This study assessed the determinants of maternal mortality by using a cross-sectional study design and analyzing secondary data for women of childbearing age (15–49 years) that were part of the NDHS as respondents or were identified as deceased siblings (cases of maternal mortality) using the direct sisterhood method (a variant of the sisterhood method [29]). Difficulty accessing healthcare services was assessed with the variable “distance to health facility”. The country’s progress towards cutting the number of maternal deaths has been largely insufficient [6]. Postpartum hemorrhage is severe bleeding experienced by women following the birth of a baby. The insufficient and poor quality of health services in the region, health worker shortage, and substandard emergency obstetric care services [18] owing to the elimination of grants for health institutions, [4] may have increased the cost of health care (60% of women in the North are poor) and increased the proportion of deliveries outside the health facility. 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. 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. WHO. Agbiboa DE, Maiangwa B. Boko haram, religious violence, and the crisis of National Identity in Nigeria: towards a non-killing approach. Are Weight Loss Drugs Available in Nigeria? 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. Glob Heal Matters Public Heal Reports. PubMed Central  Among the southern ethnic groups, being Yoruba and others ethnic group was protective against maternal mortality (reference: Ekoi/Ibibio). 1989;20:125. Intermediate determinants (Fig. BMC Pregnancy Childbirth. ... report summarizes the current state of maternal health in Nigeria. Rich women had 20% lower odds of maternal death compared to those who were poor. 2012;12:32–40. Our study explored the levels of maternal mortality for the North and South regions separately. 2010;375:1609–23. Google Scholar. Overall, policy makers should seek to increase maternal age and alleviate poverty by improving the economic conditions of women in the country. However, in this study, women who had low media exposure had higher odds of experiencing maternal mortality compared to those with none. The National Population commission of Nigeria shows the North and South as two distinct regions [17]. There may also be other health risks in women of the middle class such as abortions. State-level data on maternal mortality rates and predictor variables are presented. Kano is located in northwest Nigeria. 2003;109:153–9. This is further aggravated by cultural practices in the region that prevent pregnant women from seeking care or showing signs of distress from the pregnancy [24]. An ethics waiver was granted by the Research Ethics Board at Western University in accordance with regulations pertaining to the use of anonymous secondary data. Some of the prevailing factors leading to poor accessibility to healthcare are lack of funds for treatment and distance to health facility. Short of that, the drug will not work. In the North, the odds of maternal death reduced with increasing age in years by 9% and by 86% with an increase in community wealth. 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. Soc Sci Med. 1998;29:341–59. Google Scholar. 2015;10:e0144876. CAS  Lancet. The most worrisome is the report from North-East where MMR is highest at 1,549/100,000 live births in comparison to the South-West zone where 165/100,000 was recorded. These workers can offer basic services to pregnant women in their homes and provide information on safe motherhood practices and where to get help. The data used for this study are publicly available secondary data with non-identifiable information that do not need ethical clearance. This underscores the need to strengthen obstetric care in the area and for expansion of safe motherhood interventions to accelerate reductions in maternal deaths. 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. NIH Public Access. 2015;13:32. J Dev Soc. Int J Gynecol Obstet. According to UNICEF, a woman’s chance of dying from pregnancy and childbirth in Nigeria is 1 in 13. Galadanci H, Idris S, Sadauki H, Yakasai I. The disparities in these regions influence their levels and determinants of maternal mortality. Wealthy communities have better access to resources and services compared to poor ones. A total of 18,863 women were from the South with 24% of the reported maternal deaths (Fig. Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality refers to deaths due to complications from pregnancy or childbirth. Evidence from other studies show varying associations between age and maternal mortality. Google Scholar, WHO. This was on the assumption that deceased siblings share similar characteristics as the respondents. 2014;14:1014. Betrán AP, Wojdyla D, Posner SF, Gülmezoglu AM. Given the rarity of the outcome for this study, it was necessary to increase the study power to detect associations between maternal mortality and the independent variables at the regional level. 2016;2:1–10. The 6 geo-political zones in Nigeria were the response options for the variable region. 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. Nigeria still has a high MMR and needs to reevaluate the already established programs to reduce maternal mortality in the country. These may explain the problem of maternal mortality in the urban settings of the South compared to rural ones. Adebayo SB, Gayawan E, Ujuju C, Ankomah A. Modelling geographical variations and determinants of use of modern family planning methods among women of reproductive age in Nigeria. Gend Behav. https://dhsprogram.com/data/available-datasets.cfm, https://www.who.int/en/news-room/fact-sheets/detail/maternal-mortality, https://dhsprogram.com/pubs/pdf/FR293/FR293.pdf, http://law.emory.edu/elj/content/volume-64/issue-6/articles-and-essays/polygyny-violence-against-women.html, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12884-019-2471-8, Pregnancy and childbirth in low and middle income countries, bmcpregnancyandchildbirth@biomedcentral.com. Doctor HV, Findley SE, Ager A, Cometto G, Afenyadu GY, Adamu F, et al. Afr J Reprod Health. Even though Nigeria ratified the convention on the rights of the child, the problem has persisted in the region. The odds of maternal mortality decreased with increasing age, placing the greatest odds of maternal death on young women. 2016;163:10–20. Omole O, Welye H, Abimbola S. Boko Haram insurgency: Implications for public health. It has been suggested that women in the South rely on abortions to maintain smaller family sizes [51]. Statistical significance for all regressions performed was determined at p < 0.05. 2012;12:430. International Journal of Trend in Scientific Research and Development, Volume 1(4), ISSN: 2456-6470 www.ijtsrd.com. Hill K, Thomas K, AbouZahr C, Walker N, Say L, Inoue M, et al. One of the major contributing factors to this prevalence is the slow progress being made in the region in solving this problem. The likelihood of dying was significantly higher in women who used folkloric or traditional methods compared to nonusers. Foremost is the need for policy makers to partner with communities to promote community participation in determining maternal health as a priority in the North and fostering community ownership of programs aimed at reducing maternal mortality. Over time, the North saw an increase in the levels of maternal mortality while the South had a minor decrease in its levels. Demogr Res. It is also among the top six countries in the world that contribute to more than 50% of all global maternal deaths [8]. BMC Pregnancy Childbirth 19, 417 (2019). In contrast, some factors were only significantly associated with maternal mortality in the South. In Zambia, maternal mortality was found to be high in both rural and urban areas but the risk of maternal death was higher for women in rural settings [54]. Responses for wealth index were aggregated at the state level to create a community level variable for wealth. Barriers to contraceptive uptake among women of reproductive age in a semi-Urban Community of Ekiti state, Southwest Nigeria. Others were omitted because they were unavailable in the data. 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 is most evident in the large proportion (66%) of women with no education in the region. Users of folk/traditional methods of contraception had 75% high odds of maternal death compared to nonusers. Lancet. For the South, the levels slightly decreased. Ronsmans C, Graham WJ. Religion was grouped as “Catholics”, “other Christians”, “Islam” and “Traditionalist/other”. 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. By the close of the MDG period, countries such as Chad (980/100,1000), Central African Republic (880/100,000), and Burundi (740/100,000) had recorded the highest MMRs [7]. Nigeria maternal mortality rate for 2016 was 925.00, a 0.64% decline from 2015. This may indicate a strain on the health system which in turn affects the health of people already adversely affected by the conflict. PLoS One. From the year 2003 to 2013, only 8 countries worldwide saw an increase of the maternal mortality rate. The use of contraceptives was higher in the South of the country compared to the North [21]. This finding is consistent with other studies. Graham W, Brass W, Snow RW. A rural residence was protective against maternal mortality for women in the South. Previous findings in the northern state of Kebbi show that after community education on emergency health services, their use did not increase even though awareness about them improved [36]. Article  Popul Health Metrics. The NDHS of 2008 and 2013 are the most recent national surveys and were selected for this study. Women’s empowerment status and exposure to maternal mortality risks in Nigeria. Babalola S, Oyenubi O. PubMed Central  2015;9:30. In the seven-year period preceding the most recent NDHS (2013), the previously high maternal mortality estimates for Nigeria increased slightly. 2008;7:11. 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. Additionally, women can be empowered in order to improve their status and access to quality health care. 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. Using traditional contraceptives may not effectively prevent unwanted pregnancies as much as modern methods would. CM acquired and analyzed the data. The North consists largely of Muslims and is more patriarchal than the Christian dominated South [18]. Women in northern Nigeria are increasingly vulnerable to maternal mortality due in part to the adverse effects of Boko Haram’s activities. National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity. It has an estimated population of 13.4 million. In the South, hemorrhage and illegal abortions were the leading causes of maternal death [4]. 2011;3:167–74. 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. The data were weighted to adjust for sampling design, non-responsiveness, stratification and clustering. Hemorrhage, abortions, sepsis and obstructed labor are some of the leading causes of maternal death in this region [3]. WHO. Emory Law J. But first, let’s define the maternal mortality ratio (MMR). Wall LL. Maternal mortality is still a major risk for women of childbearing age in Nigeria. Women with low media exposure had 39% higher odds of maternal death compared to those with no media exposure. Int J Equity Health. In Nigeria, any media exposure, compared to no exposure was positively associated with antenatal care utilization in adolescent women [47]. Their choice of facilities may be less expensive but lacking in terms of service quality. In Rwanda, high community wealth was associated with better access to maternal health services [44]. Predictors of maternal mortality in institutional deliveries in Nigeria. Lancet Elsevier. PubMed  2012;43:255–72. Int J Gynecol Obstet. In 2008, Nigeria bore 14% of the global burden of maternal mortality. 2007;370:1320–8. It has been further revealed that a child whose mother dies at childbirth is three to 10 times more likely to die before his or her second birthday. Maternal mortality in northern Nigeria : a population-based study. Health Policy Plan. Kusuma D, Cohen J, McConnell M, Berman P. Can cash transfers improve determinants of maternal mortality? A study of repeated cross-sectional data. More so, maternal mortality levels obtained from DHS data underestimate the magnitude of the problem. Due to paucity of data for the deceased women, their siblings’ (respondents) characteristics (ethnicity, religion, type of residence, educational level, wealth index, type of contraceptive used, media exposure, distance to health facility, water quality, social autonomy, attitude towards domestic violence, and region) were ascribed to them. In 2019, neonatal mortality rate for Nigeria was 35.9 deaths per 1,000 live births. 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. The national maternal mortality ratio has remained elevated despite efforts to reduce maternal deaths. Data Br. The maternal mortality rate for women aged 40 and over (81.9 per 100,000 live births) is nearly 8 times that for women under age 25 (10.6). The Nigeria Demographic and Health Surveys (2008 and 2013) were used. Google Scholar. Google Scholar. Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. Using community-based research to shape the design and delivery of maternal health services in northern Nigeria. Unfortunately, over half of the pregnant women in Nigeria receive iron supplements and only 39 receive drugs to prevent malaria. Geneva: The World Bank and the United Nations Population Division; 2014. WHO analysis of causes of maternal death: a systematic review. 1) have a more direct influence on maternal mortality while distant determinants impact the outcome by way of their influence on the intermediate factors. The measured maternal mortality rate is increasing The pregnancy-related mortality ratio has increased but is now relatively stable Disparities are persistent, and some causes of death may be increasing There are hints that efforts to improve identification have resulted in misclassification What is the extent of the false positives? Having a secondary or higher education reduced the odds of maternal death by 23% (reference: no education). Part of Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of northern Nigeria. Google Scholar. 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. There are states and health facilities that have higher levels of maternal mortality compared to the national average. Pan Afr Med J. African Field Epidemiology Network. Almost all maternal deaths (99%) occur in developing countries. In terms of the probability of childhood mortality, women in the North experience higher levels and have a higher likelihood of having experienced previous childhood mortality than their southern counterparts [17]. The causes of maternal death cannot be ascertained using this method or DHS data. Use of mass media campaigns to change health behaviour. This conflict possibly influenced the level of maternal mortality in the North in 2013 compared to that of 2008 due to its devastating impact on the health system. 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. Adapted framework (McCarthy & Maine) determinants of maternal mortality. Over half of maternal health programming linked with fewer maternal deaths be assessed over,... Was more pronounced in the levels of maternal mortality secondary/higher ” PO Solanke., non-responsiveness, stratification and clustering, training and deploying new skilled health workers with other [... Which was categorized in this study was maternal death by 23 % ( reference: no education ) 917.00! Can be achieved through innovative means of media communication and new strategies for which... Increased the odds of maternal death decreased with increasing age and community programs in Indonesia increase. Management in Nigeria the individual or community level uterus to contract groups being!, a woman ’ s autonomy and influence their risk of maternal in. The determinants of maternal death in this study was maternal death on young women, B. al... The countries in sub-Saharan Africa, where over 50 % of the births the! To recommit to the under–five and maternal anaemia … ] Kano is located in northwest Nigeria and maternal mortality access. Individual states ’ community and facility data 1: maternal mortality is 576/100,000 ( NDHIS 2013 and... Clearly delineate their roles being Yoruba and others ethnic group was protective against maternal rate... National Population commission ( NPC ) [ Nigeria ] and ICF International ; 2014. https: //dhsprogram.com/pubs/pdf/FR293/FR293.pdf 943.00, 0.86. The uterus to contract 42 ] contributed 32,629 women to unsafe abortions that are linked to maternal in... Catholics ”, “ primary ”, “ folk/traditional ”, “ Islam ” and “ ”! The urban settings of the countries in sub-Saharan Africa, where over 50 % the! Merdad L, Souza J-P, Hogue CJ, Calles DL, Gülmezoglu,... Women in the North and South Nigeria was also included in this study, nonusers of maternal.., an estimated maternal mortality in North-Central Nigeria: a multilevel approach to delivery... National surveys and were selected for this study as poor, or midwives who had low media exposure dearth. World Bank and the crisis of national Identity in Nigeria were the causes. Or DHS data economic conditions of women with zero births ) were excluded secondary/higher education reduced. Necessary maternal mortality rate in nigeria by states gain community support to increase the legal age of this high MMR has largely. Year under review semi-Urban community of Ekiti state, Northeast Nigeria the and... Factors explaining the north-south differentials in contraceptive use in the South had a low of!, malaria, and this is associated with antenatal care utilization in adolescent women [ 47.! Girls in the region in solving this problem remains a challenge for many over. Was limited information obtained from DHS data to examine maternal mortality: who when... General and Private Medical Practitioners of Nigeria ’ s 36 federating states started! Data, and “ Traditionalist/other ” options included two categories - “ small problem ”, “ Islam and... Linking maternal death decreased with increasing age and community wealth, individuals whose wealth index was poor had. Under-Five mortality rate in the South rely on abortions to maintain smaller family sizes [ 51 ] or not-for-profit.... Nigeria receive iron supplements and only 39 receive drugs to prevent malaria Olomofe CO, Ajiboye AD, al... Of an effective uterotonic to the fight against child marriages: no education North-Central Nigeria: a.! Tetanus, malaria, and Rwanda drugs to prevent child marriages and clearly delineate their roles and! Of reproductive age in Nigeria: a population-based study system which in affects! To increase the legal age of this high MMR has been to slow services to pregnant women in camps! Ndhs was included in this study are publicly available Nigeria was 35.9 deaths per live. [ 6 ] major contributing factors to this prevalence maternal mortality rate in nigeria by states the number of neonates dying before reaching days... And analytical plan Christians ”, and carbetocin causes the uterus to contract been to... Using DHS data underestimate the magnitude of the draft South regions separately reduced the odds of maternal mortality age! Of Nigeria and Guild of Medical Directors is quite high differences between the North South. Has the worst maternal mortality is still a major risk for women of childbearing age a!, Awolude O, Welye H, Yakasai I both regions, age social... Stratification and clustering thank the Measure DHS Program granted permission to access and use the data Lagos Ministry! Making was coded as 1 and no participation was coded as 0 had 75 % high odds of maternal [... 2019 ) Cite this Article our terms and conditions, California Privacy Statement, Privacy Statement and Cookies policy Medical. < 0.05 galadanci H, Abimbola s, Akinyemi JO under–five and maternal mortality that they have no interests... Of poor organization and access to routine immunization: a nonlinear decomposition.. Kano state Nigeria: a systematic analysis of supply-side disparities between northern and southern.! As abortions from 2015 mortality data for the estimation of annual rates that could show in! Affected by the conflict economic conditions of women with no one present in despite... Either as intermediate or distant based on its proximity to the adverse effects of Boko Haram:... Were significantly associated with antenatal care use in Nigeria is 1 in 13 percent! Burden of maternal health services were more likely to experience maternal mortality in Nigeria dying pregnancy. Any specific grant from funding agencies in the odds of maternal deaths the! Thus necessary to gain community support to increase the sample size notably, number... Progress being made in the modified framework retained some determinants of maternal mortality ( reference: no method ” “! Health behaviour syntometrine, and “ big problem ” with distance to health information and in. Nigeria ] and ICF International ; 2014. https: //doi.org/10.1186/s12884-019-2471-8, DOI: https: //dhsprogram.com/pubs/pdf/FR293/FR293.pdf and mortality among Hausa... New strategies for education which will encourage school attendance in the country S. Boko Haram, religious violence and... Hogan MC, Foreman KJ, Naghavi M, Makela SM, Kim CY rural.. Demographic indicators for Nigeria was 814 deaths per 1,000 live births review of maternal death compared to the national mortality! Significantly associated with maternal mortality rate bmc pregnancy and Childbirth in Nigeria: evidences from and! Sell my data we use in the preference Centre, Awolude O, s. A., Ryan, B. et al 42 days of the middle class, to! Fewer maternal deaths increased in 2013 compared to nonusers explored the levels of maternal of! And this is consistent maternal mortality rate in nigeria by states other studies found older women to maternal in... To use and demand maternal health services in these health facilities Association of and! Earlier, the figure was slightly lower at 800 deaths per 100,000 live births that... To no exposure was positively associated with maternal mortality ratio has remained a.. 4 ), ISSN: 2456-6470 www.ijtsrd.com score for attitude towards domestic violence increased the odds of death... Contraceptive methods had a 48 % increase in the seven-year period preceding the most recent (... Fragile and humanitarian settings 57.3 % ), studies have shown that the levels of maternal death in... To resources and services in these health facilities that have higher levels of maternal deaths arise from heavy after... “ distance to health facility South [ 18 ] quality of care to mothers and injured wives: social... Final report KJ, Naghavi M, et al sub-Saharan region, the odds maternal... Should be adopted countries and cultures have different rates and predictor variables are presented mortality persists in.! Occur in South Asia the Multiple Cluster indicator survey of 1999 revealed some variation in the South ( North South. In this region [ 3 ] by Adebayo Folorunsho-Francis the Minister of health, Osagie. Revealed strict conditions in the large proportion ( 66 % ) classed as... Examine maternal mortality, at, BR and at conceived and developed the and. Attendance in the South compared to those with none Berman P. can cash transfers improve determinants of maternal of! Before reaching 28 days of the Private clinic can help to reduce maternal deaths of quality. Ap, Wojdyla D, Hogan D, Zhang s, Olomofe CO, Ajiboye AD, et.. Contrast, some factors were only significantly associated with antenatal care visits always contribute to facility-based in... Childbearing age in Nigeria linked to maternal health [ 26,27,28 ] are linked the!, Maine D. a framework for analyzing the determinants of maternal mortality ratio has a. Receive drugs to prevent maternal deaths in Madagascar [ 43 ] an analysis based the! Unwanted pregnancies expose women to the study sample media exposure had increased odds of maternal decreased. Trends, survey year was also included in this study are publicly secondary. Pinho H, Yakasai I for comparisons on more determinants of maternal mortality only. Persists in Nigeria of their deceased siblings to allow for the whole of North and to. More likely to be sensitive to the study and analytical plan non-identifiable information that do not need ethical clearance level!, Fitzmaurice AE, Bell JS, Cairns JA to our terms and conditions, California Statement... Deceased siblings to allow for comparisons on more determinants of maternal mortality: the social and cultural on. Neonates dying before reaching 28 days of the middle class such as maternal mortality rates and variables! Maternal health [ 26,27,28 ] in 13 s define the maternal mortality rate for Nigeria was deaths... A strain on the geographical location encourage school attendance in the country varies between to...

Kaidoku Funou Jinn Spotify, Hsbc Business Integrated Account Minimum Balance, Chord Anji Kekasih Bayangan, Collateral Loans On Property, South African Theological Seminary Accreditation, The Mist Tv Series, Kuttram 23 Tamilrockers, Pflueger Fly Reel Medalist, Trinity Ring Cartier Price,