A report by the World Health Organization (WHO) has ranked Nigeria as the country with the second highest number of maternal, neonatal and child deaths worldwide.
The report made public on Tuesday, May 9, shows Nigeria trailing India as the two leading nations where mothers and their babies are most likely to die.
Eight other countries with high maternal, neonatal and stillbirths are Pakistan, the Democratic Republic of the Congo, Ethiopia, Bangladesh, China, Indonesia, Afghanistan, and the United Republic of Tanzania.
The report shows that progress in improving mothers’ and babies’ survival has stagnated since 2015, with around 290,000 maternal deaths occurring yearly.
The United Nations Economic Commission for Africa says that one in seven global maternal deaths occurs in Nigeria. That is more than 50,000 women dying per year in Nigeria.
Health experts, however, said about 95 per cent of deaths during childbirth are preventable.
Nigeria’s health minister, Osagie Ehanire, had attributed the high maternal, infant and under-five mortality in the country to lack of access to quality healthcare services.
The WHO in a statement said COVID-19 pandemic, rising poverty, and worsening humanitarian crises have intensified pressures on stretched health systems.
It said according to the report, global progress in reducing deaths of pregnant women, mothers and babies has flat-lined for eight years due to decreasing investments in maternal and newborn health.
The WHO, Director of Maternal, Newborn, Child and Adolescent Health and Ageing, Anshu Banerjee, said pregnant women and newborns continue to die at unacceptably high rates worldwide.
Mr Banerjee said the COVID-19 pandemic has created further setbacks to providing women and babies with the healthcare they need.
“If we wish to see different results, we must do things differently. More and smarter investments in primary healthcare are needed now so that every woman and baby – no matter where they live – have the best chance of health and survival,” he said.
Steven Lauwerier, UNICEF Director of Health, said since the COVID-19 pandemic, babies, children, and women who were already exposed to threats to their well-being, especially those living in fragile countries and emergencies, are facing the heaviest consequences of decreased spending and efforts on providing quality and accessible healthcare.
Lauwerier said funding shortfalls and underinvestment in primary healthcare can devastate survival prospects.
“For instance, while prematurity is now the leading cause of all under-five deaths globally, less than a third of countries report having sufficient newborn care units to treat small and sick babies,” he said.
“Meanwhile, around two-thirds of emergency childbirth facilities in sub-Saharan Africa are not considered fully functional – meaning they lack essential resources like medicines and supplies, water, electricity or staffing for 24-hour care.”
Maternal mortality ratio is 512 deaths per 100,000 live births. Thus, for every 1,000 live births in Nigeria, about five women die during pregnancy, childbirth, or within two months of childbirth. Clearly, there is a need for continuous investment in promoting maternal and child health.
According to the Nigeria Demographic and Health Survey (2018 NDHS), the rate of under-five mortality is 132 deaths per 1,000 live births, while the infant mortality rate is 67 deaths per 1,000 live births. Maternal mortality ratio is 512 deaths per 100,000 live births. Thus, for every 1,000 live births in Nigeria, about five women die during pregnancy, childbirth, or within two months of childbirth. Clearly, there is a need for continuous investment in promoting maternal and child health.
According to the National Agency for the Control of AIDS (NACA), Nigeria has the greatest number of HIV-infected babies in the world. Akwa Ibom state has the highest HIV prevalence in the country (5.6%). HIV prevalence among pregnant women aged 15-24 years is also highest in Akwa Ibom state. Despite the successes achieved by the PMTCT program in Nigeria, a large percentage of women do not go to health facilities to access ANC and PMTCT services due to poverty and lack of trust in the healthcare system; instead, they patronise the services of traditional birth attendants. In fact, the 2018 NDHS notes that 56% of women giving birth in Nigeria are not assisted by skilled providers.
Findings reveal that reducing maternal and child mortality is hinged on the nation’s commitment to improving access to quality and affordable healthcare for people in underserved communities, improving uptake of antenatal care (ANC) services and promoting the prevention of mother to child transmission (PMTCT) of HIV in rural communities and improving access to quality healthcare services through training of health workers for improved healthcare delivery and engaging the wider community for a change in health seeking behavior.
Women are incentivised to take up ANC and PMTCT services at designated health centres, while mentor mothers are engaged to ensure that HIV positive mothers give birth in health facilities where babies can be immediately put on prophylaxis. Also, behavioural change communication for better health seeking behaviour is an integral part of the strategy.
We therefore advocate that Nigerians must take a human rights and gender transformative approach to address maternal and newborn mortality, and it is vital that we stamp out the underlying factors which give rise to poor maternal health outcomes like socio-economic inequalities, discrimination, poverty, and injustice.
