- Nigerian authorities must tackle contributory factors to high maternity death rate
Chilling information supplied by the Minister of Health, Dr Osagie Ehanire, gives an insight into the gravity of maternal mortality in the country. He was reported saying about 100 women die every day during childbirth.
This figure may not reflect the true picture because of unreported cases. Only a third of Nigerian women are said to deliver in a facility or are attended to by someone skilled.
The minister presented the alarming information on maternal deaths in his address at the launch of Nigeria’s Family Planning 2030 (FP2030) Commitment and Dissemination of Other Reproductive Health Policy Documents in Abuja.
“Our key aspiration,” he declared, “is to ensure universal access to sexual and reproductive healthcare services, including for family planning information and education, and the integration of reproductive health into national strategies and programmes which align with past and ongoing efforts in Nigeria.”
Health experts say about 95 percent of maternal deaths are preventable, which raises questions about the high rate of such deaths in the country. There may well be inadequate clarity on the causes of maternal deaths in facilities because of the lack of a strong surveillance and response system.
Central to the problem of high maternal mortality is the country’s under-resourced and weak primary healthcare (PHC) system. According to the CEO of the National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib, “only approximately 43 percent of Nigerians have access to quality primary healthcare services with only about four doctors available per 10,000 people, a fraction of the minimum rate recommended by the United Nations (UN) for basic health coverage.”
The country’s doctor-patient ratio is alarmingly low, and is nowhere near the World Health Organisation’s (WHO) standard doctor-patient ratio of one doctor per 600 people.
This situation is connected with, and compounded by, the increasing exodus of Nigerian doctors to foreign lands because of poor working conditions in the country. About 2,000 doctors are said to leave Nigeria yearly; and there are currently more than 5,000 Nigeria-trained doctors registered in the UK.
There is no doubt about the importance of a strong primary healthcare system in tackling high maternal deaths in the country. The primary healthcare centres are supposed to be the first service points for expectant mothers and infants, and when they are ill equipped to respond to their medical needs it exposes many mothers and babies to untimely death.
It is reassuring that the Federal Ministry of Health, in collaboration with the NPHCDA, is holding a Primary Health Care Summit on March 24 and 25 in Abuja to address the problems. Tagged “Reimagining PHC,” the programme is designed to provide solutions for improved PHC services nationwide.
Necessary improvements include providing more facilities, especially in the rural areas, and increasing the availability of trained health personnel. Apart from improving PHC services, the authorities must also address other factors that contribute to high maternal deaths, including poverty, illiteracy, early marriage and cultural practices.
More importantly, the authorities must review the approach to budgeting for the health sector to reflect a greater focus on healthcare delivery. In April 2001, heads of state of African Union countries met in Abuja and pledged to set a target of allocating at least 15 percent of their annual budget to improve the health sector. It is disappointing that Nigeria has consistently failed to meet the standard of the Abuja Declaration.
The country’s 2022 budget is N17.16 trillion, and N724 billion (4.2 percent) was allocated for healthcare across the 36 states of the federation and the Federal Capital Territory. This picture of poor funding shows why health-sector budget improvement is a necessity.
It is unacceptable that Nigeria ranks among the countries with the highest maternal mortality rates. The authorities should urgently deal with the contributory factors.
The Nation
