FEATURES X-raying the disturbing rate of maternal mortality
Nigeria has a high Maternal Mortality Rate (MMR) of 814 deaths to 100,000 Live Births (LB), and this is considerably higher than the statistics for many other countries
When his wife started experiencing labour pains, anxiety took hold of Mr Lateef Basheer. Although he was remotely happy that his new set of twins were about to be born, Lateef was as nervous as any expecting fathers would be in that situation.
As his wife’s labour pains increased, Basheer quickly packed the bag and rushed her to a private hospital. The twins were eventually delivered through Caesarean Section (CS). The pains experienced by the new mother vanished immediately she set her eyes on her twins. Also, Basheer and other family members were very happy and excited. However, their joy began to diminish few days later, as the mother of the twins developed post delivery complications.
According to Basheer, “the twins were through the Caesarean section and they were in good condition. Few days after, there were problems with the mother but the doctor at the private hospital assured us that my wife would be okay. It was when the situation became worse that the doctor referred her to Our Lady of Fatimah Catholic Hospital at Jolayemi area in Osogbo. When we got there, the doctors read the referral letter and asked us to take her to Ladoke Akintola University of Technology Teaching Hospital, (LAUTECH). When we got to LAUTECH, they told us that just two of the hospital’s life support machines were functional, and the two were already being used for some patients.”
“From LAUTECH, they asked us to take her to Wesley Guild Hospital in Ilesa. When we got there, the doctors at Wesley Guild Hospital asked us to take her to the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife. When we got there, they also asked us to take her to the Seventh Day Adventist Hospital, Ile-Ife. At the Seventh Day Adventist, Hospital, Ife, they admitted her just to stabilise her before she would be taken to the University College Hospital, Ibadan the following morning, but she died around 6am. It was a very sad and horrible experience for me, as I’m left to take care of the twins without her”.
This was just one of several cases of avoidable maternal deaths occurring in Nigeria on a daily basis. According to an American based Nigerian born Consultant of Family Medicine and Obstetrics, Dr. Omoniyi Yakubu Adebisi, Nigeria has a very high Maternal Mortality Rate (MMR) with 814 deaths per 100,000 Live Births (LB) in Nigeria when compared with other countries, like Norway, which has 5 deaths per 100,000 Live Births; Canada with 7 deaths per 100,000 Live Births; USA with 14 deaths per 100,000 Live Births. “Even the Maternal Mortality Rate in Ghana 319 per 100,00 LB); Republic of Benin is 405 MMR per 100,000 LB and many war torn countries like Liberia has 725 per 100,000 LB); Libya is 9 per 100,000 LB; Afghanistan has 398 per 100,000 LB; Botswana has 129 per 100,000 LB and many others fare much better than Nigeria”, Adebisi stated. He said the data was derived from the 2015World Factbook of the United States of America’s Central Intelligence Agency and the 2015 data of the World Health Organization.
However, in an attempt to curb the problem of the unacceptably high maternal mortality in the country, Adebisi embarked on a medical mission under the auspices of Save Nigerian Mothers Initiatives (SANMINIT). He told Daily Trust that the initiative was a free medical mission, targeted at reducing the rate of maternal and perinatal mortality rate in Nigeria. SANMINT has performed many free Caesarean Sections, non-surgical and assisted vaginal deliveries for many pregnant women at Asubiaro State Specialist Hospital in Osogbo, and other neighbouring towns.
He said SANMINIT is a nongovernmental organization and that it is collaborating with the Ladoke Akintola University Teaching Hospital, Osogbo and other entities and groups in Nigeria, as permitted by the Advanced Life Support in Obstetrics (ALSO) Committees of the Faculty of Family Medicine of the National Postgraduate Medical College of Nigeria and the American Academy of Family Physicians (AAFP). According to him, “Save Nigerian Mothers Initiatives (SANMINIT) is a USA registered non-government organization, that is embarking on various strategies to reduce maternal and neonatal morbidity and mortality in Nigeria.”
“We identified improvement of competence of maternity healthcare providers through capacity building training, as a very necessary factor to ensure that we provide maternity healthcare in a safer and timely manner in Nigeria.” Dr. Adebisi explained.
Adebisi further said “We are liaising with the relevant authorities, stakeholders, professional groups; community leaders to facilitate legislation and enforcement of relevant laws that would ensure safety of maternity and perinatal healthcare in Nigeria. He explained that one of the main reasons why maternal mortality rates in countries like the USA and Canada were significantly lower than in Nigeria, was that those countries have strict policies and laws that ensured that anyone that would practice maternity healthcare service must have not only minimum qualification, but must equally update his or her knowledge in Obstetrics regularly, to ensure that he or she is up to date in modern knowledge in Obstetrics. For us to achieve significant reduction in maternal mortality rate in Nigeria, we must put in place and enforce policies and laws that guarantee safe motherhood in Nigeria.”
He advised that the legislators and policy makers of Nigeria could borrow a leaf from the Faculty of Family Medicine of the National Postgraduate Medical College of Nigeria (NPMCN) that mandated that every resident of that faculty must have certification in Advanced Life Support in Obstetrics, a course that has been proved across the globe to significantly improve competence of maternity healthcare providers. He explained that from his understanding, the decision of the Faculty of Family Medicine of the NPMCN to mandate her residents to be certified in Advanced Life Support in Obstetrics (ALSO) course was made to ensure that every resident of the Family Medicine Residency program in Nigeria, had every knowledge required to competently manage pregnant women safely and in a timely manner. He advised that if the same policy can be adopted across the board for all maternity healthcare providers in Nigeria, there will be significant reduction in preventable maternal and perinatal deaths in Nigeria.
Adebisi said the group is also educating the masses on the need to patronize only qualified maternity healthcare providers for prenatal, maternity and or perinatal healthcare, and also sensitizing people about citizens’ rights to legal remedies if mismanaged during maternity healthcare.
“SANMINIT has the permission of the American Academy of Family Physicians (AAFP) and that of the Faculty of Family Medicine (FFM) of the National Postgraduate Medical College of Nigeria (NPMCN) to organize Advanced Life Support in Obstetrics (ALSO) and the Basic Life Support in Obstetrics (BLSO) in Nigeria with primary objective to reduce maternal and perinatal morbidity and mortality.” He explained.
He concluded that Mrs. Basheer would have been saved from preventable death if her postoperative complication had been recognized and adequately managed in a timely manner, before it was too late. He also observed that if the woman had been transferred by a dedicated ambulance to the higher level of care without the avoidable delays in the referral system that she had to pass through, the chances are high that she would have been saved from the preventable death. He explained that many Nigerian mothers are victims of these various preventable delays and mismanagement in Nigeria, and that SANMINIT is willing to liaise with all policy makers and stakeholders to address these problems.