By Foluso Ajani, Maternal and Reproductive Health Advocate
It is no longer news that Africa carries the highest maternal mortality rate in the world and the hope of fulfilling the MDG 5 by 2015 is by far out of reach albeit with slow progress. 50% of maternal mortality globally are said to be in Africa .Nigeria, herself, contributes 10% of these global estimates. In Parts of Africa, mortality rates are 1 in 16. Most deaths are still underreported because they occur outside facilities and are not counted.
The statistics are staggering, to state the obvious, but let’s soft-pedal on the statistics and go beyond the overwhelming figures which more often than not have become a rhetoric, not successfully passing the in-depth message across. What we fail to acknowledge is the chain of distress and an intricate web of dire circumstances beyond these figures. The orphaned children, the widowed husband, the bereaved family, the agonised community, the burdened nation, lost hopes, pain and then, more pain. The death of a single woman creates a wave of grief that reverberates millions of miles affecting everyone in its path.
Beyond the Rhetoric of figures
What makes it more sinister is that most of these deaths are preventable and the journey to recovery lies not in a hurried approach but in a gradual process that addresses the problem from its foundation.
From birth, the girl child is vulnerable to a lot of vices, from female genital mutilation and sexual abuse to early marriage. As she grows, with little or no knowledge of sex education, unaware of ad/or with limited access to contraceptives, exposure to STDs, unwanted pregnancies and unsafe abortions, the pitfalls seem endless.
In marriage, lack of empowerment and low social status limits her decision making ability. In pregnancy, antenatal care is abandoned either from ignorance or poverty coupled with the lack of appreciation of the importance and benefits and with that goes the opportunity of identifying high risk pregnancies, jeopardizing chances of a successful pregnancy and delivery. To make matters worse, some of those who attend antenatal clinic still go on to deliver at home with traditional birth attendants or in religious houses! This is deeply confounding!
At delivery, there is either delay in seeking care due to ignorance or cultural factors and even when the decision is made, there is delay in reaching the health facility either due to the long distance, lack of transportation or affordability and then. At the health facility, there are either inadequate or unskilled personnel, lack of equipments or worse still, poor staff motivation!
In most rural areas, ignorance and superstitious beliefs are the order of the day. Hospitals are usually non-existent. When they exist, they are often ill equipped with no back up emergency obstetrics care. Given the numerous traditional and unskilled birth attendants available in these areas, the rest of the story is well imagined.
Lack of access to information about family planning and modern contraceptives and lack of access to safe, effective, affordable and acceptable methods of family planning also affect the decision on the number and spacing of children by women.
The Way Out of the Maternal Quagmire
What needs to be done is not far-fetched. Cultural beliefs that militate against maternal and reproductive health can be dispelled with proper education. Sexual and Reproductive health education would reduce ignorance and help make informed, life saving reproductive choices. Health care delivery needs to be improved upon and access made easier. Our policy on women’s health needs to be reviewed and available resources judiciously used and not misappropriated on the altar of bad governance and corruption.
We have the financial resources and the technical know-how to reduce these deaths. The political will of states must be stimulated. Each individual must contribute his/her own quota by advocating for our women and children. It is time to end this gross inequality and save more women and children from untimely and preventable deaths.
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