires refrigeration during transportation and storage.
Year | MMR
2008 | 840
2010 | 630
2015 | 814
The 2015 figure indicates that Nigeria recorded 58,000 women in that year. The high maternal mortality rate has been linked to flawed government policies, education, culture, religion, education, culture, religion and lack of access to skilled health workers and necessary drugs.
Also, the prevalence has been linked to other factors like living in an urban or rural area, socio-economic status, and geopolitical zone.
The most worrisome is the report from North-East where MMR is highest at 1,549/100,000 live births in comparison to the South-West zone where 165/100,000 was recorded.
The progress in reducing maternal ratio has been to slow. According to the Nigerian Demographic and Health Survey (NDHS) reports for 2008 and 2013, Nigeria achieved practically no reduction in MMR.
The lifetime risk of dying from pregnancy-related causes according to NDHS reports also showed practically no change in the year under review.
There is the need for a national focus in providing quality health care facilities and ensuring high quality of care to mothers and children.
Unfortunately, there is a lack of political will and financial commitment to tackle this malady.
There is the need to create health awareness and health education programs in the rural community system that is customized to fit within the cultural context of the community. Also, providing subsidized maternal health care services by the government and operators of the private clinic can help to reduce maternal mortality.