Barriers to Safe Motherhood in Nigeria

HIGHLIGHTS ■ Nigeria has one of the highest maternal mortality ratios in the world: 1,100 maternal deaths for every 100,000 live births. ■ Although patterns vary by region, high-risk births persist in Nigeria. In both 1990 and 2003, two-thirds of all births were high risk because of the mother's age, parity or spacing of births. ■ More than 40% of women giving birth do not receive prenatal care from a trained health care provider. This proportion did not improve during the 13-year period. It is above average in the North East and North West regions. ■ The proportion of women receiving health care from a trained provider at delivery has increased somewhat—from 30% in 1990 to 37% in 2003. Even so, it is still low and less than that in some other West African countries. ■ Increasing urbanization and education coupled with a drop in the proportion of women who are married have led to declines in fertility desires and childbearing. However, the desire for a smaller family appears to be outpacing reductions in fertility. This is evident in the increasing proportion of births that are unplanned, which largely reflects a low level of contraceptive use in Nigeria. ■ The Nigerian government has adopted several policies aimed at reducing maternal mortality by 75% by 2015. However, they lack effective implementation, largely because of the very low level of government spending on health care. Most programming on safe motherhood has been initiated by nongovernmental organizations working with funding from international donors. ■ Some recent programs and policies have the potential to improve the quality of maternal health care in Nigeria. To achieve this goal, the Nigerian government must make a commitment to provide adequate resources—trained providers, up-to-date equipment and, most importantly, sufficient funding—to end the many needless deaths associated with childbearing among Nigerian women. APPENDIX TABLE 1. Selected social and demographic measures, and measures of maternal morbidity and mortality among women in Nigeria, by region, Foundation, for meeting with us during our visits to their establishments in the course of our research. We also greatly appreciate the contributions of the other members of the project Nigeria, the most populous country in Africa, has one of the highest maternal mortality ratios in the world. 1 Newly revised estimates of the World Health Organization (WHO) indicate that there are 1,100 maternal deaths for every 100,000 live births in the country 2(Annex 5) and …