The maternal mortality ratio (MMR) is defined as The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, expressed per 100,000 live births, for a specified time period. The leading causes of direct maternal mortality in Nigeria are:
1. Obstetric hemorrhage (18.7%),
2. Eclampsia
3. Sepsis (20.6%)
4. Complications from unsafe abortions
5. Anaemia in pregnancy (3.2%),
6. Hypertension (27.0%),
7. Human Immunodeficiency Virus (3.2%)
8. Sickle Cell Disease (2.4%)
The current rate of maternal mortality rate in Nigeria from 2000 2019 is 917.00 per 100,000 live births expressed in annual percentage of 0.86%.
What can be done to reduce maternal mortality in Nigeria?
Strategies that could prevent 4 out of 5 maternal deaths included an integrated and stepwise approach that includes
1. Increased Skilled Deliveries
The skilled attendant is an accredited health professional who possesses the knowledge and a defined set of cognitive and practical skills that enable the individual to provide safe and effective health care during childbirth to women and their infants in the home, health center, and hospital settings. Skilled attendants include midwives, doctors, and nurses with midwifery and life-saving skills. This definition excludes traditional birth attendants whether trained or not.
2. Facility Births
Maternal and prenatal mortality are still unacceptably high in many countries especially in Nigeria, despite steep increases in facility birth. The evidence that childbirth in facilities reduces mortality is weak, mainly because of the scarcity of robust study designs and data.
3. Access to Antenatal/Postpartum Care
Access to antenatal care (ANC) and postnatal care (PNC) services has a great deal of impacts on major causes of infant death and significantly affects trends of mortality in a population. Antenatal care may play an indirect role in reducing maternal mortality by encouraging women to deliver with assistance of a skilled birth attendant or in a health facility.
4. Improved Recognition of Referral Need
Referrals are the second easiest way to increase patient volumes, next to making sure that you retain existing patients. People are more likely to trust their primary care physician's opinion over a Google search, after all.
5. Transport
Emergency transport alone had been demonstrated to reduce maternal mortality by as much as 50 per cent.
6. Availability Quality of EMOC In Addition To Family Planning and Safe Abortion
Access to quality emergency obstetrics care (EMOC) is fundamental to reducing maternal and newborn deaths and is a possible way of achieving the target of the fifth millennium development goal.
In Conclusion, early intensive efforts to improve family planning and control of fertility choices, accompanied by a stepwise effort to scale-up capacity for integrated maternal health services over several years, will save lives and provide equal or greater value than many public health interventions we consider among the most cost-effective (e.g., childhood immunization).