Environmental factors influencing maternal mortality in Zaria, Nigeria

Abstract

Zaria is a university town with a population of 200,000 people, mostly Hausas, who are rural farmers and small scale traders. The Ahmadu Bello University Teaching Hospital has over 300 beds and serves nearly 500,000 people. Maternal and other services are provided free of charge. The number of women having babies in the hospital has more than doubled in the last 5 years, as has the number of doctors, but not the number of midwives and nurses. In 1976-77 the maternal morality rate was 10/1000, nearly 50 times as high as in Western Europe. The main influences on maternal death were anemia, prolonged labor, parity, age, health and reproductive history prior to each pregnancy. Early marriages are common as are pregnancies between the ages of 14-16. Blood transfusion is often refused because it is believed to do harm. Operative deliveries are also refused because it is shameful for a woman not to deliver herself. Purdah is the practice among Muslims of restricting the women to their matrimonial homes to avoid infidelity. Lives may be lost because no one is available to give a woman permission to leave the house. As education becomes more widespread and medical facilities improve, more and more demands will be made on the health delivery system. The National Youth Service Corps is relieving the personnel shortage in rural areas, and the government is emphasizing preventive care.