Nigeria fights high maternal mortality through improved quality of care
Abuja, 20 June, 2018 - “There were no signs that the morning of 31 May 2018 would be different until I started feeling the pangs, requiring medical assistance,” said Naomi Muyadeen. "Initially, I dreaded going to the government facility but stepping into the health facility, I immediately noticed the change.”
A resident of Kuchingoro, a suburb of Abuja, Mrs Muyadeen is a 23 year old mother of one and nine months pregnant. She has had previous antenatal visits to the Primary Healthcare Centre (PHC) in Kuchingoro.
Mrs Muyadeen’s initial fear was informed by the demise of her elder sister while giving birth in a similar setting. According to her, members of her family were shocked as they held the widespread belief that one cannot die while giving birth in a hospital.
“My sister was consistent with her antenatal sessions and did everything a pregnant woman should do, yet she bled to death.” Mrs Muyiwadeen lamented.
The head of nursing unit at Kuchigoro PHC, Mrs Esther Adepoju stated there are several causes of maternal mortality. “A woman can die while giving birth due to poor hygiene on the woman’s part, negligence by nurses and doctors, lack of consistency in attending antenatal sessions, and even fear can cause death during childbirth”, she said.
Government poised to address maternal mortality
A joint report (Trends in Maternal Mortality: 1990 to 2015 by WHO, UNICEF, World Bank and United Nations Population Fund) estimates that Nigeria has approximately 58,000 maternal deaths, accounting for 19% globally. Put differently, at least 800 women die in every 100,000 live births. Northeast has the highest maternal mortality rate, compared to other regions, with 1,549 deaths per 100,000 live births.
To address the high maternal mortality rates, Minister of Health, Professor Isaac Adewole in July 2017 inaugurated a 34-member Task Force to accelerate reduction of maternal mortality in Nigeria.
“Maternal mortality remains unacceptably high in Nigeria, ranking among the highest in the world and the rate of reducing these deaths have been slow as many of the contributory factors remain unaddressed. The Federal Ministry of Health is committed to bringing it to an end,” Professor Adewole said while inaugurating the Task Force.
Combined efforts and partnership to curb fatalities
In Nigeria, World Health Organization (WHO) and other partners are supporting government to develop and adapt various guidelines and policies on reproductive, maternal, new-born and child health. Records indicate that between 2000 and 2015, the maternal mortality rate in Nigeria reduced from 1,170 deaths to 814 deaths per 100,000 live births (30.4% decrease).
Additionally, WHO with support from Bill & Melinda Gates Foundation is providing technical support for implementation of the initiative in Federal Capital Territory, Sokoto and Kebbi states as well as supporting the Federal Government through the Quality, Equity and Dignity (QED) network for coordination and monitoring implementation in Nigeria. There is also in the pipeline, a maternal and newborn Quality of Care (QOC) initiative to be supported by partners (led by WHO & UNICEF) which will focus on instituting quality improvement in selected health facilities towards ensuring positive pregnancy and birth experience for women.
According to Dr Wondimagegnehu Alemu, WHO Country Representative to Nigeria, QOC interventions will improve the capacity of health workers to provide efficient, evidence-based interventions to pregnant women.
However, “In order to effectively reduce maternal mortality rates in Nigeria, it is imperative that government, working with other stakeholders, including community and traditional leaders at all levels; ensure provision of affordable quality maternal and new born services to the people wherever they live at a cost that will not impoverish them while accessing the services,” Dr Alemu noted.
The Kuchigoro PHC is one of the recently revitalized PHCs in Nigeria, where pregnant women can have easy and equitable access towards achieving health-related Sustainable Development Goals (SDGs). The target of SDG 3.1 for instance, is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. In order to reach this target, Nigeria needs to reduce its maternal mortality rate by 7.5% every year.