2016;14:7085–99. Rich women had 20% lower odds of maternal death compared to those who were poor. Gend Behav. Google Scholar. Trends in maternal mortality: 1990 to 2013. Int Perspect Sex Reprod Health. Estimating maternal mortality: the sisterhood method. Hence, nulliparous women (women with zero births) were excluded. Ujah IAO, Aisien OA, Mutihir JT, Vanderjagt DJ, Glew RH, Uguru VE. There may also be other health risks in women of the middle class such as abortions. As many women in the North continue to give birth unattended outside health facilities [57], the government of Nigeria, together with community leaders in the North, need to tackle this by identifying members of the community that can be trained as local midwives and birth attendants. Wall (1998) revealed strict conditions in the North that undermine women’s autonomy and influence their risk of maternal death. McCarthy J, Maine D. A framework for analyzing the determinants of maternal mortality. The incidence of abortion in Nigeria. 2). The national maternal mortality ratio has remained elevated despite efforts to reduce maternal deaths. Maternal mortality is 576/100,000 (NDHIS 2013) and child mortality rate is 103/1000 live births. In one study, nonusers of maternal health services were more likely to be less educated [48]. The use of contraceptives was higher in the South of the country compared to the North [21]. Other North-South differentials exist in Nigeria. This problem remains a challenge for many countries that still struggle to prevent it. Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. A respondent in the NDHS was included in this study if she had a total of one or more children ever born. PubMed  In 2008, Nigeria bore 14% of the global burden of maternal mortality. The middle class, compared to poor women, were more likely to experience maternal mortality in the South region. Maternal mortality ratios for 2008 and 2013 were computed for each region (North and South). Currently, Nigeria has the second highest burden of maternal mortality in the world and contributes about 15 percent of the annual total global deaths which represent two percent of the global population. 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. It is also among the top six countries in the world that contribute to more than 50% of all global maternal deaths [8]. Maternal Mortality Rate in Nigeria: Past & Present Figures, Weight Loss: How to Lose Weight Using Dumbbells, Common Yoruba Herbs, their English Name & Uses. Hemorrhage, abortions, sepsis and obstructed labor are some of the leading causes of maternal death in this region [3]. In contrast, some factors were only significantly associated with maternal mortality in the South. International Journal of Trend in Scientific Research and Development, Volume 1(4), ISSN: 2456-6470 www.ijtsrd.com. More than half of these deaths occur in sub-Saharan Africa and almost one third occur in South Asia. Community wealth was associated with maternal mortality in the North meaning that states with high proportions of wealthy women had reduced odds of maternal death compared to those states that consisted mostly of poor or middle-class women. Nigeria is one of the countries in Sub-Saharan Africa where maternal mortality has remained a problem. BioMed Central. 2013. These differences between the North and South of Nigeria have implications for maternal health programs to prevent maternal deaths. An increase in the score for attitude towards domestic violence increased the odds of maternal death by 10%. Confl Heal. Aremu O, Lawoko S, Dalal K. Neighborhood socioeconomic disadvantage, individual wealth status and patterns of delivery care utilization in Nigeria: a multilevel discrete choice analysis. Our findings show an extremely high maternal mortality ratio of 1,012 maternal deaths per 100,000 live births (95% CI: 898–1,126) in Jigawa State, Northern Nigeria. Factors contributing to maternal mortality in North-Central Nigeria: A seventeen-year review. Stephenson R, Elfstrom KM. 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. The risk of maternal death may be higher in women with less education because of factors such as early marriage and other cultural practices that restrict their access and participation in the labor force. This was on the assumption that deceased siblings share similar characteristics as the respondents. The 2008 and 2013 Nigeria Demographic and Health Survey datasets used for this study are publicly available through the Measure DHS program https://dhsprogram.com/data/available-datasets.cfm and the formats used in this study are available upon request to the corresponding author. Also, the prevalence has been linked to other factors like living in an urban or rural area, socio-economic status, and geopolitical zone. For the South, the levels slightly decreased. The association between maternal mortality (outcome) and relevant sociocultural, economic and health factors was tested using multivariable logistic regression in a sample of 51,492 living or deceased women who had given birth. As of 2015, the maternal mortality rate in Nigeria was 814 deaths per 100,000 live births. Hence, the aim of this study was to assess the levels and determinants of maternal mortality in the Northern and Southern regions of Nigeria among women of childbearing age using Nigeria Demographic Health Surveys. 2007;370:1320–8. Maternal deaths in the camps were due primarily to excessive bleeding [38]. Maternal mortality adversely affects women, their families and communities. Maternal mortality is still a major risk for women of childbearing age in Nigeria. Nigeria maternal mortality rate for 2016 was 925.00, a 0.64% decline from 2015. PLoS One. However, studies have shown that the levels of maternal mortality vary within the country. 2015;9:30. Levels and determinants of maternal mortality in northern and southern Nigeria. In 2019, neonatal mortality rate for Nigeria was 35.9 deaths per 1,000 live births. In 2008, Nigeria bore 14% of the global burden of maternal mortality. Lancet. The North had more maternal deaths than the south. In African communities especially the sub-Saharan region, the rate is quite high. Similarly, studies show that factors such as age [14], education, antenatal care, parity [13], domestic violence and social autonomy [16] (which have been established as determinants of maternal mortality) are associated with this outcome in Nigeria. The mean of these values was then assigned to individuals in the respective states. Because access to care is usually better in urban than rural areas, this finding may imply that the quality of health services such as emergency obstetrics services in the urban areas of the South is poor. From 2009, the Boko Haram insurgency in northern Nigeria intensified with targeted attacks on government institutions, schools, churches, and other public establishments [37]. Cookies policy. 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. A secondary/higher education significantly reduced the odds of maternal mortality by 47% (reference: no education). This makes the country the second largest contributor to the under–five and maternal mortality rate ... child mortality rate in the state. The authors declare that they have no competing interests. Using community-based research to shape the design and delivery of maternal health services in northern Nigeria. Int J Equity Health. Religion was grouped as “Catholics”, “other Christians”, “Islam” and “Traditionalist/other”. As UNICEF states, Nigeria loses 145 women to maternal mortality each day. Some counter-insurgency tactics have been restrictive in terms of health services provision and access [39]. 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. The national maternal mortality ratio has remained elevated despite efforts to reduce maternal deaths. Predictors of maternal mortality in institutional deliveries in Nigeria. Int J Women's Health. Int J Gynecol Obstet. Maternal deaths increased in the North and slightly decreased in the South between the years 2008 and 2013. Rural-urban differentials in pregnancy-related mortality in Zambia: estimates using data collected in a census. CM, AT, BR and AT contributed to the interpretation of data, and revision of the draft. BMC Public Health. This underscores the need to strengthen obstetric care in the area and for expansion of safe motherhood interventions to accelerate reductions in maternal deaths. 1989;20:125. Lancet. The likelihood of dying was significantly higher in women who used folkloric or traditional methods compared to nonusers. The South saw a slight decline in its MMR but there remains a need for the government to ensure that there are appropriate family planning services and education available in the South. 2014;17:2. This means the country has a lifetime risk of maternal death of 4.62 percent. Article  Fapohunda BM, Orobaton NG. Springer Nature. Hence, new and current strategies need to be sensitive to the environmental of the women in the North. Elsevier. Women who had low media exposure had increased odds of maternal mortality (reference: no exposure). To achieve this, the two survey cycles were pooled to increase the sample size notably, the number of maternal related deaths. BMC Public Health. Community influences on antenatal and delivery care in Bangladesh, Egypt, and Rwanda. Abuja and Rockville: NPC and ICF International; 2014. https://dhsprogram.com/pubs/pdf/FR293/FR293.pdf. In 2015, Nigeria’s estimated maternal mortality ratio was over 800 maternal deaths per 100 000 live births, with approximately 58 000 maternal deaths during that year. Lancet. The middle class, compared to the poor, had higher odds of maternal death. Int J Gynecol Obstet. The values for this composite variable ranged from 0 to 4, where 0 was no participation and a score of 4 meant participation in all four individual measures of decision making. Accessing antenatal care can prevent neonatal mortality arising from neonatal tetanus, malaria, and maternal anaemia. Soc Sci Med. Lancet Elsevier. 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. 1) have a more direct influence on maternal mortality while distant determinants impact the outcome by way of their influence on the intermediate factors. Women with low media exposure had 39% higher odds of maternal death compared to those with no media exposure. Their choice of facilities may be less expensive but lacking in terms of service quality. Also, health facilities show similarly high levels of maternal mortality with 927 deaths per 100,000 livebirths reported for 21 health facilities in three states - Katsina (North), Lagos (South) and the Federal Capital territory (North) [13]. But first, let’s define the maternal mortality ratio (MMR). PLoS One. The maternal mortality ratio in developing countries in 2015 is 239 per 100 000 live births versus 12 per 100 … Most women (79.4%) had a low or medium level media exposure and a secondary or higher education (57.3%). Low access to information may be contributing to the low level of health service utilization and a high proportion of women who do not use any antenatal care services in the North [48] which influence maternal mortality. Use of mass media campaigns to change health behaviour. 2012;12:430. 2010;376:1261–71. Google Scholar, WHO. The method of contraception used in the South was associated with maternal mortality. This study focused on women who had been pregnant and had given birth to at least one child in Nigeria. Google Scholar. Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. Lanre-Abass BA. A study of repeated cross-sectional data. From the year 2003 to 2013, only 8 countries worldwide saw an increase of the maternal mortality rate. PubMed Central  In the South-West, MMR was 166 maternal death per 100,000 livebirths compared to 1549 maternal deaths per 100,000 livebirths in the North-East [11, 15]. Most of the recorded maternal deaths (75.4%) were from this region which is also reflected in the MMR of the region (Fig. 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. This ratio includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year. Kusuma D, Cohen J, McConnell M, Berman P. Can cash transfers improve determinants of maternal mortality? CAS  It does not allow for the estimation of annual rates that could show variations in maternal mortality levels across time.

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