Nigeria will not meet MDG targets on maternal, child health, says report

DESPITE the recent successes recorded by the country in reducing maternal and child deaths, she will not be able to achieve the Millennium Development Goals (MDG) targets on maternal and child health.

According to a report on global maternal and child mortality released at the just concluded United Nations Summit on Non-Communicable Diseases (NCDs) and published in The Lancet medical journal by Lozano and colleagues, no country in sub-Saharan Africa is expected to achieve MDG 4 to reduce the under-five mortality rate by two-thirds between 1990 and 2015 and the target for MDG 5 to reduce the maternal mortality ratio by three-quarters during the same period.

“Even though progress on reducing maternal and child mortality in most countries is accelerating, most developing countries will take many years past 2015 to achieve the targets of the MDGs 4 and 5.”

The report is titled “Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: An updated systematic analysis.”

Also, the report noted that Nigeria has recorded a 42 per cent decrease in maternal deaths due to pregnancy-related complications between 2008 and 2011. However, the country has not made similar progress on child mortality. According to the report, the fraction of deaths in sub-Saharan Africa has increased from 33 per cent (3·9 million of 11·6 million) in 1990 to 49 per cent (3·5 million of 7·2 million) in 2011.

In fact, Nigeria, Republic of the Congo, and Ethiopia accounted for slowest rate of decline. “For child mortality, most countries have a faster rate of decline than the worldwide rate because of the concentration of births and child deaths in key sub-Saharan African countries with slow rates of decline, including the Republic of the Congo, Nigeria, and Ethiopia.”

Commenting on the report, Minister of State for Health, Prof. Muhammad Ali Pate, said the success was due to improved access to skilled birth attendants by pregnant mothers through the Midwives Service Scheme (MSS) and Community Health Workers (CHW).

Pate said the Ministry plans to accelerate the progress by investing more in frontline services and integrating Traditional Birth Attendants (TBAs) into obstetric care.

Lozano and colleagues published a maternal mortality ratio in Nigeria for 2011 of 487 (398—582) per 100,000 live births. Compared to Hogan and colleagues who published in early 2010 the maternal mortality ratio in Nigeria for 2008 as 608 (range 372—946) per 100,000 live births, which shows a 19.9 per cent reduction.

Also, comparing the new report with another work by the UN Maternal Mortality Estimation Inter-agency Group 8 later in 2010, which estimated a ratio for 2008 of 840 (460—1500) per 100,000 live births, the country has recorded 42 per cent reduction.

Also, the National Demographic Health Survey (NDHS) 2008 had put the figure at 545 per 100,000 live births, which is 10.6 reduction.

Pate said the report shows Nigeria has a yearly maternal death decline rate of two to three per cent and that is good as far as the country will continue to make progress. “We have to accelerate. For us with the 2008 NHDS and what we have seen so far, we have made progress but it has to be sustained,” he said.

The minister added: “The lesson for us is to invest in frontline services, human health resources are at the lead through community health workers and midwives and other interventions that are necessary to make mothers survive so that it boost our effort to provide basic obstetric care to prevent post partum haemorrhage with referral health system for women that will have complication. And if you do that it helps for further progress.

“The bottom line is that skilled birth attendant is really the best intervention to save the lives of mothers. When you have skilled birth attendants mothers can be referred to when complications arise. The MSS has shown that where it exists in rural areas Ante Natal care (ANC) attendance has increased, which was corroborated by the decline in facility-based maternal mortality. But that is facility based data not population data, there is a difference. So with that if we can further increase the availability of midwives we will see more progress.

“Other parts of the world that have shown similar decline, what they have done is to provide basic midwifery services. It is key to saving the lives of mothers in pregnancy. For us TBAs have a role to play, not necessarily taking deliveries but helping mothers in obstetric care and also referring them and providing good information.”

http://www.thenigeriandaily.com/2011/09/29/nigeria-will-not-meet-mdg-targets-on-maternal-child-health-says-report-3/