SEATTLE, Washington — Maternal mortality rates in Nigeria are high. In fact, women having a one in 13 chance of dying from pregnancy and childbirth. With approximately 40,000 maternal deaths every year, Nigeria accounts for 14 percent of all maternal deaths worldwide. Several organizations, including the World Health Organization, Bill & Melinda Gates Foundation, UNICEF and HelpMum are working to improve maternal health in Nigeria.
Cost and Distance: Contributing Factors
A major contributor to Nigeria’s high maternal mortality rate is the fact that 60 percent of births in Nigeria take place at home without a skilled health professional. This rate has been consistent since the 1990s. Additionally, fewer than half of pregnant women attend the recommended number of prenatal care visit. A mere third of women will access postnatal care.
For many women, especially those living in poverty, there are significant barriers that prevent them from accessing care in a health facility and receiving care from a skilled health professional. High costs and long waiting times are often prohibitive. When money is scarce, it is more likely to be spent on the children than the pregnant wives. Women’s healthcare is often a lower priority. Particularly for rural women, health facilities are often not located near their homes since a majority of health services are located in urban areas. The distance to a hospital may make it impossible for them to go.
Age and Cultural Beliefs: Contributing Factors
Young mothers are at additional risk because they are even less likely to access health services during pregnancy and childbirth. Approximately one-third of adolescent mothers in northern Nigeria delivered their child without any assistance, even from a relative or friend. Pregnancy-related complications are the leading cause of death for women aged 15-19 in Nigeria. Young mothers are also at a higher risk of anemia, obstructed labor and fistula, all of which can lead to death.
Certain cultural beliefs and practices, particularly in regards to gender roles, have a negative impact on maternal health in Nigeria. Many Nigerian women are expected to continue performing household chores while they are pregnant and are not given any special care or attention. This prevents many mothers from getting the rest they need during the pregnancy, which can result in complications. Additionally, being in a patriarchal society prevents Nigerian women from being able to take control of their own healthcare needs.
Improving Quality of Care
Poor health care is also a contributor. Even if women do access medical services, they may not receive high-quality care. Health facilities in Nigeria are underfunded and, therefore, often lack adequate resources. Many facilities do not have the training or equipment needed to detect common complications like postpartum hemorrhage and hypertensive disorders. Postpartum hemorrhage accounts for 23 percent of all maternal deaths in Nigeria. Furthermore, instances of the abuse of patients by health care staff in public health facilities can discourage women from seeking professional medical services.
In response to poor maternal health in Nigeria, the Minister of Health, Professor Isaac Adewole, created a task force in July 2017 to focus on reducing maternal mortality. The World Health Organization is supporting the Nigerian government in updating its policies on maternal health. WHO, along with support from the Bill & Melinda Gates Foundation and UNICEF, is helping implement quality improvements to health facilities. The goal of these efforts is to improve the ability of health workers to provide efficient care and to ensure they are able to effectively recognize complications and intervene to save the life of the mother and child.
Providing Clean Birth Kits
A Nigerian health service provider, HelpMum, was created by Abiodun Adereni in direct response to the dismal state of maternal health in Nigeria. HelpMum focuses its efforts on rural areas. These women are at higher risk of dying from pregnancy or childbirth complications largely due to their lack of access to health facilities or professionals. HelpMum distributes clean birth kits to rural women. These kits include delivery mats, surgical blades and other supplies necessary for a safe home delivery that will not lead to infections. This way, women who are unable to access professional health services will be able to conduct safer home births.
In 2018, HelpMum was one of four companies to win the Google Impact Challenge Africa in Nigeria. It was awarded a grant of $250,000. Juliet Ehimuahn-Chiazor, the Google Country Director in Nigeria, stated, “Google is eager to provide support to individuals and organizations using technology in new ways to make a positive difference.” With the grant, HelpMum intends to reach more Nigerian women. Its current goal is to reach 100,000. The organization is also working with Google to improve the health of young children by creating an immunization tracker that will help women keep track of when their children need to receive certain vaccinations.
While efforts by the Nigerian government and its international partners are essential to saving lives in Nigeria, much more needs to be done to decrease maternal mortality in the nation. Improving health facilities is an important step, but it does nothing to help rural women who remain unable to access these facilities. Greater priority needs to be placed on ensuring health services are available in rural areas and that they are high quality and affordable. Maternal health in Nigeria will only improve when the most vulnerable women are able to access adequate care during pregnancy and childbirth.
– Sara Olk