Nigeria, Africa’s largest democracy, is the second most dangerous place for a pregnant woman, according to data from UNICEF, with only India having a worse maternal mortality rate globally.
At least 82,000 women die annually in Nigeria due to complications arising from their pregnancy.
Maternal mortality is defined as the death of a woman during pregnancy, childbirth, or within 42 days of termination of pregnancy, and it remains a pressing global issue that seems to be worse in Nigeria.
There are many stories about pregnant women dying from avoidable circumstances in Nigeria.
In oil-rich Bayelsa State, Ebiladei Amabipi, a 29-year-old advocate for enhanced healthcare in her local Ayamasa community, experienced the issues she had been campaigning against. Ayamasa, which only had a single health facility and an incomplete road linking it to the main town, faced significant challenges.
Tragically, Ebiladei’s own pregnancy laid bare the severe difficulties she had campaigned on. Due to the absence of a suitable healthcare facility nearby, she embarked on a journey to Ekeremor main town for the birth of her child. However, her journey was cut short. She gave birth inside the vehicle she was travelling in and succumbed to a haemorrhage, far from any available healthcare assistance.
Ebiladei’s story is only one of many other stories of where Nigeria’s health care system, or a lack of access to it, has led to the death of a woman.
Rooted in Nigeria’s health crisis
Several interrelated factors contribute to the persistently high maternal mortality rate in Nigeria.
One such contribution to worsening maternal mortality in the country is the state of the health system: limited access to quality healthcare is a significant concern, particularly in rural areas, where inadequate access to skilled birth attendants, emergency obstetric care, and essential medical supplies escalates the risks associated with pregnancy and childbirth.
Nigeria suffers from a shortage of medical doctors. According to Dr Uche Rowland, the President of the Nigeria Medical Association or NMA, the country has only 24,000 practising medical doctors.
Rowland held that per the World Health Organization or WHO, a nation needs a combination of 23 medical professionals, including doctors, nurses, and midwives per 10,000 population, to provide fundamental healthcare services.
According to the president, the number in Nigeria is way below that. In certain Southern states, the ratio is one doctor available to treat 30,000 patients, and in the Northern region, the situation is even more dire, with one doctor serving 45,000 patients.
Nigeria also suffers from an insufficient health facility. The country has 17 health facilities per 100,000 persons, and in some communities, pregnant women have had to travel long distances to access care.
Moreover, the lack of education, especially among women, plays a pivotal role in poor maternal health outcomes. Nigeria has a 31% illiteracy rate. Women with limited education might not be aware of proper prenatal care practices or the importance of seeking medical assistance during complications.
The prevalence of early and forced marriages in Nigeria is another critical factor contributing to maternal mortality. Child marriage exposes young girls to the dangers of pregnancy and childbirth before their bodies are fully mature, resulting in a higher risk of complications and maternal mortality. Additionally, the country’s high fertility rates, with many women experiencing multiple pregnancies quickly, strain women’s bodies and increase the risk of complications.
The lack of skilled birth attendants presents a significant challenge. Many births in Nigeria occur at home without qualified healthcare professionals, increasing the risk of complications and maternal deaths.
Also, infrastructural and transportation challenges, including poor road networks and limited transportation options, promptly hinder pregnant women’s access to healthcare facilities.
What needs to happen better?
Different governments have proposed various health interventions, from the Midwife service scheme to even the recent Basic Health Care Provision Fund, to reduce Nigeria’s maternal mortality rate. Still, in most cases, the intervention programs were poorly implemented and barely moved a needle.
Addressing maternal mortality in Nigeria demands a multi-faceted approach involving government initiatives, community engagement, and international support.
Firstly, improving access to healthcare is paramount. This includes investments in healthcare infrastructure, particularly in rural and underserved areas, as well as training healthcare professionals and ensuring the availability of essential medical supplies. The BHCPF aimed to tackle this, but the result could have been more encouraging.
Secondly, education and awareness campaigns are crucial. These campaigns should focus on educating women, families, and communities about the significance of prenatal care, skilled birth attendance, and family planning.
The provision of family planning services plays a pivotal role in empowering women to make informed decisions about their reproductive health. Empowering women through education and increased agency enables them to make informed choices, positively impacting them and their children’s health. Training and deploying skilled birth attendants, midwives, and other healthcare professionals to communities can drastically reduce maternal mortality rates.
Community engagement is a vital strategy. By working closely with communities, healthcare interventions can be tailored to align with cultural practices and beliefs, increasing their effectiveness and cultural sensitivity.
Enforcing policies prioritising maternal health, allocating adequate resources, and monitoring progress are essential for reducing maternal mortality. International collaboration is also crucial. The global community can provide financial support, technical expertise, and knowledge sharing to assist Nigeria in its efforts to address maternal mortality.
Until Nigeria takes a more serious and honest approach to tackling maternal mortality, the country’s commitment to SDG Goal 3, target 3.5 of “By 2030, end preventable deaths of newborns and children under five years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births” would remain a pipe dream.
Nigeria, Africa's largest democracy, is the second most dangerous place for pregnant women, with only India having a worse maternal mortality rate. Annually, at least 82,000 Nigerian women die due to pregnancy-related complications. These deaths are often due to limited access to quality healthcare, particularly in rural areas where there is a shortage of medical professionals and health facilities. Nigeria has only 24,000 practicing medical doctors, far below the necessary ratio recommended by the WHO. The country also grapples with high illiteracy rates, early and forced marriages, and infrastructural and transportation challenges.
Efforts to reduce maternal mortality have included various government health interventions, but these have often been poorly implemented. Effective strategies to tackle the issue include improving healthcare infrastructure, increasing the number of trained healthcare professionals, running education and awareness campaigns on prenatal care and family planning, and engaging with communities to tailor healthcare practices culturally. Enforcing policies that prioritize maternal health and seeking international support for financial and technical assistance are crucial. Without a serious approach, Nigeria risks failing to meet its Sustainable Development Goal of reducing preventable neonatal and under-5 mortality by 2030.
