SDG 3: Dealing with a high rate of maternal deaths in Nigeria
According to the World Health Organization, the poor women in Nigeria’s remote areas are least likely to receive adequate healthcare. The places also lack a good number of skilled health workers.Subhro Prakash Ghosh | Updated: 13-03-2020 02:00 IST | Created: 13-03-2020 02:00 IST
In Africa, maternal death is the second biggest cause of women's death at the reproductive age. Approximately, 2,87,000 females die every year due to complications in pregnancy and delivery. The problem is severe in countries like Nigeria, Kenya, South Africa, etc. Nigeria is the most populous country on the continent with a population of over 200 million people. It is currently considered the seventh most populous country on the planet and referred to as the 'Giant of Africa' owing to its large population and economy.
Nigeria continues to rank second globally in the number of maternal deaths and unfortunately, nearly 20 percent of all global maternal deaths take place in this west African country. A woman here has a 1 in 22 lifetime risk of dying during pregnancy, childbirth or postpartum or post-abortion, whereas, in the most developed countries, the lifetime risk is 1 in 4900. According to the researchers, the average age at maternal death in Nigeria is 30.8 ± 5.7 years.
Why Nigeria has a high rate of maternal deaths
According to the World Health Organization (WHO), the poor women in the country's remote areas are least likely to receive adequate healthcare. The places also lack a good number of skilled health workers. In other words, millions of births are not assisted by trained nurses, midwives or doctors. In Nigeria, haemorrhage and pre-eclampsia or eclampsia account for 43.4 and 36.9 percent of cases respectively. Leading contributory factors of maternal deaths include inadequate human resource for health, delay in seeking care, lack of ambulance transportation, inadequate equipment, and delay in referrals services. Around 51.1 percent of the women had antenatal (or prenatal) care while a significant proportion of the women were referred from traditional birth attendants.
Prof. Oluwarotimi Akinola, President, Society of Gynaecology and Obstetrics of Nigeria has recently cited that the country has not recorded a significant reduction in maternal death ratios over the years despite the struggle against maternal mortality. He elaborated the situation as 'static' while comparing progress made by other countries. According to him, there is no such huge fall in the maternal mortality number in the last 3 to 4 years.
While citing the Society of Gynaecology and Obstetrics of Nigeria's contributions to the effort of reducing maternal mortality rate, he said that his organization is also doing many things to reduce maternal deaths in the country. But multiple indicators, WHO and National Demographic and Health Survey show that maternal deaths are still high in Nigeria.
One of the main priorities of WHO is improving maternal health across the world. WHO continues to work to contribute to the reduction of maternal mortality by augmenting research evidence, providing evidence-based clinical and programmatic guidance, setting global standards, and providing technical support to the Member States.
Necessary actions to be taken
It is the duty of the team leaders, hospital managers and policymakers to act on the information received from the survey with the obvious objective to reduce maternal deaths and morbidity in Nigeria. It is also important to note that similar initiatives should be applied in those locations where health information systems are not totally functioning resulting in a lack of actionable information.
Some vital steps need to be followed to improve the quality of care in health facilities. According to WHO's recommendation, a woman should visit the healthcare facility centre at least 8 times during her pregnancy. This will reduce the potential problems and likelihood of stillbirth or neonatal death or maternal death. The health workers should provide information to pregnant women and families on healthy lifestyles, preventing diseases and family planning. The families should take care of the breastfeeding mothers by giving them a healthy diet to ensure that she doesn't fall short of haemoglobin, calcium, protein, vitamins and essential elements.
One of the most vital approaches for the Nigerian government is to pump out funds in developing the public hospitals, bringing in new technology, encouraging women to opt for delivery through surgery during complications, and installation of hospitals at rural places to ensure women's accessibility for getting advice on nutrition, installation of blood banks, etc. All of these steps will reduce maternity deaths in Africa.
Nigeria needs to focus on family planning
Another vital reason for high maternal deaths in Nigeria is lack of adoption of family planning methods and proper education to prevent teenage pregnancy. Deficient or incorrect family planning methods, wrong attitudes and behaviours toward the methods and consequent unplanned pregnancies, and increased maternal and infant mortality rates are the main health problems in Nigeria. In reality, the country has made no progress in improving the use of contraceptives in the last decade. In other words, contraceptive use in the country is incredibly low. It is the duty of the health officials to remove the myths and misconceptions related to contraceptives and ensure its maximum use to avoid unintentional or continuous pregnancies.
Due to lack of education on promiscuity, unsafe sex and healthcare, girls become pregnant before crossing teenage, resulting in more complications including maternal death and premature death of babies. On these grounds, the governments must push in more efforts for raising vast awareness.
The WHO is focusing on 2020 as the year of nurse and midwife in honour of Florence Nightingale's 200th birthday. The midwife profession is largely dominated by women in Nigeria but confronts the issue of recognition and adequate remuneration while compared to the entire health workforce. The UNFPA declared that midwives could help in preventing two-thirds of all maternal and neonatal deaths.
The above steps must be taken by the government, public, private bodies including national and international NGOs with the objective to meet the Sustainable Development Goals 3 (SDG 3 - good health and well-being for people at all ages) set by the United Nations to be met by 2030.
(Disclaimer: The opinions expressed are the personal views of the author. The facts and opinions appearing in the article do not reflect the views of Devdiscourse and Devdiscourse does not claim any responsibility for the same.)
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