Daily Independent (Lagos)
10 March 2010
editorial
The statistical data on the ever-increasing maternal mortality rate in Nigeria is not only mind-boggling, but pathetic. More so, because evidence abounds that successive administrations, both military and civilian have put rhetoric before action in mitigating the effect of a scary public health issue.
It is important to recall that battling the scourge of maternal mortality was one of the critical issues which took the front burner at the Beijing Conference held at the instance of women activists from across the globe way back in 1995.Others included the crying need to address escalating household poverty, ensure economic empowerment, improve on women's healthcare status, promote girl-child education and uphold their human rights.
Important as these are, many developing countries have fallen far short of the standards set by the World Health Organisation's initiative on Safe Motherhood. And that includes Nigeria. According to the WHO/United Nations Children Fund, UNICEF, in 1995, Nigeria had the third highest number of maternal deaths in the world, approximately 45,000 deaths. By the year 2000 the worrisome death-wave was yet to abate. For every 100,000 live births about 800 women died in the process of child birth. Out of the 27 million Nigerian women of reproductive age back then about 2 million did not survive either pregnancy or childbirth.
So appalling has the maternal mortality rate become that on the 3rd of July, 2008, Nigerian government officials were invited by the UN Special Committee dedicated to the protection of women's rights to explain the deplorable rate of deaths of pregnant women in the country. That year the figure stood at between 1,100 and 1,500 deaths according to the UN. On its part UNICEF in it's the State Of The World Children Report, 2009 stated that "one out of nine global maternal deaths occurs in Nigeria." Today, Nigeria posts the second largest mortality rate in the world, with about 144 girls and women dying everyday from complications at childbirth.
The growing pain is that 15 years after the Beijing Conference declaration and more than a decade after the return of democratic governance: "Nigerian women are still poor and their economic status has not been upgraded." lamented the Director, Gender and Development Action, Ada Agina-Ude.
Maternal mortality, it should be noted is the death of a woman during pregnancy, or within 42 days of delivery. That is, with the exception of accidental deaths. The reasons include complications such as haemorrhage, unsafe abortion, infection, eclampsia and obstructed labour. Many of the victims, sad to say, lack access to adequate antenatal care, which encapsulates the close monitoring of mother and child's health and development of the foetus during pregnancy.
According to the WHO several of these deaths are traceable to undue delays in seeking medical help during pregnancy and the post-partum period. Since 1987 that global efforts have been focused on reducing high maternal mortality rates especially in developing countries, it has succeeded by reducing it to 50 percent by year 2000. But after the follow up assessment in Colombo 1997, Nigeria was discovered as having a paucity of skilled midwifery manpower at the local government level.
Going by the New York based Centre For Reproductive Rights recent report entitled Broken Promises: Human Rights Accountability and Maternal Deaths "Nigeria has done little to address them". Not too surprisingly, the Federal Government has since admitted it faces serious challenges in meeting the Millennium Development Goals, MDGs 4 and 5.These include reducing child mortality ratio and improving on maternal health respectively.
The way out is for a holistic approach by both the public and private sectors. More nurses, midwives and doctors have to be trained. Non-Governmental Organizations, NGOs have to get involved. For instance, propelled by the damning figures on the nation's maternal mortality rate one Opeyemi Ogunlola initiated LEAP Africa Youth Leadership Programme which has since launched the Save Mothers, Save Babies initiative at the rural Bwari community near Abuja. So far, Ogunlola has organized relevant symposia that featured nutritionists, physiotherapists and medical doctors speaking to the pregnant women in their local languages. Up to 49 women in Bwari and 60 others in Mokola-Sango, Ibadan communities have since upgraded their knowledge of antenatal care.
Similarly, the Governor Olusegun Mimiko-led administration in Ondo State, supported by MTN and Globacom telecommunication companies has taken the bull by the horn by giving out handsets free- of -charge to registered pregnant women in the state. With the phones the women can call the health ranger, doctor, midwife, health commissioner or even the state governor to communicate her health problems. The aim, as Mimiko explained is to ensure that pregnant women can deliver safely at the nearest medical facility and are attended to by skilled hands at no cost to the families.
We commend both life- saving initiatives and ask that the bold move be adopted as a nationwide health policy. Governments at all levels should muster the political will to earmark adequate budgetary funds to the health sector and ensure their expenditure is closely monitored. Women have to be enlightened continously to raise only the number of children they can cater for. They should also be economically empowered and given the nutritional awareness to improve on their health status. Health facilities should be upgraded across the country while efforts should be made to involve the private sector. That done, the fight back against a national disgrace, the embarrassment of high maternal mortality rate would have commenced, albeit belatedly, in earnest.
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This is appalling. Nigeria is at the top, globally, for several terrible health indicators and diseases- HIV/AIDS, poor access to water and sanitation, infant mortality and maternal mortality, malaria, TB, you name it. What is our government doing to improve the health of Nigerians? Why do our leaders run out of Nigeria for their minor health needs, instead of developing and improving what we have?