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Global worry over Nigeria’s low rating in maternal health

…58,000 maternal deaths

…Most deaths occur from heavy bleeding after birth

Nigerians are yet to hear the last about the implications of the country’s high maternal mortality rate.

Last week, Co- Chair of the Bill and Melinda Gates Foundation, Mr. Bill Gates, had said Nigeria is one of the most dangerous places in the world to give birth and 4th country with the worst maternal mortality rate  ahead of Sierra Leone, Central African Republic and Chad.

At the just- concluded maternal health meeting  held in Brussels, Belgium, experts noted that while global maternal mortality dropped by about 43 percent since 1990, Nigeria still rank ed highest among sub-Saharan African nations with high maternal deaths.

Pregnant-mother

According to the World Bank estimates, Nigeria’s Maternal Mortality Rate, MMR  is still as high as 821 per 100,000 live births.

Worst still, of the 303,000 women that died globally due to complications of pregnancy and child births in 2015, 58,000 women died in Nigeria.

Reeling out these gloomy statistics at the 18th General Membership Meeting on Reproductive Health Supplies Coalition (RHSC) in Brussels, Belgium,  the experts who noted that  out of the maternal deaths which would have been prevented, 99 percent occurred in developing countries like Nigeria stressed that increasing efforts is needed to meet Sustainable Development Goals in reducing global MMR to less than 70 per 100’000 live births by 2030.

In the report, of the key maternal health statistics in Sub Saharan Africa, according the World Bank modeled estimate and presented at the reproductive health event, 58,000 Nigerian women died in 2015 due to birth related complications.

The report which revealed that in sub-Sahara Africa, Nigeria has  a modeled estimate Maternal Mortality Ratio of modeled estimate of 821 per 100,000 live births, the country lead  with wide margin.  The closest was Kenya with 540 per 100,000 live births and 8,000 maternal deaths in 2015.  Followed  with Tazania and Uganda.

Nigeria, according to the report has a life time risk of maternal death of 4.62 percent, fertility rate of 5.71, and annual births of almost 7 percent.

Despite these deaths, only 37 percent of births happens in health facilities with skilled healthcare personnel.

The experts further linked majority of the deaths to  hypertensive disorders and haemorrhage.

In his presentation, the Deputy Director of RHSC, Brian McKenna, raised alarm over the need to reduce global maternal mortality to less than 70 per 100, 000 live births by 2020 according to the target set by the Sustainable Development Goals, SDGs.

McKenna noted that access to quality medicine, better infrastructure and adequate personnel would go a long way in preventing women from dying while pregnant or giving birth, adding that any delay in the system and lack of essential drugs of reproductive health can lead to the death of women.

Also in her presentation, Reducing maternal deaths from postpartum hemorrhage, the Programme Manager in-charge of Maternal Health, Concept Foundation, Fiona Theunissen, regretted that maternal mortality also affects a woman but the family suffers more following her death.

Theunissen said: “A child whose mother dies in childbirth is three to 10 times more likely to die before his or her second birthday.”

Tracing most deaths to Postpartum haemorrhage, she said it accounts for 36·9 percent of deaths in northern Africa, but only 16·3 percent in developed regions.

Tagged as number one cause of maternal death, she said in her presentation that an estimated 480,000 women died from postpartum hemorrhage (PPH) between 2003 and 2009.

Postpartum haemorrhage is severe bleeding experienced by women following the birth of a baby

Leading cause of PPH is   failure of the uterus to contract.  PPH is Preventable through  administration of an effective uterotonic to the mother immediately after the birth of her baby.

She noted that quality and effectiveness of uterotonics available in low and low-middle income countries was often low and findings have shown that uterotonics fail to prevent PPH due to the poor state of medicines.

She revealed that a recent evidence of poor uterotonics quality conducted in 2018, showed 74.2 percent of oxytocin samples failed in Nigeria.

Corroborating her views, the RHSC Regional Advisor, Milka Dinev, said PPH is preventable through the administration of an effective uterotonic to the mother immediately after the birth of her baby.

Dinev explained that uterotonic medicines that cause the uterus to contract include oxytocin, misoprostol, ergometrine, syntometrine and carbetocin.

She noted that the quality and effectiveness of uterotonics available in low and middle-income countries is often low and as result, uterotonics fail to prevent postpartum haemorrhage.

“Oxytocin must be stored in a cold storage to remain potent in temperature of between 2°C- 8°C. Short of that, the drug will not work.  “Oxytocin, which is recommended by WHO as the first-line medicine for prevention and treatment of postpartum haemorrhage, is temperature-sensitive medicine and requires refrigeration during transportation and storage,” Deniv said.


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