Despite reported improvement in the global healthcare system, many countries, especially in the sub-Saharan Africa, are still grappling with high maternal mortality rate, figures by the CIA World Factbook, as recently as January 2018, have indicated.
These figures relate to the maternal mortality ratio (MMRatio), which is “the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes). The MMRatio 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.”
Thus, of the 181 countries listed in the Factbook, African countries occupy the first 27 positions with the highest number of daily deaths at between 398 and 1,360, while 48 countries have above 120 deaths.
Sierra Leone, which is number one on the log, has the highest number of deaths at 1,360, and Poland, Iceland, Greece and Finland have the lowest of three deaths per day, and thus fill up the positions 181, 180, 179 and 178, respectively.
Interestingly, war-ravaged and unstable Libya is the only African country with a single digit death rate of nine per day, and occupies the 151 position on the log of maternal mortality worldwide.
Coming down to Nigeria, as all health issues are local, it appears that “the more things change, the more they stay the same.”
Consider the following scenario: In the year 2000, India had the highest estimated number of maternal mortality, followed by Nigeria. However, while India has moved down to number 56 on the log with 174 deaths per day, Nigeria only dropped to position number four (of the 181 listed countries), with 814 deaths daily – a position it also held in 2015.
With an average maternal mortality rate of 800, Nigeria records about 292,000 deaths yearly. The figure could be higher, as the number of daily deaths fluctuates. It’s 946 in 2005, 820 in 2014, 814 in 2015 and 814 observed this January. The highest maternal mortality rate was reached in 2005 (946) and the lowest was noticed in 2015 (814) – the same figure as early this year.
What are the main causes of maternal deaths that happen, although by lower rate, even in well-developed societies that operate quality healthcare systems?
Among the main causes are: Postpartum (occurring after childbirth) complications, such as severe bleeding (haemorrhage) and infection; unsafe abortion; diseases, like high blood pressure, malaria and HIV/AIDS during pregnancy; inadequate prenatal care; inaccessible medical and sanitary services; and failure of health practitioners to detect early warning signs.
One or a combination of these factors could result in complications before, during and after childbirth.
The high maternal mortality in Nigeria is a reflection of failure of the governments, both federal and states, to sufficiently provide funding and facilities for healthcare delivery, especially for expectant mothers, to prevent complications during pregnancy and childbirth.
This was why the people of Ondo State, and indeed many Nigerians, applauded the establishment of the state-of-the-art Mother and Child Hospital in Akure, the state capital, during the administration of Governor Olusegun Mimiko, a medical doctor.
Within a few years of its operation, the hospital received accolades from local and international bodies, as the best that could happen to humanity in this clime, given its reference and referral status, and the quality free services, including caesarean operations, it rendered to pregnant women, and children below five years of age.
With about 200,000 pregnant women patronising the hospital in a year, and a record of over 80 per cent successful deliveries, the medical centre tremendously reduced maternal mortality to the barest minimum in the state.
But sadly, the hospital has gradually waned in status and standard, due to alleged neglect and poor attention paid to it by the incumbent administration in the state, resulting in the failure of its management to properly run the facilities.
Patronage of the hospital has apparently reduced owing to the introduction of charges for services hitherto rendered free to patients, prompting their return to traditional birth attendants. This does not augur well for the state’s healthcare system, and the care that the people desire and deserve for their wellbeing.
While we acknowledge that the times are hard, especially among competing demands, we call on the Ondo State Government to reconsider its withdrawal and/or reduction in funding to the hospital, to return it to its glorious days.
We similarly enjoin other states and the Federal Government to establish more functional health facilities that cater to the needs of the mother and child, and fund them adequately, to further reduce the rate of maternal mortality in the country. After all, the health of the people is the wealth of a nation, and nothing should be done to undermine this very important resource.
Nigeria that prides itself as the “Giant of Africa,” and is endowed with enormous resources, should not lag behind, or compete with less-privileged countries, healthcare-wise, on the continent. It’s time we advanced our position on the maternal mortality log, the way India did between 2000 and 2015.
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