The commencement of the Global Gag Rule (GGR) policy of the United States of America, which blocks U.S. federal funding to non-governmental organisations (NGOs) with focus on women’s reproductive health and sexual rights across the world, has generated fears among stakeholders in the Nigerian health sector because of probable increase in the nation’s maternal mortality rate.
The implementation of the GGR policy has led to a gradual decline in activities of organisations that deal with women’s reproductive health and sexual rights in the country, due to their difficulty in accessing grants from the US, a major donor nation. There are also fears that the development may increase maternal mortality rates in Nigeria and other developing countries in Africa and Asia.
It will equally worsen the fragile health situation in the two regions. According to the World Health Organisation (WHO), nearly 100 per cent of global maternal deaths occur in developing countries with more than half of these deaths in sub-Saharan Africa and almost one-third in South Asia.
Nigeria’s situation is more pathetic considering the fact that maternal mortality is still a huge health challenge. Undoubtedly, all tiers of governments have implemented some programmes to address maternal mortality in the
country but there are still gaps because indices from the sector have not shown significant progress. Nigeria presently has about 512 maternal mortality per 100,000 live births, making it the worst in the world, according to the Health Minister, Prof. Osagie Ehanire.
If the figure of the National Demographic and Health Survey of 2018 is anything to go by, Nigeria has not witnessed a significant reduction from the maternal mortality rate of 545 per 100,000 live births recorded in the 2013 survey. The worry is that the Nigeria is likely to displace India as the country with the highest maternal death rate globally
This may explain why the WHO recently described Nigeria as a country with nearly 20 per cent of all the global maternal deaths. The global health agency further stated that a Nigerian woman has a 1 in 22-lifetime risk of dying during pregnancy, childbirth or postpartum/postabortion; whereas in the most developed countries, the lifetime risk is 1 in 4,900. This shows that the country still has a long way to go.
There are several factors responsible for high maternal mortality in the country and other developing nations. They include poverty, illiteracy, poor access to health facilities, inadequate health care providers, especially midwives and obstetricians; lack of or insufficient items to be used during delivery, poor attitude of health workers, unsafe abortion, among others.
Also, it is estimated that more than 50 per cent of births in the country are handled by traditional birth attendants, with many of them occurring in rural areas where they do not have the chance to get proper and immediate care in the event of complications. Poor women in remote areas are the least likely to receive adequate health care. The ravaging impact of the COVID-19 pandemic has equally worsened the situation.
The introduction of the GGR policy should serve as a wake-up call on all tiers of government to evolve pragmatic measures to adequately fund maternal health. We say this because many agencies handling women’s health-related cases are likely to fold up on account of the GCR.
Therefore, the government must invest more money in healthcare. The proposed N547 billion for health care in the 2021 budget is not enough to tackle the challenges in the sector. Private individuals should also assist in funding maternal healthcare.
Given that most of the victims are the poor and rural dwellers, primary healthcare should be given priority so as to reduce the maternal mortality rate. The health centres that are in existence should be adequately funded and equipped and new ones established in areas that none exist. The government must not rely on foreign donors to fund maternal health.
Relevant government agencies should pay special attention to maternal and child health in view of the fact that a healthy nation is a wealthy nation. Government must do all within its powers to reduce the high maternal mortality rate.