Maternal Mortality Dimensions in North-Western Nigeria: A Case Study of Kaduna Metropolis

Abstract

Maternal mortality in Nigeria is ranked second in the world after India and Nigeria is part of a group of six countries in 2008 that collectively accounted for over 50% of all maternal deaths globally. Midway to 2015, the date set for attaining the MDG 5, many women still die in Nigeria when compared to most other countries. About 53,000 women die every year, which means one woman dying every 10 minutes. This frightening situation is indeed a call for research. A purposive sampling method was adopted using Hospital record of 5 years to review maternal deaths. Following the projection of women within the reproductive age in Kaduna metropolis, the researcher adopted a sample size of 384 to capture maternal mortality cases in the Household survey. A number of 277 maternal death occurred among 38,058 deliveries in the hospitals during the 5-year period under review, with maternal mortality ratio (MMR) of 729/100,000 live births and incidence of 1 in 137 deliveries. Considering geographical distribution, Kaduna North hospitals recorded 233 maternal deaths with MMR of 979/100,000 live births while Kaduna South hospitals recorded 44 maternal deaths with MMR of 309/100,000 live births. By yearly variation MMR records 649/100,000 live births in 2003, in 2004 (811/100,000 live births), in 2005 (945/100,000 live births), in 2006 (459/100,000 live births) and in 2007 (814/100,000 live births). The greatest risk of MMR was among young adult women of age (15-24 years) and older women from 35 years and above. Parity-specific maternal mortality ratio was highest in the grand multiparous women. Unbooked as well as illiterate women were associated with very high maternal mortality ratio. Hausa-Fulani tribe contributed a disproportionate 47.6% to maternal deaths, which is the group with the highest maternal deaths. The major direct causes of deaths in the medical record are Eclampsia which accounted for (37.0%); obstructed labour is the highest in household survey. The most common indirect causes of maternal deaths identified in the medical records are HIV/AIDS (31.3%). Among others are some socioeconomic and cultural factors which are also underlying causes, such as poverty, lack of education, cultural taboos and gender inequality. However, improvement in family planning services, enlightenment through education, more skilled attendants, government policy in favour of maternal health and prompt efficient and emergency obstetric care will go a long way to help reduce maternal mortality in Nigeria.