Are we really seeing a dramatic fall in maternal mortality rates in Nigeria?

Over the past few months, there have been various reports in the media about a dramatic fall in maternal mortality rates in Nigeria. This has been carried by a few newspapers and blogs quoting various government officials…
Premium Times: The Minister of Health, Onyebuchi Chukwu, has said that the maternal mortality rate in Nigeria dropped from 704 per 100,000 live births in 1990 to 487 per 100,000 live births in 2011. 

Daily Time: Maternal Mortality Rate Drops by 30%, Says President 

The Eagle online: Maternal mortality in Nigeria has reduced by 50 per cent, says expert Maternal mortality rate has reduced to 224 deaths per 100,000 

I have to written everyone in the sector that we have access to, in order for us to share the original data or publications that showed this dramatic decline, so far unsuccessfully. If you have access to this data, or you know who does please do share. If true, this is obviously great news for Nigeria and will show that Mr President’s “Transformation Agenda” is having its desired effect. We will keep an open mind and appeal to you, our readers to share these results with us should you find them. It is important to realise that  dramatic falls in maternal and child mortality never happen in a vacuum. They are often as a result of significant changes in the socioeconomic well-being of a population and specific public health interventions. The reports above all quote government officials – right up to the President. No source is given for the data. The statements do not appear to be questioned by the journalists reporting them. The only questioning voice that we have found is in Dr Aminu Magashs’s column in the Daily Trust where he asserts that;

 “…the 2012 MDG Survey was done surreptitiously” …”The way and manner the findings were shared in the meeting revealed that it was a survey conducted in a clandestine manner without credibility and scientific relevance”

We will not draw any conclusions just yet as we wait to see the much quoted figures and understand the validity of the survey that was apparently conducted. Please if you have access to this – do share, and no – it is neither on the website of the MDG office nor on that of the Federal Ministry of Health. If the maternal mortality rates have indeed fallen, maybe our officials can at least agree by how much as every report seems to quote a different figure!

In the meantime, lets share with you two modern day miracles that have happened in the health space on the continent, published in peer review journals, and driving policy in other African countries. This is the way epidemiology works; it is not rocket science. 

Firstly, the reduction of child mortality in Rwanda from 275 deaths in children under 5 per 1000 live births in 1995 to 54/1000 in 2015. These were results of surveys carried out in Rwanda and published by Paul Farmer et al in the British Medical Journal. These results have been described as the most dramatic fall in child mortality ever recorded. The determination with which Rwanda has implemented its public health policies over the past 20 years is no secret. Read our previous blog here describing a recent talk given by the Rwandan Minister of Health Agnes Binagwaho. These things do not happen by chance. They do not represent just numbers – but lives of children spared and families strengthened. This is probably the most important indicator of development in a society.

The second example is an increase of over 10 years in life expectancy in South Africa, over the past 10 years, published by  Science by Bor et al. This is directly attributable to the rapid expansion of the antiretroviral treatment programme for people living with HIV/AIDS in South Africa. At the moment, South Africa is closing in to 3 million people on treatment, all funded by the South African government itself (not donors as in Nigeria).

Increases in Life Expectancy in SA by Bor et al: Science. Feb 22, 2013; 339(6122)

Sadly there is no alternative to scientific rigour in carrying out and publishing surveys. Absolutely no one will take us seriously in Nigeria until we do things the right way. Like a lady with an emerging pregnancy, it can only be hidden for so long.

We will keep searching until we find out the truth…..

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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