Worsening child and maternal mortality

In yet another report, the United States Agency for International Development has bemoaned the alarming maternal and child mortality rate in the country. The USAID’s 2008 report on maternal and child mortality says that, “With approximately 2.5 per cent of the world population, Nigeria has more than 10 per cent of all under-five and maternal deaths – more than one million newborn, infant, and child deaths and more than 50, 000 maternal deaths every year.”

The report, which ranks the situation of maternal and child health in Nigeria among the worst in Africa, puts Under-five mortality rate at 201 deaths per 1,000 live births and maternal mortality rate at 1,100 deaths per 100, 000 live births.

The report also says coverage and utilisation of key interventions are correspondingly low while attributing this gloomy picture to “a significant breakdown of basic services, and particularly of primary health care, in the country.” The report regrets that the country does not still have a health sector strategic plan.” This is, indeed, a serious indictment on the nation’s health care delivery system.

But the USAID report is not strange to objective watchers of the nation’s healthcare delivery system in view of the obvious neglect of the sector over the years. Today, less than 20 per cent of health facilities offer emergency obstetric care and only 35 per cent of deliveries are handled by skilled birth attendants in the country.

Up to the ‘70’s, Nigeria had a robust primary health care delivery system. Almost every village had a dispensary or a maternity centre. Drugs were available and trained dispensers and midwives were in high supply. But all these enviable primary health outlets did not only disappear at the close of that decade, budgetary allocations to health became parlous. This has inevitably led to the alarming maternal and child mortality rates in the country.

The United Nations Children’s Fund says that a woman’s chance of dying from pregnancy and childbirth in the country is 1 in 13. While the World Health Organisation estimates that 500,000 women die yearly from pregnancy-related causes, UNICEF declares that every single day, about 2,300 under-five year olds and 145 women of childbearing age are lost in Africa’s most populous country. This makes the country the second largest contributor to the under-five and maternal mortality rate in the world.

The failure of the Yar’Adua administration to appoint a substantive minister for the ministry since the sack of the last occupant in March also underscores the levity with which the government handles the health sector and may partly explain the reasons for the gloomy report.

It is regrettable that this is happening in the nation when other countries the world over are making strategic plans to achieve Millennium Development Goals. The Netherlands, Sweden and Norway were able to achieve low child and maternal mortality rates as a result of an extensive collaboration between physicians and highly competent locally available midwives.

The three tiers of government should go back to the drawing board and revive the health sector. Apart from making relevant funds available, government should embark on public enlightenment in local languages for mothers on basic child and maternal issues. The exemplary commitment demonstrated by a former minister of health, the late Prof. Olikoye Ransome Kuti, by popularizing the Oral Rehydration Therapy (ORT), the Expanded Program on Immunization (EPI) and other health programs through public enlightenment should be revived.

Health campaigns on preventable and treatable infectious diseases such as malaria, pneumonia, diarrhoea and measles should be stepped up.

The Punch