Nigeria: Talking about mothers

Abstract

In Nigeria where the likelihood of a woman dying in pregnancy or childbirth is 1 in 21 President Ibrahim Babangida has called for a massive enlightenment campaign focused on maternal morbidity and mortality. Babangida has met with representatives from the Society of Gynecology and Obstetrics of Nigeria and is considering establishing a national institute of maternal health. Operations research projects are underway to determine why maternal mortality is so much higher in Nigeria than in other developing countries. Research is documenting a drastic decline in hospital births at university teaching hospitals as well as an increase in maternal deaths in these hospitals. For example the number of obstetric admission at Zarias Ahmadu Bello University Teaching Hospital declined from 7450 in 1983 to 5437 in 1985 to 3376 in 1988 while maternal deaths at the facility rose by 56% in 1985-88. Increased hospital fees and a deterioration of services due to a lack of adequate funding are in part responsible for this phenomenon. However focus group discussions indicate that cultural factors that create suspicion of modern medicine and the often arrogant attitudes rural women experience from hospital personnel are equally responsible. Nigerian womens groups have mobilized to improve the treatment of vesicovaginal fistulae and reduce long waiting times for treatment but have faced problems convincing surgeons and gynecologists to offer their services. It appears that there will be no significant progress in maternal health in Nigeria until there is greater communication between hospital personnel traditional birth attendants and rural communities.