Cited 28 June 2017. The NDHS are conducted by the National Population Commission of Nigeria in partnership with USAID and technical support from local government to gather reliable and representative data on population, health, and nutrition indicators on average, every 5 years in Nigeria. Massachusetts’s maternal mortality rate of 8.4 per 100,000 births makes it the state with the … In the North, early marriages expose young girls to early childbearing and pregnancies that are prone to complications and may lead to maternal death. It is against this background that the North is said to have had a worse performance than the South on maternal mortality [24] and other health outcomes. PubMed Google Scholar. 2013;29:379–403. From 1990 to 2015, the global maternal mortality ratio declined by 44 percent, and everyday, approximately 830 women die from preventable causes related to pregnancy and childbirth; 99 percent of all maternal deaths occur in developing countries. Lancet (London, England). A response of “no” was coded as 0 and meant disapproval of domestic violence while “yes/don’t know” was coded as 1 and represented approval or lack of knowledge on whether domestic violence was justified. The study participants could either be respondents (living women) or deceased women (respondents’ siblings) who were cases of maternal mortality that were identified through the direct sisterhood method. The national maternal mortality ratio has remained elevated despite efforts to reduce maternal deaths. Having a secondary or higher education reduced the odds of maternal death by 23% (reference: no education). Bankole A, Adewole IF, Hussain R, Awolude O, Singh S, Akinyemi JO. Oxytocin is recommended by W.H.O as the first-line medicine for prevention and treatment of postpartum hemorrhage, is temperature-sensitive medicine and requires refrigeration during transportation and storage. By Adebayo Folorunsho-Francis The Minister of Health, Dr. Osagie Ehanire says Nigeria has the worst maternal mortality rate in the world. 1992;23:23. Overall, policy makers should seek to increase maternal age and alleviate poverty by improving the economic conditions of women in the country. The modified framework retained some determinants of maternal mortality from the McCarthy and Maine framework. Educational level was defined as “no education”, “primary”, and “secondary/higher”. The odds of maternal death decreased with increasing age and increasing community wealth. 2013;8:e59834. Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St., London, ON, N6A 5C1, Canada, Catherine Meh, Amardeep Thind, Bridget Ryan & Amanda Terry, Department of Family Medicine, Western University, 1151 Richmond St., London, ON, N6A 5C1, Canada, Amardeep Thind, Bridget Ryan & Amanda Terry, Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London, ON, N6A 5C1, Canada, You can also search for this author in Over time, the North saw an increase in the levels of maternal mortality while the South had a minor decrease in its levels. Secondary or higher education was protective against maternal mortality in the North compared to having no education. Google Scholar. Nigeria presently has about 512 maternal mortality per 100,000 live births, making it the worst in the world, according to the Health Minister, Prof. Osagie Ehanire. The influence of the social and cultural environment on maternal mortality in Nigeria: evidence from the 2013 demographic and health survey. In fact, Africa has the highest maternal mortality rate in the world and Nigeria is one of the countries with the highest rate in the region. By using this website, you agree to our Maternal Mortality Rate in Nigeria: Past & Present Figures, Weight Loss: How to Lose Weight Using Dumbbells, Common Yoruba Herbs, their English Name & Uses. Dove Press. For instance, Borno state capital received several internally displaced persons while one of its prominent health facilities recorded 76 maternal deaths within 6 months in 2009 [40]. Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. BMC Pregnancy and Childbirth California Privacy Statement, This finding is consistent with other studies. ... report summarizes the current state of maternal health in Nigeria. Overall, the low level of care received by pregnant women in the country is one of the major contributors to the high infant and maternal mortality ratio. Lancet. Hence, the government needs to call all stakeholders to recommit to the fight against child marriages and clearly delineate their roles. The country’s progress towards cutting the number of maternal deaths has been largely insufficient [6]. Our study explored the levels of maternal mortality for the North and South regions separately. A secondary/higher education significantly reduced the odds of maternal mortality by 47% (reference: no education). Some residents became internally displaced or refugees in neighboring countries. 2013. In Bangladesh, induced abortions were more common among educated women [41] although the risk of mortality was low for them compared to uneducated women, this may not be the case in the South of Nigeria, where abortion is restricted, and most of its services are illicit and unsafe. Chinkhumba J, De Allegri M, Muula AS, Robberstad B. Maternal and perinatal mortality by place of delivery in sub-Saharan Africa: a meta-analysis of population-based cohort studies. The findings of this study show that maternal mortality remains a problem in Nigeria and reveal its levels and determinants in the North and South. The Multiple Cluster Indicator Survey of 1999 revealed some variation in the levels of maternal mortality between zones in the North and South. This included an initial state-wide assessment of maternal mortality rates which identified un-acceptably high rates in the most rural Local Government Areas of the State [6,7]. Nigeria maternal mortality rate for 2014 was 943.00, a 0.84% decline from 2013. Rich women had 20% lower odds of maternal death compared to those who were poor. Since the ethnic composition of the North and South were different, two variables for ethnicity were created and used only for the separate regional analyses. Banda R, Fylkesnes K, Sandøy IF. Wall (1998) revealed strict conditions in the North that undermine women’s autonomy and influence their risk of maternal death. Article  BMC Pregnancy Childbirth. Maternal mortality adversely affects women, their families and communities. For the South, the levels slightly decreased. This makes the country the second largest contributor to the under–five and maternal mortality rate ... child mortality rate in the state. Lancet. Nigeria maternal mortality rate for 2016 was 925.00, a 0.64% decline from 2015. The familial technique for linking maternal death with poverty. Galadanci H, Idris S, Sadauki H, Yakasai I. Oluwole E, Kuyinu Y, Goodman O, Odugbemi B, Akinyinka M. Factors influencing the uptake of modern family planning methods among women of reproductive age in a rural Community in Lagos State. NIH Public Access. 2015;385:941. This is consistent with other studies [4, 41, 49]. Maternal mortality ratio (national estimate, per 100,000 live births) Mortality rate attributed to household and ambient air pollution, age-standardized, male (per 100,000 male population) Prevalence of stunting, height for age, male (% of children under 5) These programs need to be innovative in their efforts to ensure that maternal health services are available, affordable, acceptable and utilized within and outside health facilities. In the South, contraceptive method used, type of residence, and wealth index were significantly associated with maternal mortality. In fact, only a little over a third of the births in the country are attended by doctors, nurses, or midwives. Community influences on antenatal and delivery care in Bangladesh, Egypt, and Rwanda. Meanwhile, highly educated women tend to use and demand maternal health services [50]. Overall, new policies to improve women’s socioeconomic status should be adopted. Oxytocin must be stored in cold storage to remain potent in temperature of between 2°C- 8°C. It is thus necessary to gain community support to increase the legal age of marriage for girls in the North. Evidence from the literature supports this approach of using respondent characteristics as proxy for deceased sibling in the assessment of maternal mortality [26, 33, 34] particularly in settings where cases of maternal mortality cannot be directly evaluated because of limited data on the deceased. Survey adjusted simple and multivariable logistic regression analyses were used to investigate the association of the independent variables and maternal mortality in the North and South of Nigeria using pooled data for the North (2008 and 2013) and South (2008 and 2013). Media exposure and education were associated with maternal mortality in the North while contraceptive method, residence type and wealth index were associated with maternal death in the South. Unfortunately, over half of the pregnant women in Nigeria receive iron supplements and only 39 receive drugs to prevent malaria. It is possible that some deceased siblings had different characteristics compared to those ascribed to them which may lead to the misclassification of their own attributes. In the South, hemorrhage and illegal abortions were the leading causes of maternal death [4]. Int J Gynecol Obstet. This gap in contraceptive use between the North and South is attributed to socioeconomic and ideational (ideal number of children, awareness of contraceptive method, and self-efficacy) factors [22]. Generally, maternal mortality reflects the status of the country’s population and quality of life and the factors affecting this parameter are often sociocultural, economic and logistics coupled with the poor healthcare delivery. PubMed  Maternal deaths in the camps were due primarily to excessive bleeding [38]. Graham WJ, Fitzmaurice AE, Bell JS, Cairns JA. 1997;59:S191–200. PLoS One. Adamu YM, Salihu HM, Sathiakumar N, Alexander GR. WHO. Ratios for Nigeria were obtained from NDHS 2013 final report. The DHS Program granted permission to access and use the data files. CM, AT and AT conceived and developed the study and analytical plan. From the foregoing, it is obvious that Nigeria has one of the highest maternal mortality rates in the world, second only to India whose population is eight times larger than that of Nigeria. Maternal mortality rate is the number of maternal deaths within 42 days of the termination of pregnancy due to . By comparison, the total number of maternal deaths in 2015 in the 46 most developed countries was 1700, resulting in a maternal mortality ratio of 12 maternal deaths per 100 000 live births. Cookies policy. CAS  WHO. In 2015, of the 303,000 women that died globally due to complications of pregnancy and childbirths in 2015, 58,000 women died in Nigeria. Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. 2016;14:7085–99. The women from the South were mostly Christian (84.3%). Lancet. BMC Public Health. Though estimates of maternal mortality levels can be derived with the Sisterhood method, these estimates are not current in terms of representing the survey year in which the data were collected. The maternal mortality rate in the United States is three times higher than that in neighboring Canada and six times higher than in Scandinavia. Maternal mortality is still a major risk for women of childbearing age in Nigeria. An increase in the score for attitude towards domestic violence increased the odds of maternal death by 10%. More so, maternal mortality levels obtained from DHS data underestimate the magnitude of the problem. Community wealth influences availability and access to maternal health services. A composite variable for media exposure was created using three measures: frequency of listening to the radio, watching television, and reading a newspaper or magazine. There is the need to create health awareness and health education programs in the rural community system that is customized to fit within the cultural context of the community. Neonatal mortality rate of Nigeria fell gradually from 65.8 deaths per 1,000 live births in 1970 to 35.9 deaths per 1,000 live births in 2019. CM, AT, BR and AT contributed to the interpretation of data, and revision of the draft. Article  WHO analysis of causes of maternal death: a systematic review. CAS  Geneva: Estimates developed by WHO, UNICEF, UNFPA and World Bank; 2010. 2007;370:1311–9. Poverty and maternal mortality in Nigeria: towards a more viable ethics of modern medical practice. One of the major contributing factors to this prevalence is the slow progress being made in the region in solving this problem. 2001. The NDHS measured wealth index with an asset score which was categorized in this study as poor, middle and rich. While countries like Rwanda - which once had the highest level of maternal deaths in the world (in 1995, maternal mortality ratio (MMR) was 2300/100,00 livebirths) [4, 5] – have met their MDG 5 target of reducing maternal deaths [6] to 320/100,000 livebirths [7], other countries in Sub-Saharan Africa either had no significant change or experienced an increase in their levels of maternal mortality, even with implementation of evidence-based interventions. This incorporates the roles of socioeconomic, cultural, behavioral and biological factors on maternal mortality, thereby making it the most inclusive framework for assessing determinants of maternal mortality. Eur J Obstet Gynecol Reprod Biol. Nigeria maternal mortality rate for 2015 was 931.00, a 1.27% decline from 2014. Respondents’ stated ethnicities were categorized into major ethnic groups of each region (North and South). Hence, nulliparous women (women with zero births) were excluded. Trends in maternal mortality: 1990 to 2008. Graham W, Brass W, Snow RW. Gend Behav. The relationship between maternal education and mortality among women giving birth in health care institutions: analysis of the cross sectional WHO global survey on maternal and perinatal health. Meanwhile, they should also coordinate and properly structure interventions to prevent child marriages. Similarly, attitude towards domestic violence was a composite variable that measured a participant’s attitude towards husband/partner beating wife in four circumstances: for going out without telling husband/partner, neglecting children, arguing with husband/partner and refusing sex. We would like to thank the Measure DHS Program for making the data used for this study publicly available. 2016;31:277–84. This high level of maternal mortality is also linked to Nigeria’s high rate of deaths for children under 5—newborns account for a quarter of the under-five deaths which occur in the country. A rural residence was protective against maternal mortality for women in the South. In African communities especially the sub-Saharan region, the rate is quite high. 2013;8:e69569. 2006;368:1189–200. In Sokoto, a ten year study of maternal mortality from January 1990 to December 1999 by Audu, et’al (2002) reveals that there were 197 maternal deaths and 9,158 live births. The causes of maternal death cannot be ascertained using this method or DHS data. There are states and health facilities that have higher levels of maternal mortality compared to the national average. Factors contributing to maternal mortality in North-Central Nigeria: A seventeen-year review. Lancet. Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. Rai RK, Singh PK, Singh L. Utilization of maternal health care services among married adolescent women: insights from the Nigeria demographic and health survey, 2008. NCHS has identified instances where application of the checkbox information according to coding rules led to misclassification of maternal deaths, and NCHS is making changes in coding rules and reporting to make data more accurate. 2012;22:407–14. Fawole AO, Shah A, Fabanwo AO, Adegbola O, Adewunmi AA, Eniayewun AB, et al. These two cycles allow for the regional levels of maternal mortality to be assessed over time. Maternal mortality in northern Nigeria : a population-based study. Like the North, age and community wealth were also significant in the South, where the odds of maternal mortality decreased by 10% with increasing age in years and by 62% with increasing community wealth. This study focused on women who had been pregnant and had given birth to at least one child in Nigeria. Estimating maternal mortality: the sisterhood method. 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