Pregnancy-related complications claimed the lives of an estimated 515,000 women worldwide every year, with most of these deaths occurring in the developing world.
For women in industrialized countries, the lifetime risk of death from pregnancy complications is one in 2,800, but that risk for women worldwide is one in 74.

The leading causes of maternal mortality are hemorrhage, obstructed labor, hypertension-related disorders, infection, HIV/AIDS, malaria and anemia also take a huge toll on pregnant women living in areas of high prevalence.

The majority of these deaths could be prevented with access to quality emergency obstetric care. Furthermore, family planning services can play a major role in preventing maternal deaths by reducing health risks associated with unplanned pregnancy.
The reduction of maternal deaths is a key international development goal. Evidence based health policies and programmes aiming to reduce maternal deaths need reliable and valid information.

It has been established all over the world that lack of skilled attendants at birth is a major indicator for maternal morbidity and mortality. And it is also known from data from all over the world that non-use of antenatal care is one factor for increased rational morbidity and mortality.

Based on these facts, the Chief Medical Director, Lagos University Teaching Hospital (LUTH), Idi-Araba, Prof. Akin Osibogun, has appraised the initiative of the Federal Ministry of Health in deploying midwives through the Primary Healthcare Development Agency, in all the local government areas of the country.

Osibogun said that the midwives will be at the vanguard of health promotion, disease prevention and recognition of any signs of problem in pregnant women and in children and will refer such women and children to higher levels of care.
According to him, “I think we need to understand fully the responsibilities for health in the country. If you look at our national health policy, the federal level have responsibilities for tertiary healthcare and human capital development, that is manpower training. The state government have responsibility for secondary care and the local government have responsibility for primary care.

“In addition, the Federal Government or the Federal Ministry of Health provides leadership in health and that is why the honourable minister is providing that leadership in revamping the primary healthcare sub-system. But a lot still depends on local governments because health centres and close to local governments. So, local governments and state governments have their roles to play in revamping the primary healthcare sub-system.

“And we must continue to emphasize that health is a shared responsibility. It is a responsibility that is shared between the Federal, state and local governments, as well as the communities, families and individuals. It is a responsibility for all of us. All stakeholders.
“Some of the activities in primary healthcare that we want to be interested in is immunization. The National Policy on Immunization is being driven by the Federal Ministry of Health. The Federal Government is interested in the vaccines. In fact, all vaccines against childhood diseases are being imported by the Federal Government. The Federal Government is providing that and they provide to states, local governments and all health facilities. And immunization is one of the most efficient interventions in health. The federal level is investing in that area.

“The federal level, through the Federal Ministry of Health is also investing in the control of malaria. Millions of bed nets have been imported and being distributed all over the country. And only recently, the National Primary Healthcare Development Agency which is a parastatal under the Federal Ministry of Health are now in the deployment of midwives in all local governments in Nigeria. So, the Federal Government is funding the Midwives Service Scheme. And that’s a primary healthcare approach or a primary healthcare strategy to reduce maternal and infant mortality.

“Once you have midwives in every local government area and districts, then, they will be able to monitor pregnancies and they will be looking out for early danger signs in pregnant women and they can get them referred to higher levels of care. So, you can see the efforts of the Federal Government and there are several other intervention that the Federal Ministry of Health is providing.

“But very critical intervention that I will like to mention at this point will be the immunization programme and then the Midwives services scheme. The nurses were just posted last week. The scheme is just starting. So, it is too early to start assessing a programme that is just starting. But I expect that once the midwives are in place and positioned in all the local government and all the districts and wards, they will be at the vanguard of health promotion disease prevention and recognition of any signs of problem in pregnant women and in children. And therefore they will refer such women and children to higher levels of care.

“If you read the newspapers, you would have seen the names of all the midwives and the local governments they were posted. The scheme is almost similar to the National Youth Service Corp. but it just that it is the Midwives corp. and midwives are trained health workers and we know from evidence all over the world that lack of skilled attendant at birth is a major indicator for maternal morbidity and mortality. And we also know from data from all over the world that non-use of antenatal care is one factor for increased national morbidity and mortality.

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