Nigeria, 9 others responsible for 60% of global maternal deaths

As the 2015 Millennium Development Goal (MDG) 5 target of reducing maternal mortality and achieving universal access to reproductive health draws closer, latest reports by the World Health Organisation (WHO) has ranked Nigeria among the 10 countries in the world that contribute about 60 percent of the world’s maternal mortality burden.

Nigeria currently has a maternal mortality ratio of 560 per 100,000 live-births, an improvement on the 630 per 100,000 recorded in 2010, according to the report titled ‘Trends in Maternal Mortality: 1990 to 2013’.

Also, sub-Saharan Africa was observed to be the riskiest region globally for women dying of complications in pregnancy and childbirth, says the report.

A breakdown of the figures shows that India recorded 50,000 deaths in 2013, Nigeria (40,000), Democratic Republic of the Congo (21,000), Ethiopia (13,000), Indonesia (8,800), Pakistan (7,900), United Republic of Tanzania (7,900), Kenya (6,300), China (5,900), and Uganda (5,900).

Jide Idris, commissioner for health, Lagos State, explained to BusinessDay that many mothers and newborns in developing countries do not have access to adequate health systems, birth attendants and low-cost interventions, which, taken together, could reduce newborn death rates by up to 75 percent, saving as many as 2 million babies annually during the first 28 days of life.

“Low-cost solutions such as the gel chlorhexidine (CHX) which can help clean the umbilical cord and protect a baby from infection are now available to reduce these deaths. We know how to train and equip health workers to provide these solutions,” said Idris.

“Nigeria, with its huge population, is key to reducing infant mortality in Africa, as even a small reduction in the death rates of newborns can result in thousands of lives being saved. We must do it in Nigeria first, to set examples for others in Africa,” he said.

A Lancet Global Health report reveals that more than 1 in 4 (28 percent) maternal deaths are caused by pre-existing medical conditions such as diabetes, HIV, malaria and obesity, which are usually aggravated by pregnancy.

Other causes of maternal deaths include severe bleeding (mostly during and after childbirth), 27 percent; pregnancy-induced high blood pressure (14 percent); infections (11 percent); obstructed labour and other direct causes (9 percent); abortion complications (8 percent); and blood clots (3 percent).

While there is uncertainty over  whether Nigeria will meet the MDG 5, 11 countries that had high levels of maternal mortality in 1990 (Bhutan, Cambodia, Cape Verde, Equatorial Guinea, Eritrea, Lao People’s Democratic Republic, Maldives, Nepal, Romania, Rwanda, Timor-Leste) have already reached the MDG target of a 75-percent reduction in maternal mortality from the 1990 rate by 2015.

Somalia and Chad also have the highest lifetime risk of maternal death as women face a 1-in-18 and 1-in-15 lifetime risk in the two countries, respectively.

To tackle the high rate of maternal mortality, the WHO recommends strong health systems – with facilities that have adequate health workers, equipment and medicines. The global body advocates for proper documentation of deaths in order to provide accurate information about maternal deaths and help to channel resources where they are most needed.

“There is growing consensus worldwide that ending preventable maternal deaths can be achieved by ensuring that every woman has access to quality health care. Global and national targets beyond 2015 will be important for tracking progress in reducing maternal deaths and ensuring that maternal health continues to be a global development priority,” the WHO said.

The Abuja Declaration by African Heads of States in 2000 agreed to devote 15 percent of the national budget to funding healthcare. However, BusinessDay research shows that the health sector in Nigeria has enjoyed a maximum of 7.5 percent and minimum of 3.1 percent funding from national budgets in the last 10 years.

While the health sector got N273 billion (5.6 percent of the budget) in 2013, it received N262.74 billion in the 2014 budget, with N216.4 billion (82.38 percent) earmarked for recurrent expenditure and N46.3 billion (17.62 percent) for capital expenditure.

Alexander Chiejina