Monday, March 25, 2013
Tuesday, March 12, 2013
Maternal Health in Nigeria
As the
2015 deadline for the Millennium Development Goals (MDG) draws near, the debate
has intensified in many quarters about the issue of countries that may not meet
some of the goals. Unfortunately, Nigeria features very high on the list of
such countries because it is unlikely to meet the MDG’s related to maternal
mortality –“Promoting gender equality and
improving maternal health”. As a
Nigerian doctor, I am appalled by statistics that indicate that Nigeria is responsible for about 14 percent of global
maternal deaths. The inability of the Nigerian healthcare sector to rise to its
challenges and its persistent failure have made people – particularly women pay
a very heavy price. The lack of access
to quality and affordable health care,
the menace of untrained traditional birth attendants,
obnoxious cultural and religious practices which rob women of healthcare
decision making powers, have all contributed to the rise in maternal mortality in Nigeria. Almost
every week, I see or hear about women of various ages and backgrounds who walk
in to the hospital to have their babies and are driven out in hearses. In spite
of the seemingly bleak picture, I am consoled by the fact that in the Chinese
language the term crisis and opportunity are represented by the same word. In
that view, Nigeria’s crisis therefore represents its deployable idle capacities
to challenge maternal mortality. What must be done for Nigeria to harness its
idle capacities and turn it into a success story? How can the double headed
monster of ignorance on the part of the women and negligence on the part of the
government be fought?
There must
be a conscious, well thought out and articulated decision by the government to improve
the parlous state of healthcare. The Government must realize that reductions in
maternal mortality would not just happen. The strategies to reducing it have to
be well planned and implemented by good leaders with good governance
structures. The lack of foresight and the pursuit of wrong policy choices over
the years is responsible for the state of Nigerian healthcare today.
Politicians and policy makers must understand that good health is one of the
major conditions for any form of economic growth or national development to
occur and an important reason why some countries develop faster than others is
that their citizens enjoy better health. Government policy should also be
directed towards improving the social determinants of healthcare i.e the conditions
in which Nigerians are born, grow, live, and work.
This is because the
social determinants of health are mostly responsible for health inequities and
these inequities have persisted and widened considerably over the years.
As part of the efforts to
improve the health system of Nigeria, government health care policy should be
geared towards primary healthcare as opposed to the current situation where
about 70% of the health budget goes to hospitals and tertiary care centers. The
importance of Primary Health Centre becomes evident in the context that Primary
Health Centre services maybe the only service accessible to 60% of Nigerians
living in rural areas. The poor are also less likely to visit hospitals and
more likely to go to Primary Health Centre facilities to obtain medical treatment since they are
cheaper. Additionally, women also need to get educated, informed and have their
minds disabused about certain beliefs and practices concerning
pregnancy and childbirth.
In
conclusion, the challenge therefore to Nigerians today is that we need to get
informed, educated and proactive about maternal mortality. We all need to
tackle maternal mortality in whatever way we can and in whatever situation we find
ourselves. It is only when we do this that our country can begin a realistic
march towards achieving the Millennium Development Goals and achieving significant reductions in
maternal mortality.
