October 3, 2023

Nigeria’s deprecatory outlook for deaths among its womenfolk of childbearing age and children remains a perilous matter of concern. Data just published by The Reportr Door reveals that thousands of women and children under the age of five are dying daily from preventable causes. The consequence is devastating. Nigeria firmly remains among the most dangerous places on earth to be a mother or be born. Therefore, there should be concerted efforts across the board to reverse the ugly indices.

Between 1990 and 2020, many other parts of the world made real improvements in reducing maternal and infant mortality rates. Nigeria did not, as revealed by data from the Federal Ministry of Health: 145 Nigerian women die every day from pregnancy-related causes; 2,300 children below age five suffer the same fatal fate daily. These are among the highest rates globally.

Proof of this grim reality abounds nationwide, though the urban centres, where there is a semblance of health services, are slightly better off. Acknowledging the high rates, the Minister of Health, Osagie Ehanire, said, “The poor health indices for which Nigeria has not fared comfortably are the maternal and child mortality and morbidity, they are not very good, but these are generated largely in the rural areas where there is no access to any form of health care….”

Like other regions of the world, experts link the death of women during pregnancy, childbirth, and post-childbirth directly to postpartum haemorrhage (27 per cent), pre-eclampsia and hypertensive disorders (14 per cent), pregnancy-related infections (11 per cent), and complications of unsafe abortion (8.0 per cent), as well as indirectly by pre-existing medical conditions aggravated by the pregnancy. The Paediatric Association of Nigeria says Nigeria’s MMR is 814 in 100,000 lives births.

In 2022, the World Health Organisation said a woman in Nigeria had a one in 22-lifetime risk of dying during pregnancy, childbirth, or postpartum/post-abortion, putting its own figure at 917 deaths for every 100,000 live births. Consequently, the NGO, Concern Worldwide US listed Nigeria as the fourth worst place on earth to be a mother after South Sudan (1,150 per 100,000 live births), Chad (1,120) and Sierra Leone (1,120). The UN Sustainable Development Goals target is 70 maternal deaths per 100,000 live births by 2030.

Skilled birth attendants, nurses, and midwives are scarce in Nigeria, while there are few properly equipped birth centres and hospitals. Where available, the costs of medical services are too expensive for the masses. During the ongoing naira scarcity, several men reported losing their pregnant wives because they had no cash to pay hospital bills.

In droves, skilled medical professionals – doctors, nurses, laboratory attendants, consultants, and others – are fleeing Nigeria’s broken health system for Europe and North America. PAN estimates one doctor to 3,000 patients in Nigeria; made worse by the 2,000 locally trained doctors that leave the country annually. The Nigerian Medical Association estimates the doctor-to-patient ratio at between 1:5,000 and 1:8,000. The Medical and Dental Consultants Association said 500 of its members left the country for overseas practice in the two years to September 2022.

UN agencies report that women in sub-Saharan Africa face the highest lifetime risk (1 in 41), or about 268 times higher than in Western Europe (1 in 11,000). “The lifetime risk of maternal death ranges from one in 5,300 in high-income countries to one in 49 in low-income countries,” UNICEF said. Sadly, this is so true for Nigeria.

Africa’s largest economy also fares woefully in child health. Thousands of its children die from malaria, neonatal encephalopathy, infections, preterm birth complications, lower respiratory infections (such as flu and pneumonia) and diarrhoea. Although Sierra Leone, at 80.1 deaths per 1,000 live births, reports the highest infant mortality rate globally, World Population Review data shows Nigeria not far behind at 72.2. The Central African Republic posts 77.5, and Somalia 72.72.

Elsewhere, these ailments have been tamed. Iceland reports the lowest IMR globally at 1.54 per cent, says Infoplease, an online resource. The UN SDG 3.2 aims to reduce the IMR to as low as 2.5 per cent in all countries by 2030.

Nigeria is so far away from this lofty target. Of concern is that the country depends too much on global aid, including medicines, for the health of its people. This is aggravated by the domestic drug manufacturing crisis. Imported medicines are expensive since they are priced in foreign exchange.

To make amends, all tiers of government must progressively buy into initiatives aimed at eradicating the MMR and IMR scourge. The Centre for Public Impact said mortality rates have decreased to less than half of their 1990 levels in India through initiatives anchored on the Reproductive and Child Health programme in 1997. Under-fives deaths dropped from 12.7 million per year in 1990 to 5.9 million in 2015 there. Nigeria must learn from such ingenuity.

Cuba, with the second lowest IMR in the Americas at 5.5 per cent (behind Canada’s 4.9 per cent), demonstrates that success is not all about money. Cuba’s is driven on its strong primary healthcare system, according to the US National Library of Medicine, anchored on universal healthcare and universal education. The country’s 99.7 per cent literacy rate is a major factor, while Nigeria has 20.3 million of school age are out of school, the world’s second highest.

Undoubtedly, there must be new approaches and initiatives to decelerate the woeful health indices.

The three tiers of government – especially the state and local governments – should establish training centres for birth attendants and midwives in the remote rural areas. These categories of workers will attend to pressing cases before complications are referred to better-qualified professionals. Many women die by accessing unskilled traditional birth attendants; this should stop. Caesarean sections should not be expensive.

For a newborn, health professionals say the first 28 days are the most critical. Therefore, mothers should be sensitised on care for newborns during this delicate period. The governments should stop shying away from their responsibilities by making the treatment of certain ailments like malaria and diarrhoea largely free.

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