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Nigeria: 99 Percent Maternal Deaths Occur in Country

Sola Ogundipe

23 September 2008

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With the second highest maternal mortality rate in the world, Nigeria continues to contend with the grim statistics of maternal mortality and morbidity, even as the newest report on maternal mortality, released by UNICEF gives an even more daunting verdict on the risks faced during pregnancy and childbirth by women in developing countries.

Going by the report, entitled "Progress for Children: A Report Card on Maternal Mortality", it is noted that nearly all recorded maternal deaths occur in developing countries. Precisely, the report states that more than 99 per cent of all maternal deaths occur in developing countries, that include Nigeria and several other countries in sub-Saharan Africa and South Asia.

In a commentary on the report, UNICEF's Chief of Health, Peter Salama, notes that "The tragic fact is that every year more than half a million women lose their lives as a result of complications due to pregnancy or childbirth. The causes of maternal mortality are clear - as are the means to combat them. Yet women continue to die unnecessarily."

Amongst issues of concern listed in the report are haemorrhage, poor nutritional level and HIV which influences the chances of a positive outcome to her pregnancy and childbirth. Other influences include societal factors, such as poverty, inequity and general attitudes towards women and their health.

Maternal mortality rates are often impacted by cultural or traditional practices that often prevent women from seeking delivery or post-partum care.

In developing countries like Nigeria, the risk of death from complications relating to pregnancy and childbirth over the course of a woman's lifetime is higher when compared the industrialised world.

The report says most maternal deaths are avoidable and that a key to avoiding them is better health care - particularly during pregnancy, delivery and in the post-partum period.

According to the report, interventions that improve maternal health include: antenatal care, provider-initiated HIV testing and counseling, skilled attendance at birth, emergency obstetric care, post-partum care and family planning in keeping with national policies.

When offered across a continuum of care that integrates home, community, outreach and facility-based services, these interventions can have multiple benefits for mothers, children and the communities in which they live.

There have been some promising areas of improvement in maternal health interventions in recent years. Coverage of antenatal care throughout the developing world has increased by 15 percentage points in the past decade, with 75 per cent of expectant mothers now receiving some antenatal care.

At the same time, many countries have boosted coverage of skilled delivery attendance. In parts of Asia, for example, the proportion of women who have a skilled attendant present during delivery jumped from 31 to 40 per cent between 1995 and 2005. Increases have also been seen in many African countries.

Ensuring that skilled personnel are present at all deliveries and that these personnel have access to emergency care where necessary is the most effective means of saving the lives of mothers.

However the pace of progress towards reaching the Millennium Development Goal on maternal health, which calls for a 75 per cent reduction in the maternal mortality ratio between 1990 and 2015, has been too slow throughout the developing world and must now be accelerated if the goal is to be reached.

UNICEF says to achieve the MDG target, maternal health must be addressed as part of a continuum of care that connects essential maternal, newborn and child health services. Indeed, levels of maternal mortality often reflect the overall performance of a country's national health system - particularly during delivery and in the postnatal period, when mothers and newborns are most vulnerable.

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