Last week’s categorisation of Nigeria as being home to 28.5% of global maternal deaths is a sad commentary on our healthcare sector. The Kaduna State Deputy Governor, Dr Hadiza Sabuwa Balarabe, made the startling disclosure during a Stakeholders Engagement Symposium on Sustainable Healthcare Financing held in Kaduna on Wednesday.
According to her, the 2023 World Health Organisation (WHO) report reveals that Nigeria has the second highest maternal, stillbirth and neonatal deaths worldwide. She was alarmed that one woman in Nigeria faces a 1 in 19 lifetime risk of dying during pregnancy or childbirth, starkly contrasting with the 1 in 4,900 risks in the most developed countries, noting that Nigeria’s life expectancy, currently hovering at 63.4 years, remains below Africa’s average of 63.6 years, with preventable illnesses such as lower respiratory infections, malaria, diarrhoeal diseases, tuberculosis, among others, as leading causes of death.
The frightening statistics, she further said, are a clarion call for action to prioritise the health of the poor and vulnerable, particularly women and children, on the nation’s health agenda. Dr. Balarabe, however, disclosed that the Kaduna state government understood that health was not merely a service but one of the fundamental human rights of the people because it is intrinsically tied to life itself.
Worthy of note is that the Uba Sani administration proposed in its 2025 draft budget, an unprecedented N127 billion for the health sector, representing 16.07% of the total budget. It exceeds the 15% threshold recommended by the Abuja Declaration of 2001, underscoring the administration’s recognition of health financing as essential for achieving the Universal Health Coverage (UHC) in the state.
Many factors are responsible for the poor global rating for Nigeria. We recall that a few years ago, the United Nations International Children’s Emergency Fund (UNICEF) ruffled feathers in the healthcare sector with the disclosure that in every 10 minutes of the day, one Nigerian woman loses her life as a result of pregnancy-related complications. On the average, about 52,560 women die annually during pregnancy or at childbirth.About 50 per cent of pregnant women and children are believed to die unnecessarily in the hands of unskilled personnel handling childbirth.
Earlier before the UNICEF reeled out its startling figures, a professor of obstetrics and gynaecology, Abiodun Aboyeji, raised a serious alarm over the poor maternal health in the country, putting the figure about 50,000 yearly.
Worried by the trend, Prof. Aboyeji called for the declaration of a state of emergency in the sector to address the issue. He stressed the need for the political prioritisation of maternal health needs and commitment to safe motherhood.
He wondered: “Indeed, how else can we describe a condition that is responsible for the death of 3,333 women every month, 769 every week, 109 every day and five every hour, leaving between 800,000 and 1.2m others with permanent disabilities?”
The professor hit the bull’s eye when he stressed that “Nigerian women had always been at a disadvantage. They were unable to use modern contraceptives because of non-availability and inaccessibility and a male dominated society not approving legal abortion services because of restrictive abortion laws and sheer hypocrisy. Even when the pregnancy is intended and wanted, health facilities across the country are mal-distributed, poorly equipped and understaffed to take care of them. Eventually in the process of delivery, thousands die which in itself is a tragedy as most of the deaths are avoidable.”
This continuous worrisome state of affairs is a direct consequence of the deplorable state of the nation’s healthcare delivery system. Death toll arising from pregnancy and childbirth has remained high in the face of the advancement of modern medical science which those charged with the country’s health management have failed to tap into owing to poor policy programme and implementation across the board.
Other factors fueling these preventable deaths include inaccessibility to good medicare, delivery through unskilled birth attendants, patronage of traditional midwives, poverty and ignorance. Then, there is the spiritual angle. Many women have thrown their lives away while exercising their faith on the orders of their pastors for natural delivery when it is obvious that a caesarian section is inevitable.
Also, the healthcare policy of the government at all levels is not citizen-friendly and does not favour the average Nigerian woman who depends on the public hospitals and clinics to access medicare. Owing to congestion in public healthcare destinations, deplorable service delivery and high charges, many have surrendered their fate to patent medicine dealers, hospital/clinic attendants masquerading as midwives in their neighbourhoods as well as quack healthcare givers.
In the build-up to delivery, some women do not attend ante-natal clinics regularly either out of ignorance or poverty especially in the rural communities where maternal mortality rate is very high. It is during this gestation period that the health condition of the mother and the unborn baby is monitored to ensure safe delivery.
Overall, Nigeria’s healthcare delivery system is a casualty of the general malaise afflicting the country where nothing seems to function well. It is also regrettable that the public health sector is perpetually at war with itself and the government as exemplified by frequent strike actions by doctors. Many wealthy Nigerians and policy makers are known to send their spouses overseas for ante-natal attention and delivery. This habit is a disservice to the citizenry on which basis the government exists.
However, we acknowledge the efforts of some state governments that have put in place free medical programmes as a deliberate attempt to address the needs and challenges of maternal and child care. These policies are commendable. Getting pregnant should not be a death sentence. The joy of motherhood is to have a safe delivery.
