WUNRN
NIGERIA:
Childbirth Still Deadly
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Fatima, from northern Nigeria, married when she was 14 and
fell pregnant soon after (file photo) |
ABUJA, 3 June 2009 (IRIN) - Aishat Umar in the
northeastern state of Adamawa, Nigeria, had her first child at age 16. By age
33 she was pregnant for the ninth time in a quest to deliver a prized male
child, but following 36 hours of labour she bled to death, at home.
None of Umar’s nine children was delivered in the
presence of a medical professional.
Umar’s experience is common in Nigeria, where just 35
percent of births are attended by a skilled health professional, and one in 18
women dies in pregnancy or childbirth, according to World Health Organization
(WHO) and UN Children’s Fund (UNICEF) statistics.
The statistics have changed little over the past decade.
“Nigeria’s maternal mortality rate is still comparable
to those countries at war or [just emerging from war],” Iyabo Obasanjo-Bello,
who chairs the Nigerian senate health committee, told IRIN.
Half of Nigeria’s maternal deaths are due to postpartum
haemorrhaging, which unskilled health workers lack the know-how or equipment to
stop, said maternal health expert Arabi Tukur of Yola, 473km northeast of the
capital Abuja.
With an average of 5.5 births per woman, West Africa has
the world’s highest fertility rates, which puts women at greater risk of dying
in birth, according to UNICEF.
“If a woman has more than four children, the fifth
pregnancy can be more dangerous than the other pregnancies put together,” said
Ejike Oji, a gynaecologist with the reproductive health NGO IPAS. Starting
young also increases mortality, he said.
Many Nigerian women, particularly in the conservative
north, give birth in their teenage years. But reducing early pregnancy can be
tough given women’s disadvantaged social position, according to UNICEF’s latest
State of the
World’s Children report.
In Kano state many men do not allow their wives to have
a doctor present during childbirth. “I don’t think it is proper for a male
doctor to attend to my wife, not to talk of assisting her during delivery,”
Hassan Kurfi, 48, a farmer in the village of Nassarawa in Kano state, told
IRIN.
“In our tradition, culture and religion, we do not
encourage close contact between men and women [who are not related]; especially
for unmarried women…I would rather have a female traditional birth attendant
attend to her.”
“Even my wife is not comfortable with having a male
doctor around her when she is delivering a baby,” he added.
More needs to be done to break down these cultural
barriers, said Kirrin Gill, maternal health expert at the International Center
for Research on Women. “Change must be community-led, so we need to do more
work with community members to get them on board.”
Only with combined pressure from within the community
and from the government, will change gain momentum, she said.
The Nigerian government in 2007 launched a maternal,
newborn and child health strategy that called for improving antenatal care,
training staff and distributing insecticide-treated bednets to pregnant women.
The strategy has faced delays because health systems are
lacking, Health Minister Babatunde Osotomehin told IRIN. “It is not about the
buildings – the hospitals or the clinics – it’s about [health] structures that
we need to put in place. The government is not happy with the current situation
and will soon issue comprehensive plans on how to tackle it.”
One of the challenges facing the government, according
to Gill, is the decentralized control of health services, which makes it
difficult to implement national strategies in the states.
She noted that the federal government pledged to
allocate 15 percent of its overall budget on health in its 2008 budget launch,
but since then has only committed 5 percent.
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