Maternal Health Problems in Nigeria Essay

Introduction

In 2008, the maternal mortality ratio for Nigeria was 545/100,000 live births. According to WHO, it accounted for 14% of the global maternal deaths and the second largest annual death in the world. They accounted the high mortality rate to the inadequate nature of the three tiers of the national health system. The facilities and infrastructures of the hospital system are not well maintained, and many healthcare facilities lack adequate trained medical personnel. Demographics from the health survey state that only 35% of births occur in health facilities and 56% of women receive postnatal care within six weeks of birth. The government is concerned with the rising number of maternal mortality and is committed to increasing funding and policies that are directed towards maternal health. Change in policy is paramount if Nigeria aims at reducing the problems that lead to maternal mortality. This paper will identify maternal mortality issues in Nigeria public health, the current legal framework relevant to maternal mortality issues and possible reforms that can be deployed to cater for the shortcomings of the current legal framework.

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Maternal Health Problems

Nigeria is the country in Africa with the highest population of people. Of this number of people, more than ten percent of the populations are people under the age of five. As of the year 2007, Nigeria recorded almost six million births. It is, therefore, a nation with a fertility rate of approximately 5.4 % and this shows how rapid population growth is in the country. Nigeria is well-known for its vast amount of resources in the form of oil. However, Nigeria is a country that suffers from high levels of poverty. According to reports by the World Bank, more than 70% of Nigerian lives in poverty f less than one dollar a day. The high level of poverty is a great impediment to the nation's ability to afford good health care for all its citizens.

Maternal health is very important in a country it is health care that ensures and guarantees the survival of mothers and newborn babies during childbirth. However, in Nigeria, one of the major problems that affect maternal health is poverty. Poverty is an issue of development of unsustainable laws and policies associated with the distribution of wealth in a nation. Nigeria is a country with a lot of wealth and resources, yet its citizens live in poverty. There is a lot of corruption that denies the common citizen the wealth they deserve. As a result, corruption causes the ineffective distribution of wealth and causes the development of great disparities between the rich and the poor with the gap between them widening. Maternal and neonatal mortality is very high in Nigeria, and it is thanks to demographic pressures, poverty and insufficient investment in public health care.

Poverty

The lack of adequate investment in maternal health care causes women to have compromised health especially after giving birth. A good example is the high number of women suffering from obstetric fistula. Neonatal deaths are also rampant in the nation with most of the deaths taking place within the first few weeks after birth. Some of the common health care problems in the country include inadequate health care facilities capable of meeting the needs of all the maternal health in the country, the lack of suitable transport facilities to institutional care, the inability of most women to pay for health services as a result of poverty, and resistance by most people to modern forms of health care. These are some of the critical factors responsible for the high rates of maternal, newborn and child mortality in Nigeria. Inadequate healthcare facilities lack the needed resources to ensure that women receive quality health care. The number of these facilities is also very low, and this makes it very hard for most women to access them. There are also a limited amount of transportation means to these facilities.

Most of these women live in acute poverty and cannot afford critical health care services. Most of these women also have great resistance to modern forms of medicine and thus increase their likely hood of various health risks to them as mothers and also to their children. From all these problems, the underlying factor is associated with a high rate of poverty in the society and this is because of poor distribution of wealth in the nation.

Disparities in Wealth

A disparity in wealth and therefore, health is very much pronounced in Nigeria. Differences in wealth and quality of health care differ greatly between rural and urban areas. There are, therefore, regions in the country where rates of poverty are higher than others. Some regions such as the southeastern parts of the country where there is oil are more prosperous than others and therefore, receive more quality health care than other regions. The disparities in poverty are, therefore, a major problem in the country that has created a division between the rich and the poor. The gap is slowly widening as more and more people fall on the side of poverty.

Illiteracy

Low level of education for women is also another major problem in the country. Various discriminatory attitudes in the country are against the uplifting of women. These attitudes are also complemented with various practices that act as barriers to reducing the rate of maternal mortality rates in the country. According to statistics, more than seventy-five percent of maternal mortality affected illiterate women. Illiteracy was also a major influence on the development of resistance towards modern medicine. Illiteracy was also a major influence on the number of women who had access to antenatal care. The mortality rates of women who did not receive antennal care were twenty times more than for those who did. These are records that are also representative of ethnicity in the country as a result of the geographic distribution of populations in Nigeria. A good example is the Hausa Fulani which an ethnic group found in the northern parts of Nigeria. This is a region affected by high levels of poverty, and there has a high mortality rate.

Cultural Practices and Attitudes

Cultural practices, as well as attitudes, also play a critical role in the perception of the society towards modern medicine and their influence in reducing maternal mortality. There is a lot of discrimination against women and girls in the nation that creates major barriers to their access to full health. Child marriages are very common in the country with girls being forced to get married while at a very young age. These are cultural practices that expose young girls to many health risks. These cultural practices are also responsible for the high resistance towards modern medicine.

Poverty, disparities in wealth, illiteracy and cultural attitudes are some of the major problems that influence maternal mortality and morbidity. These are problems that are representative of the high need for the development of sustainable laws and policies to protect women and their health. Health is a major right for all citizens and governments play a critical role in ensuring that all its citizens have access to quality health. Proper legal frameworks are, therefore, important in ensuring that women and their children are safe.

Maternal Mortality Rate Policies in Nigeria

The maternal mortality ratio for Nigeria is one of the highest in the world. Some of the primary causes of maternal deaths include obstetric complications including infections, unsafe abortion, obstructed labor, hypertension, and bleeding. The young maternal age for mothers in Nigeria is another leading cause of maternal deaths. Most of these deaths can be avoided if mothers receive timely medical interventions. The poverty rate in Nigeria has also aggravated the problem. Many pregnant mothers can't access good prenatal health care services promptly.

The government has initiated some policies and law reforms that aim at reducing the maternal mortality rate. A survey done showed that there were four delays that acted as major contributors to maternal health problems; delay in seeking maternal healthcare, delay in reaching health facilities due to poor transportation, communication, and infrastructure, delay in receiving care due to poorly equipped health facilities and delay in making referrals in emergency situations.

One of such policies is the policy of free maternal and Child Health (MCH) in Nigeria. This policy was enacted in 2001 and was adopted by different states, with Kano State being the first. This policy caters for the provision of free antenatal services, routine examination, and normal and caesarian section delivery, drugs during admission, early neonatal admission, and screening of blood that has been donated.

This policy has seen states budgeting to cater for these costs. In 2001, Kano state government budgeted twenty million nairas for the project. This was increased to one hundred and fifty million nairas in 2008. By 2006, all federal health institutions had implemented the free maternal and child health care service policy. This policy has had a major impact on the maternal mortality rate. Between 2001 and 2008, there has been a recorded 30% decrease in maternal mortality deaths in general hospitals.

Other than in-state effort, there is a national effort to tackle poverty as one of the factors contributing to the high maternal and child mortality in Nigeria. The cost of maternal care is quite high, and as a means to ensure easy access, the national government eliminated the user fee for maternal health services. It also ensured that pregnant women didn't pay for prenatal services in hospitals.

Under the National Health Act (2014), The Nigeria National Primary Health Care Development Agency (NPHCDA) implemented the Midwives service schemes with the aim of decreasing the maternal death rate in Nigeria. This policy mobilized midwives, fresh graduates, retired and unemployed midwives to be posted into health facilities in remote communities. This ensures that the shortage of skilled healthcare providers in rural areas was tackled. These midwives were trained in the obstetric care and life-saving skills. At the first year of the implementation of this policy, there was an overall decreased in maternal deaths in rural areas. The infant mortality rate decreased from 10.97 to 9.3 per 1,000 live births. The rate of facility deliveries and antenatal hospital visits also increased.

Conclusion and Recommendation

It should be one of the top priorities of any country to ensure that the maternal mortality rate is as low as possible. Nigeria has the second highest maternal mortality rate in the whole world. The high rate has been blamed on the high poverty levels, the disparity in wealth distribution, high levels of illiteracy and cultural practices and attributes. The Federal government of Nigeria has set up some policies that aim at curbing some of these problems but more needs to be done to ensure a reduction in the maternal mortality rate. The introduction of policies of free maternal and child Health has ensured that there is free access to medical services for all pregnant women regardless of their wealth. This ensures that both the poor and the rich accesses medical facilities and received quality medical care. The Midwife service schemes have provided healthcare services to people in rural areas. Even with these policies and law changes, more need to be done to ensure reduction of the maternal mortality rate.

Poverty is the main cause of the high maternal mortality ratio. The government should introduce policies that will ensure that there is an opportunity for economic development of the poor. This can be achieved through promoting local production, provision of credit facilities and creating opportunities for small and middle enterprises. This will ensure that pregnant...