Making Every Nigerian Mother and Child Count


A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy.

Maternal mortality is one of the most powerful indicators of the quality of a health care system. In a 2003 report, the WHO and UNICEF, the world average was 400, the average for developed regions was 20, and for developing regions 440. The worst countries were: Sierra Leone (2,000), Afghanistan (1,900), and Malawi (1,800),. Maternal mortality ratio for Nigeria, 6th largest Oil exporter in the world was 800 maternal deaths per 100,000 births, i.e 1 in every 125 pregnancies resulted in the death of the mother in Nigeria. To compare our status; it is 540 in Ghana, 570 in Togo and 730 in Cameroun. We had the second highest in absolute numbers (37,000), behind India at(136,000).

The Minister of Health Professor Adenike Grange seems to have made this the focus of her tenure in office. During the Lancet lecture she delivered in London where she pointed this out as evidence for the state of health in Nigeria. She has declared that lowering this would be one of the major trusts of her administration. The key question is how?

At another conference in London, the Woman Deliver Conference the Nigerian Ministry of Health was praised for showing the will to tackle the frightening state of maternal and infant health in the country, evident in the Maternal Newborn Child Health System (MNCHS) developed by the ministry. The ministry is reported to be creating an investment plan for women with so much emphasis on community participation.

There have been several reports in the newspapers lately on the launching of “Free medicare for pregnant women and children”. What no journalist has bothered to find out is what services exactly are free? Just the delivery of the child? The ceasarian section if required? The drugs? etc etc Where exactly will these free services be delivered? By whom? While these answers might all be clear in the files of the Minister, it is rather sad that journalists throw out banner headlines without asking these important questions!

In this report, The Guardian lauds the Federal Government on its plan to introduce these free services. We also know that the Federal governments is only directly responsible for health care services in 1 center per state in most instances, a teaching hospital or Federal medical Centre. Providing these services free here does not equate to “nationwide” as insinuated by this report!!! But it will be a great start…

Champion reports that the Honourable minister attributed maternal deaths to lack of adequate nurses, doctors and health facilities in most primary Health care centres in the country. It quotes Prof Grange thus “The time is now for government to leave no stone unturned in making the nations health care system efficient, affordable and reliable in order to serve the common man who cannot afford to fly abroad for treatment”. While all politicians love phrases like “leave no stone unturned”… Nigerians would still love to hear how!

Meanwhile…the States start announcing with fanfare:

And the heir to Chief Onifade Ibori’s estate in Delta State welcomed Prof Grange to Asaba to kick of his programme with the usual fanfare…

It is a sign of courage that Prof Grange has picked this important indicator of health to be judged by. Being a woman and a mother…she knows what is at stake. In public health terms…there can be no better indicator for the health of a population….and non easier to evaluate… we will be watching as we hope that every Nigerian Mother and Child will count…

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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