Maternal Mortality in Nigeria: A Literature Review

Piane, Gina

doi:10.1002/wmh3.291

Cited by 21 publications

(24 citation statements)

References 15 publications

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“…Uneducated women may find it difficult to recognize danger signs, are less economically empowered to seek care, have poor health seeking behaviours, and are highly dependent on the approval of their husband or male head of household to access health care. They therefore do not attend antenatal care and present late to maternal healthcare facilities when complications have already supervened [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria: A retrospective analysis from 2014–2018

et al. 2021

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Background Addressing the problem of maternal mortality in Nigeria requires proper identification of maternal deaths and their underlying causes in order to focus evidence-based interventions to decrease mortality and avert morbidity. Objectives The objective of the study was to classify maternal deaths that occurred at a Nigerian teaching hospital using the WHO International Classification of Diseases Maternal mortality (ICD-MM) tool. Methods This was a retrospective observational study of all maternal deaths that occurred in a tertiary Nigerian hospital from 1st January 2014 to 31st December,2018. The WHO ICD-MM classification system for maternal deaths was used to classify the type, group, and specific underlying cause of identified maternal deaths. Descriptive analysis was performed using Statistical Package for Social Sciences (SPSS). Categorical and continuous variables were summarized respectively as proportions and means (standard deviations). Results The institutional maternal mortality ratio was 831/100,000 live births. Maternal deaths occurred mainly amongst women aged 25–34 years;30(57.7%), without formal education; 22(42.3%), married;47(90.4%), unbooked;24(46.2%) and have delivered at least twice;34(65.4%). The leading causes of maternal death were hypertensive disorders in pregnancy, childbirth, and the puerperium (36.5%), obstetric haemorrhage (30.8%), and pregnancy related infections (17.3%). Application of the WHO ICD-MM resulted in reclassification of underlying cause for 3.8% of maternal deaths. Postpartum renal failure (25.0%), postpartum coagulation defects (17.3%) and puerperal sepsis (15.4%) were the leading final causes of death. Among maternal deaths, type 1, 2, and 3 delays were seen in 30(66.7%), 22(48.9%), and 6(13.3%), respectively. Conclusion Our institutional maternal mortality ratio remains high. Hypertensive disorders during pregnancy, childbirth, and the puerperium and obstetric haemorrhage are the leading causes of maternal deaths. Implementation of evidence-based interventions both at the hospital and community levels may help in tackling the identified underlying causes of maternal mortality in Nigeria.

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Section: Discussionmentioning

confidence: 99%

Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria: A retrospective analysis from 2014–2018

et al. 2021

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“…5 6 Some family-level characteristics such as economic status and marital relationships, social–cultural factors such as religion, gender norms and health belief have also been identified as key determinants. 12 13 While this showed that causes of maternal mortality are multifaceted, most interventions designed to tackle this major public health problem relate to the medical causes.…”

Section: Introductionmentioning

confidence: 99%

Disparities in pregnancy-related deaths: spatial and Bayesian network analyses of maternal mortality ratio in 54 African countries

2021

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BackgroundMaternal mortality remains a public health problem despite several global efforts. Globally, about 830 women die of pregnancy-related death per day, with more than two-third of these cases occurring in Africa. We examined the spatial distribution of maternal mortality in Africa and explored the influence of SDoH on the spatial distribution.MethodsWe used country-level secondary data of 54 African countries collected between 2006 and 2018 from three databases namely, World Development Indicator, WHO’s Global Health Observatory Data and Human Development Report. We performed descriptive analyses, presented in tables and maps. The spatial analysis involved local indicator of spatial autocorrelation maps and spatial regression. Finally, we built Bayesian networks to determine and show the strength of social determinants associated with maternal mortality.ResultsWe found that the average prevalence of maternal mortality ratio (MMR) in Africa was 415 per 100 000 live births. Findings from the spatial analyses showed clusters (hotspots) of MMR with seven countries (Guinea-Bissau, Guinea, Sierra Leone, Cote d’Ivoire, Chad and Cameroon, Mauritania), all within the Middle and West Africa. On the other hand, the cold spot clusters were formed by two countries; South Africa and Namibia; eight countries (Algeria, Tunisia, Libya, Ghana, Gabon and Congo, Equatorial Guinea and Cape Verde) formed low–high clusters; thus, indicating that these countries have significantly low MMR but within the neighbourhood of countries with significantly high MMR. The findings from the regression and Bayesian network analysis showed that gender inequities and the proportion of skilled birth attendant are strongest social determinants that drive the variations in maternal mortality across Africa.ConclusionMaternal mortality is very high in Africa especially in countries in the middle and western African subregions. To achieve the target 3.1 of the sustainable development goal on maternal health, there is a need to design effective strategies that will address gender inequalities and the shortage of health professionals.

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“…Predictably, maternal mortality in Nigeria remains unacceptably high at a ratio of 917 deaths per 100,000 live births and 60,000 maternal deaths occurring annually, most of which are preventable (WHO, 2019). This indisputably makes maternal mortality a human rights issue in Nigeria (Olonade, Olawande, Alabi, & Imhonopi 2019;Piane, 2019). The preamble of the 1946 Constitution of the WHO states that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…."…”

Section: Introductionmentioning

confidence: 99%

Human Rights-based Approach to Maternal Health Policy and Implementation: An Analysis of Abiye Safe-Motherhood Policy of Ondo State Nigeria

Mbada¹

2021

JPAG

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A human rights-based approach that recognizes that women deserve the right to health is critical to achieving equitable reduction of maternal mortality in Nigeria, a country that is the second largest contributor to global maternal mortality. This study evaluated the extent to which the Abiye safe motherhood policy of the Ondo State government of Nigeria incorporated human rights-principles in its formulation and implementation. The study involved interviews and focus group discussions and the OHCHR human rights principles served as the basis for the thematic analysis of data. Findings indicate that the Abiye initiative exemplified the core principles of human rights-based approach to maternal health. Whereas, the initiative showed stronger practice in terms of the principles of participation, empowerment, non-discrimination and international assistance, there was limited indication of adherence to accountability, transparency, and sustainability principles. The Abiye safe motherhood initiative responded to maternal health needs in fairly acceptable and equitable ways; allowing the creation of opportunities and enabling conditions for the fulfillment of the health rights of reproductive-age women. It is recommended that governments at all levels should prioritize incorporating human rights-based standards into new or existing programs in a way that meets the core needs of respect and welfare of every woman in pregnancy and childbirth.

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Maternal Mortality in Nigeria: A Literature Review

Cited by 21 publications

References 15 publications

Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria: A retrospective analysis from 2014–2018

Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria: A retrospective analysis from 2014–2018

Disparities in pregnancy-related deaths: spatial and Bayesian network analyses of maternal mortality ratio in 54 African countries

Human Rights-based Approach to Maternal Health Policy and Implementation: An Analysis of Abiye Safe-Motherhood Policy of Ondo State Nigeria

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