DEATH IN THE DELIVERY ROOM

The states must do more by strengthening primary health centres

The scale of maternal mortality in Nigeria has become so alarming that we must call on the health authorities to fashion out a blueprint that will extenuate this pressing challenge. According to the latest report from the United Nations Children’s Fund (UNICEF), one Nigerian woman dies every seven minutes from childbirth or pregnancy-related complications with the country recording an estimated 75,000 maternal deaths every year, one of the highest figures globally. Two years ago, the World Health Organisation (WHO) also revealed that Nigeria accounts for over 34 per cent of global maternal deaths while the lifetime risk of dying during pregnancy, childbirth, postpartum, or after an abortion for a Nigerian woman is One in 22, compared to One in 4900 in developed countries.

However, we must put the blame on the state governments and the lack of attention by many of them to the primary health care system at the grassroots. It is even worse that most of them have rendered prostrate local government administration in their states, leaving healthcare delivery at that level comatose. Where they exist, there is shortage of manpower, while many manage with obsolete medical equipment. Yet, when a pregnant woman avoids prenatal care, she puts herself under the risk of postpartum hemorrhage (PPH), a complication arising from childbirth, which can result in a fatal outcome. Besides, women who do not have access to healthcare are prone to unassisted delivery carried out by quack midwives in unhealthy conditions with dire consequences for both the mother and foetus.

To address this serious public health issue, we must begin to examine how to mitigate the acute poverty that has become the lot of our people, especially in the rural areas. Authorities in the country must find ways to cushion the economic burden on most of the women who dwell in the countryside, as that has been identified as the reason for their inability to afford quality prenatal and post-natal care. The solution, of course, goes beyond the mere formulation of some policies by the federal government. There should be a framework where states and local governments are held accountable for their constitutional responsibilities of maternal child health care services in their domains.

Indeed, while most of the deaths are largely preventable, weak healthcare infrastructure, shortage of trained health workers, poverty, poor emergency response systems, and limited access to quality maternal care, especially in rural communities, continue to make pregnant women in the country vulnerable. Health experts have repeatedly warned that the growing migration of Nigerian doctors and nurses abroad is also worsening the crisis. 

We cannot continue to put the lives of our women at risk. There is an urgent need to go beyond rhetoric and promises, to initiating actionable plans that would help in addressing all the existing gaps in the primary health sector in Nigeria. This will require a collaboration between the federal government and authorities in the 36 states. We must end the agony and tears of mothers who carry pregnancy for nine months only to die at the point of delivery.