Nigeria’s maternal mortality crisis needs actionable steps
IN Nigeria, pregnancy is still akin to a death sentence. Indeed, the high prevalence of maternal mortality in the country gives room for grave concern. All stakeholders, including the three tiers of government, NGOs, and community leaders must play a part in reducing the frequent loss of lives among pregnant women.
To reinforce the prevalence, the Coordinating Minister of Health and Social Welfare, Muhammed Pate, said recently that 57,000 mothers died from pregnancy and complications during childbirth in 2023 alone. This is highly unfortunate.
Although Pate stated that the Federal Government was committed to drastically reducing maternal mortality through the new Safe Motherhood Strategy, the central government should take actionable steps and cascade the strategies to state and local governments. States should drive the strategy while the Federal Government provides support to reduce Nigeria’s poor global outlook.
While the SMS targets at least seven million pregnant women and hopes to ease six million new births by activating the Decentralised Facility Financing package, robust collaboration with health NGOs, community leaders, and media to boost awareness is germane.
Although the UN Sustainable Development Goal 3.1 targets the reduction of the global maternal mortality ratio to less than 70 per 100,000 live births by the year 2030, Nigeria is behind the worldwide target by failing to reduce its high maternal mortality rate.
According to UNICEF, Nigeria represents 2.4 of the global population, yet it contributes 10 per cent of the global maternal mortality ratio. A 2023 WHO report stated that Nigeria has the second highest maternal, stillbirth, and neonatal deaths in the world followed by India.
This is estimated at 540 women and children per 1,000 at 12 per cent, while India is on 17 per cent at 788 deaths per 1,000. Nigeria shares the abysmal ranking with Pakistan (10 per cent), the Democratic Republic of the Congo (5.0 per cent), and Ethiopia (4.0 per cent).
In Africa, countries bogged with extremely high maternal deaths include South Sudan, Chad, and Nigeria. So, Nigeria should set a clear target with actionable timelines to end maternal deaths.
Nigeria’s health system is in a shambles. Its primary healthcare, which should be the backbone of its health infrastructure, is largely abandoned, leading to preventable deaths and epidemics. Malaria, a preventable disease, contributes 11 per cent to maternal deaths in the country.
Many of its hospitals are poorly equipped and lack adequate personnel. This is partly the outcome of the massive brain drain of medical professionals from the country for better greener pastures overseas. This places undue strain on doctors in Nigeria and a shortage of doctors in the local communities.
The current doctor-patient ratio is about 1:9,000, against the WHO-recommended ratio of 1:600. Pate said in 2023 that Nigeria needed at least 400,000 health workers to tackle the country’s healthcare needs, and experts said it might take 20 years for the country to produce enough doctors, pharmacists, nurses, and others to meet its needs.
In the alternative, Nigerians, including pregnant women seek self-help and traditional approaches to their health challenges, thereby increasing maternal deaths.
Unfortunately, multidimensional poverty, insecurity, poor rural roads, and the absence of basic amenities are extant challenges that impede maternal health.
So, the Federal Government must collaborate with the states and LGs to revamp the health sector. It should incentivise doctors deployed to the rural areas while salvaging the huge deficit by training birth attendants and midwives.
Like Cuba, it should prioritise PHCs. The WHO has praised Cuba for its emphasis on preventive care, universal access to healthcare services, and strong primary healthcare infrastructure. Nigeria should target this.
It should also look at the systems in Sweden, Australia, and Singapore, where significant progress in reducing maternal mortality has been achieved through a comprehensive healthcare system, prenatal care, skilled birth attendants, and emergency obstetrics care.
