End Maternal mortality: Time to make it happen

Wednesday, March 18, 2015

(Lagos, March 8, 2015) On this International Women's Day, experts and partners on the NOTAGAIN Campaign have called for effective implementation of policies and commitments that promote rights and access of women to quality maternal health and family planning services, while charging stakeholders on women empowerment in Nigeria.

The International Women's Day 2015, which is celebrated today (March 8) all over the world, seeks to encourage effective action for advancing and recognising women through the theme: 'make it happen'.

Nigeria currently has an unmet need of 16 percent for family planning among currently married women and  53 percent of women complain of at least one problem in accessing health care in Nigeria. Getting money for treatment (42 percent), distance to health facility (28.8 percent), and attitude of health worker (16.5 percent) are top challenges women face in accessing health care in Nigeria. According to the Nigeria Demographic Health Survey (NDHS) 2013, Nigeria recorded slight improvement in access to antenatal care - the proportion of women receiving antenatal care from a skilled provider is 61 percent compared to 58 percent in 2008.

It would be recalled that Nigeria has made several commitments to improve these undesirable indicators. The Millennium Development Goal 5, Abuja Declaration of April 2001, and commitments towards FP 2020, are among the commitments made to improve the health and wellbeing of women in Nigeria.

Family Planning
In her message for the International Women's Day 2015,  the Advocacy Advisor, Nigeria Urban Reproductive Health Initiative (NURHI), Ms. Ibeawuchi Charity noted that Nigeria joined the world at the London Summit in 2012 to commit to achieving the Global FP Vision 2020, which aims at supporting the rights of women and girls to decide freely and for themselves, whether, when and how many children they have.

She said, "government at all levels and partners should work together to ensure that Nigeria’s goal of 36% Contraceptive Prevalence Rate is achieved by 2018. Culturally appropriate information and facts about FP and its benefits should be widely available to all. In particular, the youth should know all about FP, well before they engage in active family life. It is only when young women begin early to know their reproductive health that they can genuinely achieve responsible family life. When all families are planned, the larger society will begin to also plan its affairs and eventually achieve development”.

Millennium Development Goal (MDG) 5:
With less than 297 days left to the MDG deadline (http://www.mdgs.gov.ng/), Nigeria is still far from achieving the Millennium Development Goal 5 which aims at reducing by three quarters, between 1990 and 2015, the maternal mortality ratio (MMR) and achieve, by 2015, universal access to reproductive health.

The maternal mortality ratio reduced from 1000 per 100,000 to 576 per 100,000 between 1990 and 2013 (NDHS 2013). This figure is far from the 250 per 100,000 target expected at the end of 2015. Consequently, Nigeria loses an average of 40,000 women due to child birth according to the World Health Organisation in its publication: "Trends in Maternal Mortality: 1990 - 2013". Thus, an average of 110 women die daily due to child birth.

Commenting on Nigeria's high maternal mortality ratio, the Programme Officer: Media, Development Communications (DevComs) Network, Mr. Ayodele Adesanmi  said "Nigeria will have to do something drastic to achieve MDG 5. These means intensifying efforts made regarding Midwives Service Scheme (MSS), orientation of public, wide adoption of free maternal and child health programmes, increased funding of maternal health programmes, tracking and learning from causes of maternal deaths, and something very innovative".

Women Rights
The Executive Director, Women Advocates Research and Documentation Centre (WARDC), Dr. Abiola Akiyode-Afolabi described maternal health issue as a host of human rights issues, including social, cultural, legal and accountability issues.

She said , "in the past, people look at the issue of maternal health from medical point of view. However, if you don’t situate it between the human right discourses, you may not be able to have a holistic understanding of what maternal health is and the implication of maternal health. When you situate it in that manner you will be able to understand that maternal health is a social issue, cultural issue and legal issue. it’s an issue of accountability".

"The other issue is also the fact that you deserve information that can help you secure your health as a woman. Your right to Family Planning, contraception and all that. The fact that those information are also not there is also a violation of your rights to information" she added.

Making it happen
In order to achieve the goal of this year's International Women's Day, a consultant gynaecologist and technical adviser to DevComs Network on health matters, Dr Adeleke Kaka, has called for actions to empower women. According to him, empowering women would make them to decide when to get pregnant and when not.

"When women are empowered, they are in control, their voices are heard and can make decisions about their health seeking behaviours without approval from their husbands. Women empowerment can also reduce domestic violence and help them to seek appropriate complaint channels when one occurs" he said.

Meanwhile, Mrs Ibeawuchi urged the government to ensure that all women of reproductive age in Nigeria have unhindered access to quality family planning services as a matter of right.

"The right of women to quality family planning services in the community is not negotiable; same applies to all other maternal health services. The Federal Government’s Policy of Free FP methods to all women who need the services should be equally supported by the States and Local Governments. Each level of government must commit to adequate budgetary expenditures on all the other components of a good FP programme, including consumables, logistics, supervision and training of the service providers" she said.