Users of folk/traditional methods of contraception had 75% high odds of maternal death compared to nonusers. Afr Health Sci. The odds of maternal mortality decreased with increasing age, placing the greatest odds of maternal death on young women. 2010;375:1609–23. For Nigeria to drastically reduce the rate of maternal mortality, there is a need for more people (male and female) to adopt the family planning strategy Group says maternal mortality … Cite this article. The response options included two categories - “small problem”, and “big problem” with distance to health facility. WHO. 2011;11:606. Mortality from CVD, Cancer, Diabetes Or CRD Between Exact Ages 30 and 70 The study participants could either be respondents (living women) or deceased women (respondents’ siblings) who were cases of maternal mortality that were identified through the direct sisterhood method. Evidence from other studies show varying associations between age and maternal mortality. Int J Women's Health. Postpartum hemorrhage is severe bleeding experienced by women following the birth of a baby. The figures for the Country varies between 800 to 1,000 live births based on the geographical location. Most of the recorded maternal deaths (75.4%) were from this region which is also reflected in the MMR of the region (Fig. Difficulty accessing healthcare services was assessed with the variable “distance to health facility”. Glob Heal Commun. The incidence of abortion in Nigeria. The use of contraceptives was higher in the South of the country compared to the North [21]. Stata Corp. Stata Statistical Software: Release 13. 2012;12:430. Rural-urban differentials in pregnancy-related mortality in Zambia: estimates using data collected in a census. The Nigeria Demographic and Health Surveys (2008 and 2013) were used. Stud Fam Plan. A low level of media exposure increased the odds of maternal mortality by 52% compared to women with no media exposure. In the South, it has slightly decreased and is associated with contraceptive method used, type of residence and wealth. Estimates by WHO, UNICEF, UNFPA. 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. Source Reprod Heal Matters. 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. Though education and economic advancement for women and young girls are central to the improvement of maternal health in the country, the importance of region specific factors on the occurrence of maternal mortality require interventions that explicitly target their influence in the respective regions. This problem remains a challenge for many countries that still struggle to prevent it. Maternal Mortality Rate in Nigeria: Past & Present Figures, Weight Loss: How to Lose Weight Using Dumbbells, Common Yoruba Herbs, their English Name & Uses. McDermott R, Cowden J. Polygyny and violence against women. Banda R, Fylkesnes K, Sandøy IF. For instance, some northern states like Kano in 2008 had an MMR of 1600 deaths per 100,000 livebirths [11] while 1049 deaths per 100,000 livebirths were reported in Zamfara state [12]. 2011;3:167–74. PLoS One. This finding is consistent with other studies. In Rwanda, high community wealth was associated with better access to maternal health services [44]. A total of 18,863 women were from the South with 24% of the reported maternal deaths (Fig. PLoS One. Meanwhile, they should also coordinate and properly structure interventions to prevent child marriages. Choe SA, Kim J, Kim S, Park Y, Kullaya SM, Kim CY. All authors read and approved the final version of the manuscript. The population of interest in these surveys are men and women between the ages of 15 to 49 years. Intermediate determinants (Fig. Evidence from the household and community programs in Indonesia. © 2021 BioMed Central Ltd unless otherwise stated. We would like to thank the Measure DHS Program for making the data used for this study publicly available. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards millennium development goal 5. International Journal of Trend in Scientific Research and Development, Volume 1(4), ISSN: 2456-6470 www.ijtsrd.com. The meeting was organised to discuss the implementation of the […] The sum of these individual measures (range: 0–4) were the response options for the composite variable where a score of 0 meant a negative attitude towards domestic violence while, a score of 4 was approval of violence for all the measures. Agbiboa DE, Maiangwa B. Boko haram, religious violence, and the crisis of National Identity in Nigeria: towards a non-killing approach. Hence, the government needs to call all stakeholders to recommit to the fight against child marriages and clearly delineate their roles. Kusuma D, Cohen J, McConnell M, Berman P. Can cash transfers improve determinants of maternal mortality? California Privacy Statement, J Biosoc Sci. In the North, early marriages expose young girls to early childbearing and pregnancies that are prone to complications and may lead to maternal death. For the South, the levels slightly decreased. Durowade KA, Omokanye LO, Elegbede OE, Adetokunbo S, Olomofe CO, Ajiboye AD, et al. 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. 2004;363(9402):23–7. The 2015 figure indicates that Nigeria recorded 58,000 women in that year. The NDHS of 2008 and 2013 are the most recent national surveys and were selected for this study. 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]. This incorporates the roles of socioeconomic, cultural, behavioral and biological factors on maternal mortality, thereby making it the most inclusive framework for assessing determinants of maternal mortality. Lancet (London, England). This is most evident in the large proportion (66%) of women with no education in the region. PubMed  BMC Pregnancy Childbirth. This method identifies deceased siblings through select questions asked of the respondents and is widely used by the Demographic and Health Survey Program [30] and maternal health studies [31, 32] to obtain periodic estimates of maternal mortality. Age at death (NDHS 2008 and 2013) and parity (NDHS 2013) were recorded for the deceased women. This study thereby ascribed respondent characteristics to the deceased siblings to allow for comparisons on more determinants of maternal mortality. Higher community income was linked with fewer maternal deaths in Madagascar [43]. Respondents’ stated ethnicities were categorized into major ethnic groups of each region (North and South). These were scored (0–9) and categorized as no exposure (0), low exposure (1–3), medium exposure (4–6) and high exposure (7–9). Even though Nigeria ratified the convention on the rights of the child, the problem has persisted in the region. Part of Each determinant of maternal mortality in the modified framework is classed either as intermediate or distant based on its proximity to the outcome. Demogr Res. Women in the North are less likely to give birth at health facilities [20] and many in some northern states, live far from health centers which are plagued by severe shortages of health workers [18] compared to the South of Nigeria. It is also among the top six countries in the world that contribute to more than 50% of all global maternal deaths [8]. Geneva: Estimates developed by WHO, UNICEF, UNFPA and World Bank; 2010. CM, AT, BR and AT contributed to the interpretation of data, and revision of the draft. Eur J Obstet Gynecol Reprod Biol. Other studies found older women to have the greatest risk of maternal death [41, 42]. This status was assigned to a deceased woman if a respondent indicated “yes” to whether her female sibling died while pregnant, during child birth, or within 2 months of delivery. 2016;387:462–74. There was limited information obtained from the survey respondents about deceased siblings in the 2008 and 2013 NDHS. 2012;12:32–40. Programs and policies for reducing maternal mortality in Kano state Nigeria: a review. Terms and Conditions, Child marriage, which is commonplace in the North, promotes early childbearing, exposes young women to birth complications due to the immature nature of their bodies and prevents the education of girls. There were variations in the levels of maternal mortality between the two regions. 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. Gend Behav. The national maternal mortality ratio has remained elevated despite efforts to reduce maternal deaths. 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]. The principal inhabitants of the state are the Hausa/Fulani people. J Dev Soc. There are states and health facilities that have higher levels of maternal mortality compared to the national average. These may explain the problem of maternal mortality in the urban settings of the South compared to rural ones. Stephenson R, Elfstrom KM. 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. 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. Water source was classified as improved or unimproved depending on whether there was a natural construction or a deliberate intervention to protect it from outside contamination. 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. It is also a widely used framework in studies about factors that affect maternal health [26,27,28]. Omole O, Welye H, Abimbola S. Boko Haram insurgency: Implications for public health. 1998;29:341–59. The findings of this study show that maternal mortality remains a problem in Nigeria and reveal its levels and determinants in the North and South. Unfortunately, over half of the pregnant women in Nigeria receive iron supplements and only 39 receive drugs to prevent malaria. An increase in the score for attitude towards domestic violence increased the odds of maternal death by 10%. Google Scholar. Bankole A, Adewole IF, Hussain R, Awolude O, Singh S, Akinyemi JO. There may also be other health risks in women of the middle class such as abortions. Dove Press. This study focused on women who had been pregnant and had given birth to at least one child in Nigeria. 2015;385:941. Nigeria maternal mortality rate for 2017 was 917.00, a 0.86% decline from 2016. To control for secular trends, survey year was also included in this study with 2008 and 2013 as the response categories. 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. 2014;17:2. Over half a million annual maternal deaths propelled maternal mortality onto the international stage, where it became a global priority and the chosen outcome to assess progress on maternal health [1]. The risk of maternal death was found to be greatest for teenage mothers and women close to the end of their childbearing years [4]. 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. With over 80% of women with little or no media exposure in the North, this means that information about the benefits of education and health information do not reach most who stand to benefit from them. This means the country has a lifetime risk of maternal death of 4.62 percent. And in 2015, mortality ratio for Nigeria was 814 deaths per 100,000 live births. 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. 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. PubMed  Maternal mortality ratio (national estimate, per 100,000 live births) Mortality rate attributed to household and ambient air pollution, age-standardized, male (per 100,000 male population) Prevalence of stunting, height for age, male (% of children under 5) Factors contributing to maternal mortality in North-Central Nigeria: A seventeen-year review. ... report summarizes the current state of maternal health in Nigeria. Elsevier. Reports show that non-indigenous health workers fled from conflict zones to safer states while insurgents destroyed and removed medical supplies from health facilities [39]. Factors explaining the north-south differentials in contraceptive use in Nigeria: a nonlinear decomposition analysis. These two cycles allow for the regional levels of maternal mortality to be assessed over time. Yet, there is a dearth of literature on the estimates and determinants of maternal mortality for the whole of North and South Nigeria. Survival probability and predictors for woman experience childhood death in Nigeria: analysis of north-south differentials. Health service resilience in Yobe state, Nigeria in the context of the Boko haram insurgency: a systems dynamics analysis using group model building. Among the southern ethnic groups, being Yoruba and others ethnic group was protective against maternal mortality (reference: Ekoi/Ibibio). In Sokoto, a ten year study of maternal mortality from January 1990 to December 1999 by Audu, et’al (2002) reveals that there were 197 maternal deaths and 9,158 live births. Nigeria maternal mortality rate for 2016 was 925.00, a 0.64% decline from 2015. 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. 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. Merdad L, Hill K, Graham W. Improving the measurement of maternal mortality: the sisterhood method revisited. 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? The majority of women (83.4%) had no or low media exposure, no education (66.1%) and were Muslim (75.4%). Some of the prevailing factors leading to poor accessibility to healthcare are lack of funds for treatment and distance to health facility. He disclosed this in Abuja during a meeting with the Association of General and Private Medical Practitioners of Nigeria and Guild of Medical Directors. Wall LL. In 2008, Nigeria bore 14% of the global burden of maternal mortality. Maternal mortality was more pronounced in the North and increased in 2013 compared to 2008. Overall, policy makers should seek to increase maternal age and alleviate poverty by improving the economic conditions of women in the country. This was unlike other studies that show an increased risk of maternal mortality for women living in rural areas compared to those in urban settings [4]. This is especially needed in the North where interventions (material, staffing and educational activities) have been applied to the health system [11, 18, 36] yet, the MMR for the region remains high and has slightly increased over time. Article  In the South, contraceptive method used, type of residence, and wealth index were significantly associated with maternal mortality. 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]. Maternal mortality is a key indicator of population health and social economic development. 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