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Determinants Of Maternal Mortality In General Hospital
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Several attempts have been made in the past aimed at reducing maternal
mortality in Nigeria, such attempts, especially by the Federal and state
governments, have generally not proved very successful in achieving the
desired results. Some promising results however have recently begun to
be recorded through some policy initiatives by a few state governments.
In Cross River state, the state house of assembly approved a bill in
2007, guaranteeing free maternal health services to pregnant women
(Shiffman and Okonofua, 2007). The state commissioner of health, who is
an obstetrician and gynaecologist, played a central role in its
development and adoption.
The introduction of the safe motherhood
programme in 1995,midwife service scheme (MSS) in (2011) and subsidy
reinvestment program (SURE-P) IN 2012 introduced a range of
interventions which included antenatal care, labour and delivery care,
postnatal care, family planning, prevention and management of unsafe
abortions, and health education but still MMR has not been encouraging
over the years and improvements are so slow.
The former state
commissioner of health together with some senior obstetrician and
gynaecologist, played central roles in creating this positive
environment for maternal health. Hence , today pregnant women in Cross
River now assess free medical services in General hospital, Calabar as
part of measures put in place by the state government to reduce maternal
mortality rate in the state (Media Global,2010). However, other states
like Jigawa, as part of measure in checking maternal mortality, have
provided funds for the upgrading of obstetric care facilities in
hospitals, the recruitment of obstetricians and gynaecologists and the
provision of ambulances at the local level to transport pregnant women
experiencing delivery complications to health facilities. The former
executive secretary for primary health care, who subsequently became
state commissioner for health, stood behind these initiatives.
1.2 Statement of the Problem
Maternal
mortality is the most important indicator of maternal health and well
being in any country (Herfon, 2006). Maternal mortality is a tragedy,
many children are rendered motherless, such children are deprived of
maternal care which goes a long way to affect adversely both their
physiological and psychological development. The majority of these
pitiable situations are due to maternal mortality.
From recent
estimates, the number of deaths each year from maternal causes
worldwide decreased from 536,000 in 2005 to an estimated 358,000 in 2008
and 273,500 in 2011. For every woman that dies, approximately 20 more
suffer injuries, infection and disabilities in pregnancy or childbirth
(IHME, 2012; UNICEF 2008; WHO, 2007). The situation is even more
alarming in Nigeria. For example, in the year 2000, the maternal
mortality ratio per 100,000 live births was 800 compared to 540 for
Ghana and 240 for South Africa.
Consequently, the chance of a
Nigerian woman dying from reproductive health disorders and
complications was put at 1 in 10 in 2002 (Population Reference Bureau,
2002), 1 in 18 in 2005, and 1 in 23 in 2008, placing the Nigerian woman
at far greater risk than her counterpart in the developed world, where
the risk is estimated to be 1 in 17,800 and 1 in 10000 in countries such
as the Republic of Ireland and Singapore respectively (World Bank,
2011; UNICEF, 2010; Media Global, 2010; UNICEF, 2008; UNFPA, 2005). Some
of the implications of these estimates are the depletion of the
country‟s workforce and the overall stifling of rapid development.
This
study focuses on determinants of maternal mortality in General hospital
Calabar, Cross River State. The researcher was motivated to carry out
this study based observation and experience while on clinical posting
towards the rate at which pregnant women die during childbirth as a
result of post partum hemorrhage or eclampsia. The poser is what are the
causes of women death?: thus this question can only be answered when
this study is concluded.
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