Job Osazuwa
Many Nigerian mothers have been dispatched to their early graves for no fault of theirs. Whether in the North or South, the story remains the same.
Experts have continuously maintained that systemic failure in Nigeria’s health sector, particularly at the primary level, has brought death, tears and sorrow to many homes.
Cries of anguish have continued to reverberate across Nigeria from the homes of bereaved families. Whether a Muslim or Christian, pregnant women and their newborn and, sometimes, unborn babies, have been buried in tears.
The trend is in sharp contrast with the joy that comes with the announcement of pregnancy in many homes. Every expectant mother begins to shop for her unborn baby as her due date draws near. And the parents can’t wait to welcome and carry their baby in their arms. But all these end up being terminated when death strikes.
The pain of a mother losing her baby or a husband losing his wife with the baby is simply indescribable. It is one wound that might take a lifetime to heal.
It has been said that the birth process is one of the most dreaded and dangerous journeys that most women still pass through in this part of the world. This is especially troubling as statistics show that the extent of loss of life across low and middle-income countries occasioned by the issue is increasing daily.
No doubt, maternal-child mortality is closely linked to poverty, with malnutrition as an underlying contributor in more than half of all deaths. Poor socio-economic development, weak health care system and low socio-cultural barrier to optimal care utilisation stare Nigerians in the face.
The persistent high rate of maternal-child mortality in Nigeria negates the achievement of the fourth and fifth Millennium Development Goals (MDGs), where the health of the mother and her baby is a priority, as well as improving the wellbeing of all peoples.
Antenatal care is still seen as a luxury by many couples due to financial handicaps. It is on record that many pregnant women in this category would wait till a few weeks or even days to childbirth before seeking the help of a health centre. Gynaecologists and other experts have warned against this delay tactics, saying it could cost the lives of the mother and baby. A situation whereby a couple earns N40,000 a month would surely leave such a family at the mercy of self-medication, including patronising quacks.
Mrs. Kemi Oreoluwa (not real name), who lived in the Abule-Egba area of Agbado Oke Odo Local Council Development Area, Lagos State, died in December 2019 while being delivered of her third child at a private hospital.
As reliably gathered by the reporter, the pregnant woman began to bleed at midnight. Her husband, with the help of a neighbour’s car, rushed her to the hospital, which was about 30 kilometres away. Getting there, an operation was quickly carried out and the baby was delivered.
“I jumped for joy when the doctor told me that the operation was successful. But almost immediately, he said the baby was sound but that my wife couldn’t make it. I was shattered and devastated. I am still confused till today why the doctor would term an operation that claimed my wife as successful. I have refused to accept whatever medical reason they tried to prove.
“My best friend also lost his wife in similar circumstances, having been delivered of twins. It is very unfortunate that mothers and babies are dying every day in our hospitals, while our government shows no concern. Child delivery has become a normal medical routine that no one needs to worry about in developed countries. We are still far backward and keep losing our best doctors and other health workers to the United States of America (USA), Canada, United Kingdom (UK), South Africa and so on,” the widower said.
Many have expressed concern that the number of paediatricians and gynaecologists in Nigeria is far below what is needed to cater for the growing population. The shrinking and outdated facilities in Nigeria’s hospitals also contribute to national health hazards.
This unhealthy trend has become a matter of grave concern. It has been noted that Nigeria lags behind in achieving universal coverage of key maternal and child health intervention. Therefore, there is the need for concerted efforts of all and sundry to turn the frightening tide.
The World Health Organisation (WHO) defines maternal death as the death of women while pregnant or within 42 days of termination of pregnancy. This is irrespective of the duration and site from any cause related to, or aggravated by, the pregnancy or its management but not from accidental or incidental causes. Child mortality on the other hand, is the death of a child under five years, while infant mortality is the death of a child under one year.
WHO noted that Nigeria still had one of the highest numbers of maternal deaths in the world.
According to different maternal mortality charts, Nigeria records about 600 deaths out of 100,000 live births, which many experts have interpreted as a national shame. This is against eight to 100,000 live births in most developed countries.
Different health indicators show that a woman dies every 90 seconds from complications related to childbirth. It is also pathetic that more than 90 per cent of the deaths are preventable. A woman in sub-Saharan Africa has a 1-in-16 chance of dying in pregnancy or childbirth, compared to one in 4,000 cases in developed countries.
Beneath the alarming statistics, which was provided by the United Nations Children’s Fund (UNICEF), lies the indescribable pain for families who have lost their loved ones. Even more devastating is the fact that, according to different researches, necessary interventions reaching women and babies on time would have averted most of the deaths.
Maternal mortality remains a major problem in many parts of Nigeria. Health monitors have posited that understanding the causes of maternal mortality is crucial in confronting the challenge of unyielding high rates.
In 2000, member countries of the United Nations, Nigeria inclusive, agreed on eight MDGs to improve the health and socio-economic wellbeing of the people in their countries in the 21st century. MDG 5 clearly stated the need to improve maternal health, setting a target of reducing maternal mortality by three-fourth by 2015. Sadly, five years after the target of all the MDGs, MDG 5 has made the least progress in Nigeria.
Although the huge burden of deaths among Nigerian women is caused by lack of access to proper healthcare or ignorance among most Nigerian families due to religious or cultural beliefs, experts still believe, if the country’s primary healthcare system were made more robust, effective and functional through increased health financing, maternal mortality would decline drastically in the country.
From reports, government, especially at the federal level, had at some point increased efforts to combat the menace of child mortality. But experts argue that even though a considerable amount of effort has been expended by successive administrations in a bid to save the country from the atrocious killer, progress has not been sufficient enough to meet the UN’s resolution.
Speaking on this on the telephone with Daily Sun, a Lagos-based consultant gynaecologist and obstetrician, Gabriel Akindele Akilo, blamed governments at all levels for neglecting primary health care for so long. He averred that health was the business of everyone that no one should treat with levity.
Said he: “Virtually, it is government’s fault, though the government cannot do everything alone. As I always say, if antenatal care is free in the South, then we will reduce all the problems we are talking about by almost 100 per cent. Pregnant women go to traditional birth attendants because they say is cheap.
“Once the service is free of highly subsidised, people will flood government hospitals and the number of deaths will be reduced. Government hospitals are still the best place for treatment. Many private hospitals are not well-equipped. Some of them don’t have the specialists to handle certain health issues. Many private hospitals have done a lot of harm to patients before referring them to government hospitals. At that point, there is hardly anything the government hospital could do.
“Another problem or area that government should tackle is through private-public partnership. A situation whereby 20 patients are waiting for one surgeon for caesarean to be performed on them the same day does not work that way. We see 100 babies waiting to see one paediatrician. Private practitioners can be paid to come in and fill the gap.”
Experts have identified some of the causes of maternal and infant or child mortality as: malnutrition, hypertension in pregnancy (eclampsia), human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), infections and malaria. Others are severe maternal bleeding, infections, obstructed or prolong labour, unsafe abortion and hypertensive disorders.
They have also raised the alarm that over half of the maternal deaths occurred during labour and the postpartum period.
The importance of community education and having skilled attendants during childbirth at all times have been canvassed. Health experts have urged health care providers to make referrals as soon as possible to avoid endangering the lives of the baby and mother.