DEPARTMENT OF SOCIOLOGY

FACULTY OF SOCIAL SCIENCES

BAYERO UNIVERSITY, KANO

(SOC 8310 MORTALITY) SEMINAR PRESENTATION

TOPIC:
ATTEMPT AT FORMULATING A JUSTIFIABLE NATIONAL POLICY
STATEMENT ON PREVENTING AND CONTROLLING MATERNAL
MORTALITY IN NIGERIA

PRESENTER:

MUHAMMADU MUBARAK ABDULLAHI

SPS/21/MSO/00021

COURSE LECTURER: PROF. BAFFA ALIYU UMAR

OCTOBER, 2023

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 INTRODUCTION
Maternal mortality remains an alarming global public health concern. According to
the world health organization report, about 287 000 women died during and
following pregnancy and childbirth in 2020. Almost 95% of all maternal
deaths occurred in low and lower middle-income countries in 2020, and most could
have been prevented. South Asia and sub-Saharan Africa (SSA) account for about
86% of maternal deaths worldwide. According to UNICEF (2022), the sub Saharan
African countries record the highest number of maternal deaths annually, with a
maternal mortality ratio (MMR) of 553 deaths per 100,000 live births, which is
over 50 times higher than the MMR for high-income countries with 11 deaths per
100,000 live births. According to abouzahr (2003), Nigeria With only two percent
of the world’s population, contributes ten percent of the world’s maternal
mortality. Robert (2000) reports that each year as many as 60,000 Nigerian women
die due to pregnancy related complications.
The World Health Organization (WHO) defines maternal mortality as "the death of
a woman while pregnant or within 42 days of termination of pregnancy,
irrespective of the duration and site of the pregnancy, from any cause related to or
aggravated by the pregnancy or its management but not from accidental or
incidental causes" (International Journal of Obstetric Anesthesia, 2019).
The statistics of maternal mortality across the nation is distressing and undeniable.
According to the National Demographic Health Survey 2018, the maternal
mortality ratio for the 7-year period before the report was estimated at 512
maternal deaths per 100,000 live births.
In Nigeria, where motherhood should be a time of joy and fulfillment, it has
become an ordeal with devastating consequences. According to the WHO 2020,
Nigeria's maternal mortality ratio (MMR) stands at a staggering 814 deaths per
100,000 live births. This places Nigeria among the countries with the highest
maternal mortality rates worldwide. This heartbreaking figure means that, on
average, one in every 122 Nigerian women faces the risk of maternal death during
her reproductive life. In contrast to developed countries, such as the United States,
the lifetime risk of maternal mortality is estimated at just 1 in 4900, reflecting a
stark and unjust disparity in maternal health outcomes (International Journal of
Obstetric Anesthesia, 2019).

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Furthermore, data from 2020 reveals that the maternal mortality ratio in the
African Region, which Nigeria is an integral part of, was estimated at 531 deaths
per 100,000 live births. However, several countries within the region are grappling
with extraordinarily high maternal mortality rates, with South Sudan recording a
distressing 1223 maternal deaths per 100,000 live births, closely followed by Chad
with 1063 deaths. Nigeria is not far behind, with 1047 maternal deaths per 100,000
live births. These harrowing statistics underscore the urgent need for
comprehensive and effective interventions to reduce maternal mortality in Nigeria.
Maternal mortality in Nigeria is a multifaceted issue, influenced by a complex web
of factors, including inadequate access to skilled healthcare providers, insufficient
essential medical equipment and medications, and a poorly functioning referral
system. Women in many parts of the country, especially those residing in rural and
marginalized communities, often face substantial challenges in accessing quality
maternal healthcare services.
In the pursuit of sustainable development, Nigeria stands at a crucial juncture to
address the pressing issue of maternal mortality. Recognizing the pivotal role that
maternal health plays in fostering national prosperity, we embark on formulating a
development-oriented national policy. This policy not only underscores the
urgency of accessible and high-quality maternal healthcare but also integrates
strategic development goals. By prioritizing skilled birth attendance, emergency
obstetric care, and holistic socioeconomic considerations, this policy seeks to align
with broader developmental objectives. Through collaboration with diverse
stakeholders, it aspires to create a resilient framework that not only prevents and
controls maternal mortality but contributes significantly to the socio-economic
advancement of Nigeria.
THE POLICY’S PHYLOSOPHY
The national policy philosophy on maternal mortality reduction in Nigeria is
grounded in the belief that maternal health is a fundamental human right. It
embraces principles of equity, inclusivity, and evidence-based care. This
philosophy recognizes the diversity of the Nigerian population, committing to
reducing disparities and ensuring equitable access to maternal healthcare for all,
including vulnerable and marginalized groups. It emphasizes a multi-sectoral
approach, acknowledging the interconnectedness of health, education,
infrastructure, and women's empowerment.

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Transparency, accountability, and data-driven decision-making are integral
components of this philosophy, ensuring that interventions are based on scientific
evidence and global best practices. Overall, the policy philosophy envisions an
empowered Nigeria where every woman has the right to quality maternal
healthcare, contributing to the well-being of individuals and the nation's progress.

PRINCIPLES OF THE POLICY

1. Right to Health: Central to this policy is the recognition that every woman in
Nigeria possesses an inalienable right to access quality and comprehensive
healthcare services throughout her reproductive life. This fundamental right
extends from the moment of conception to postpartum and post-abortion periods.
This principle is not just an ethical imperative but also an essential step towards
ensuring the well-being and health of women and their babies.
2. Equity and Inclusivity: This policy is unwavering in its commitment to
addressing disparities in maternal health outcomes. It acknowledges that not all
communities and populations have benefited equally from healthcare services.
Vulnerable populations, such as women in rural areas and marginalized groups,
have often faced unequal access to maternal healthcare services. Achieving equity
in maternal healthcare delivery is a cornerstone of this policy, ensuring that no
woman is left behind, regardless of her geographic location, socio-economic status,
or background.
3. Evidence-Based Care: A data-driven approach is at the core of this policy. All
interventions and strategies to reduce maternal mortality must be firmly grounded
in scientific evidence and best practices. The decision-making process will rely on
data and research, which will inform the development of policies and programs
that are effective, efficient, and responsive to the specific needs of Nigerian
women. Evidence-based care not only ensures the highest quality of service but
also promotes accountability and transparency.
4. Multi-Sectoral Approach: The multifaceted nature of maternal mortality calls
for collaboration across various sectors. This policy recognizes that addressing
maternal mortality requires more than just improvements in healthcare. It
necessitates partnerships between the health sector, education, infrastructure
development, and the empowerment of women. Only through a multi-sectorial

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approach can the root causes of maternal mortality, such as socio-economic
disparities and cultural factors, be effectively and holistically addressed.
5. Accountability and Transparency: A key element of this policy is the
establishment of mechanisms for accountability and transparency. Monitoring
progress and evaluating the impact of interventions are vital to ensure that the
policy's objectives are met. Accountability mechanisms will not only track the
allocation of resources but also gauge the effectiveness of programs and policies.
Transparency in decision-making processes, funding allocation, and program
implementation will foster public trust and promote effective governance in the
quest to reduce maternal mortality rates.

POLICY OBJECTIVES
1. Reduce Maternal Mortality: This is the central goal of the policy.
Maternal mortality refers to the death of women during pregnancy,
childbirth, or within 42 days of the termination of pregnancy, primarily from
preventable causes. The objective here is to significantly decrease the
number of such deaths in Nigeria. This involves several strategies, including
improving the quality of maternal healthcare services to address
complications, infections, and other risks associated with pregnancy and
childbirth. It also involves measures to enhance early detection and
management of maternal health issues.
2. Improve Access to Quality Maternal Healthcare: Access to quality
healthcare is essential. This objective focuses on ensuring that all women,
regardless of where they live or their economic status, have access to
comprehensive maternal healthcare services. It encompasses antenatal care,
where pregnant women receive regular check-ups and education about a
healthy pregnancy. It also includes skilled birth attendance, ensuring that
trained healthcare professionals are present during childbirth, and postnatal
care, which supports the health and well-being of both mothers and
newborns during the postpartum period. This objective aims to reduce
disparities in healthcare access.
3. Promote Skilled Birth Attendants: Skilled birth attendants, such as
midwives and nurses, are crucial for safe deliveries. This objective
emphasizes increasing their numbers and availability in healthcare facilities

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 across the country. Skilled attendants are trained to manage normal
pregnancies, identify complications, and provide immediate care when
issues arise. By promoting their presence, the policy seeks to make
childbirth safer for Nigerian women.
4. Strengthen Family Planning and Reproductive Health: Family planning
services are essential for enabling women to make informed decisions about
when and how many children to have. This objective aims to strengthen
these services, ensuring that women have access to contraception and
information about reproductive health. It also encourages healthy birth
spacing, which can reduce the risks associated with closely spaced
pregnancies. By addressing these aspects, the policy aims to reduce
unintended pregnancies and their associated risks.
5. Raise level of Awareness and Education: Knowledge is empowering. This
objective focuses on education and awareness campaigns to inform women
about the importance of maternal health. It includes promoting early prenatal
care, educating women about the risks and benefits of various healthcare
options, and encouraging informed decision-making regarding their health.
This objective aims to change behaviors and attitudes, making women active
participants in their healthcare.
6. Ensure Timely Access to Emergency Obstetric Care: Complications
during pregnancy and childbirth can arise suddenly and pose significant
risks. Timely access to emergency obstetric care is vital to address these
complications promptly. This objective involves creating systems and
facilities that ensure women can receive life-saving care when needed,
which is essential for reducing maternal mortality.
These objectives collectively form a comprehensive approach to maternal
healthcare in Nigeria. By addressing these areas, the policy aims to create a
healthcare system that is accessible, efficient, and effective, ultimately leading to a
significant reduction in maternal mortality rates, healthier pregnancies, and better
overall health outcomes for women and their families in the country.

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 STRATEGIES
1. Strengthening Health Systems: This strategy involves significant investments
in healthcare infrastructure, equipment, and training. The goal is to improve the
quality of maternal healthcare services, particularly in underserved areas. This
includes building and upgrading healthcare facilities, ensuring they are well-
equipped with the necessary medical tools and technology, and enhancing the
physical infrastructure. It also includes ongoing training for healthcare
professionals to keep them updated on the latest medical practices and
standards.
2. Skilled Workforce Development: To ensure the availability of skilled
healthcare professionals, this strategy focuses on training, recruiting, and
retaining individuals with expertise in maternal healthcare. Midwives,
obstetricians, nurses, and other specialists are critical in providing quality care
to pregnant women. This involves educational programs, incentives for
healthcare workers to stay in maternal healthcare roles, and efforts to attract
new talent to this field.
3. Community Engagement: Communities play a crucial role in maternal health.
This strategy involves mobilizing communities to actively participate in
maternal health campaigns. It includes educating community members about
the importance of maternal healthcare and women's rights. Community
engagement encourages individuals to be proactive in seeking healthcare
services and supporting pregnant women, reducing barriers and misconceptions
about maternal health.
4. Nutrition education: is a crucial element of our national policy. It is aimed at
reducing maternal mortality by empowering expectant mothers with knowledge
and skills to make informed choices about their diet and health during
pregnancy. This education promotes balanced nutrition, prevents low birth
weight, combats anemia, and encourages healthy weight gain during pregnancy.
It also enhances birth preparedness, challenges harmful cultural beliefs,
promotes breastfeeding, and addresses non-communicable diseases. By
incorporating nutrition education into our policy, we aim to empower women
and contribute to the reduction of maternal mortality in our country.
5. Data Collection and Analysis: Data is essential for informed decision-making.
This strategy emphasizes establishing a robust health information system
focused on maternal health indicators. It involves collecting data on maternal
mortality rates, healthcare utilization, and other relevant metrics. This data is

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 then used to assess the effectiveness of policies and interventions, identify areas
for improvement, and make evidence-based decisions.
6. Legislation and Regulation: Laws and regulations can have a significant
impact on maternal health. This strategy involves enforcing existing laws and
regulations related to maternal health and family planning. It also addresses
legal barriers that may limit access to maternal healthcare services. By ensuring
that the legal framework supports maternal health, this strategy helps create an
environment where women's rights are protected, and healthcare services are
accessible.
7. Financial Support: Adequate funding is essential for the sustainability of
maternal health programs. This strategy focuses on allocating sufficient
financial resources to support these programs. It includes budgetary
commitments to ensure that maternal health initiatives receive the necessary
funding. Adequate financial support ensures that these programs can continue
and expand, ultimately benefiting more women.
8. Partnerships: Collaboration is vital in addressing maternal mortality. This
strategy involves partnering with international organizations, non-governmental
organizations, and civil society. These partnerships leverage resources,
expertise, and networks to support maternal health initiatives. Collaborative
efforts can lead to a more comprehensive and effective approach to maternal
healthcare.
9. Monitoring and evaluation: Regular monitoring and evaluations are critical
for assessing the impact of policies and interventions. This strategy involves
implementing a system for ongoing monitoring and evaluation of maternal
health outcomes. By consistently assessing the effectiveness of various
initiatives, adjustments can be made to improve the overall approach to
maternal healthcare.
[Link] Transportation Improvement: Develop and enhance rural
transportation infrastructure to facilitate access to maternal healthcare services
and Collaborate with transportation authorities to ensure reliable and affordable
transportation options for pregnant women in remote areas.
11. Provision of Water: Ensure reliable access to clean water in healthcare
facilities to improve hygiene during childbirth and postpartum care. Supporting
water provision projects in rural areas to enhance overall community health and
reduce water-related diseases that could affect maternal health.
12. Agricultural Development: Implement agricultural programs that empower
women and communities, improving economic conditions and indirectly

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 impacting maternal health and also Promote sustainable farming practices and
income-generating activities that contribute to overall community well-being.
13. Education Enhancement: Promote educational programs for women,
emphasizing the importance of maternal health and family planning and
Support initiatives that provide scholarships or incentives to encourage girls'
education, fostering long-term improvements in maternal health.

.CONCLUSION
This comprehensive national policy marks Nigeria's unwavering commitment to
reducing maternal mortality, aligning with the global vision encapsulated in the
Sustainable Development Goals (SDGs). By integrating strategies that address
not only direct healthcare factors but also crucial determinants such as
education, rural transportation, agriculture, and water provision, the policy
reflects a holistic approach to maternal health.
The outlined initiatives demonstrate Nigeria's dedication to achieving SDG 3
(Good Health and Well-being) by ensuring that every woman has access to
quality and comprehensive healthcare services throughout her reproductive life.
Moreover, the emphasis on education, skilled workforce development, and
community engagement aligns with SDG 4 (Quality Education) and SDG 5
(Gender Equality), acknowledging the interconnected nature of these goals with
maternal health.
As Nigeria implements these strategies, it contributes to the broader global
agenda of leaving no one behind, as articulated in the SDGs. The policy
envisions not just a reduction in maternal mortality rates but also the creation of
an environment where women's well-being is prioritized, fostering safe, healthy
pregnancies and childbirths that contribute significantly to national
development and prosperity.
Through collaborative efforts, transparency, and continuous evaluation,
Nigeria's journey toward achieving SDGs 3, 4, and 5 in the realm of maternal
health is a testament to the nation's commitment to a sustainable and equitable
future for all.

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 REFERENCES
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World Health Organization. (2019). Trends in Maternal Mortality: 1990 to
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Okonofua, F., Ntoimo, L., Ogungbangbe, J., Anjorin, S., Imongan, W., & Yaya,
S. (2018). Predictors of women’s utilization of primary health care for skilled
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10.1186/s12884-018-1730-4.
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Roberts, H., 2000. Reproductive Health Struggles in Nigeria, Lancet, 3(61):
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