Maternal death is a major health problem around the globe and the United Nations (UN) has accorded the fight against the scourge a top priority. A lot of the world resources are being invested to stem this inevitable phenomenon. Developed nations and international donor agencies are solidly behind this important struggle against women death.

Despite these global efforts, many developing nations are yet to offer commensurate efforts in order to stem the tide of inevitable death among our daughters, wives and mothers every day. In this negligible way our nation loses precious human resources, which provide invaluable training fo r the future generations as well as contribute meaningfully to the stability of the family and development of the nation.

Because of the enormity of the problem, many countries today are tackling the death crisis, arising from maternal death the same determination and intensity as the fight against Bird Flu and HIV/AIDS. Figures from the United Nations is highly alarming especially those from the developing nations particularly in Africa.

According to the UN statistics over one million Women die every year from childbirths and 90 percent of the figure is from developing nations most poor and relatively resource endowed African countries among which is the most populous nation of the continent-Nigeria.

Nigeria with over 130 million people constitute two percent of the World population and regrettably contribute 10 percent of the world annual maternal death. The figure represents 52,000 deaths annually from complications of pregnancy and childbirths. This means that 4,400 Nigerian women- mothers, daughers, wives and young girls die on monthly basis. And by extension, there are 144 of them that die every day, making it six deaths every hour and one maternal death every 10 minutes.

Compared to many developing nations in term of maternal death, Nigeria is unfortunately on high side. The risk of dying from childbirth and pregnancy complication and other related birth problem for Nigerian women is also regrettably on the high pedestal than many countries on the same footing with in health resources and facilities endowments.

For instance figures from international maternal death statistics indicate that a Nigerian woman is three times likely to die from childbirths than a woman from Botswana, twice than a Ghanaian woman and seven times than a Senegalese woman. Compared to developed Nations, the risk is extremely and outrageously deplorable. A Nigeria woman risk of dying from childbirth is 1000 times when juxtaposed to Sweden, Denmark and Canada and many other developed nations.

 Even though authorities across the country are making efforts in reducing the tide of death occasioned through childbirths and pregnancy related death, the was the urgent need to confront these inevitable death squarely with all the supports and commitments necessary. This is because the trend has been on the rise in recent months. A study conducted last year by the Aminu Kano Teaching Hospital of Bayero University, Kano on maternal death in Kano state shows that the death trend has also been on the rise on childbirth and pregnancy related problems especially in rural areas. This figure may not different similar studies are replicated in state of the federation. Similarly several stu dies conducted in many health institutions concluded that there were increasing trends all over the country.

From these gory figures and terrifying situations, one is tempted to ask about the causes and how can they be addressed effectively in order to reverse the inevitable death toll. Health experts have adduced several causes of maternal death, which include factors such as Malaria, Hemorrhage, Sepsis, and Convulsion. Others are Obstructed and prolonged labor, unsafe abortion and notably HIV/AIDS. Socio –economic factors similarly contribute to these ugly trends. These are lack of attendance and access to ante-antenatal services, lack of adequate information pregnancy, labor complications and other related signals and cultural barriers. Unco-operat ive attitude of health services personnel in Nigeria, more especially Nurses and Midwives, early childbirth by young girls, frequent births and old age pregnancies.

The attitude of health personnel-Nurses and Midwives in particular to expectant mothers at their critical period between life and death is contributing immensely to the death toll at childbirth. No family in Nigeria, at least those having access to urban health facilities never had cause to lament and condemn the behavior of most unscrupulous lots in the birth attendant profession. The professional associations in those ca llings also never mind to listen to the series of agonizing cries by families at birth in public health institutions. Health personnel have an important soothing role for expectant mothers and therefore it is part of their duties to humanity to play this vital role whenever called upon to do so without inflicting pains to those who are in need of help..

Other causes of maternal death are lack of essential facilities in the health institutions- water, electricity, drugs aesthetic services, limited ante-natenal and obstetric services, lack of adequate and experienced personnel and health facilities. The National Bureau of Statistics (NBS) in June last year released a book titled: The Nigerian Statistical Facts Sheets that gives a vivid picture of the na tion’s health service sector in the country.

 The facts sheets indicate that Nigeria has 21,622 hospitals, 20,653 dispensaries and health centers with 73,680 beds. The figures also show that public health institutions employ only 41,935 physicians and 158,920 nurses and midwives. The facts also reveal that 728,522 patients were treated and that 43,674 death were also recorded. The total births in medical institutions, according to the statistics are 580,151.

 With the nation’s population growing at three percent annually, it only means that one seventh of every birth is deliver in public heath institution in Nigeria. And considering the low patronage of private health centers because of the prohibitive prices for the services, the number unrecorded of births at home, particularly in rural areas form the bulk of annual births in the country. Therefore both national and international statistics on maternal death may be far lower than that the actual rates reported in public health institutions or from estimate by statistical agencies.

This why at a recent meeting of the presidential committee on assessing and monitoring the realization of the Millennium Development Goals (MDGs), the president ‘Senior Special Assistant on MDGs, Hajiya Amina Ibrahim drew the attention of the gathering to the challenges of reducing child mortality rates and improving maternal health-thus reducing maternal death. The concern in facing the challenges may not be out of place, especially that the Nigerian Economic Policy 1999-2003 which envisaged reducing maternal mortality from 800 per 100,000 births to 400 per 100,000 is yet to be realized in spite of substantial investment of precious resources in that regard. 

Bearing in mind the enormity of the problem and the death toll on Nigerian women and the agony on families acr oss the nation, no amount of efforts and investment should be regarded as too much or little in addressing the daunting problem facing our society. In the first instance, there is the urgent need to mobilize the whole nation to understand the death crisis we are facing among our wives, daughters and mothers and the serious implication on the future generation, the economy and the nation’s sustainable development.

All stakeholders at the federal, states and local government levels should consider the task of reducing maternal death as a health priority in their programmes and should invest enough resources in the provision of necessary facilities, equipment, human capacity building and consumables. Establishing an assessment and monitoring mechanism to ensure that the death rate from childbirth is drastically reduced can complement the mobilization efforts. Mobilization efforts should involve everyone especially Community Based Organizations, Non-governmental groups, traditional rulers, religious leaders as well as traditional birth attendants.

Another important immediate solution is to give more priority to reducing maternal death within the framework of the implementation of the nation’s MDGs.It easier in this regard, particularly because Nigeria appears to be the only nation in Africa that has a standing committee coordinating the realization of MDGs objectives and targets. And since one the goals of MDGs is to reduce maternal death, the integration of the nation’s response within MDGs implementat ion strategy, would assist in using a fast-track approach in removing the death trap before our women. It would be out of place if the issue is also included in the implementation of the National Economic Empowerment Development Strategy (NEEDS) for which all tiers of government are currently religiously committed to the implementation

Finally a comprehensive national plan for the health sector where every tier of government complement each other with clearly defined role in addressing health would help in giving the health sector its rightful place in the nation’s scheme of development commensurate to its people’s requirement and expectations. A stitch in time definitely saves nine.

 HUSSAINI TUKUR is an editorial staff of New Nigerian Newspapers.