Nigeria: a Brief Background
Life expectancy in Nigeria is currently established at 53 years according to the 1991 national census in Nigeria; specifically 52.6 for males and 53.8 for females. The crude birth rate declined from 27 to 14 per 1000 in the same period. These statistics have not impressed the WHO that ranked Nigeria 163rd of 191 countries in terms of Disability Adjusted Life Expectancy (DALE) with a value of only 38.3 years. While the DALE ranked Nigeria higher than countries just recovering from civil war like Liberia and Sierra Leone, it was however far behind a neighbouring country like Ghana. The reason for this low ranking was due to the rather high maternal, neonatal, and infant mortality rates in the country.
The situation of maternal mortality in Nigeria
Nigeria, in spite of abundant resources and opportunities, and in spite of the numerous, though insufficient, healthcare institutions, continues to rank very low in world statistics on maternal and infant mortality. Even within Africa, on a comparative basis, Nigeria’s record is rather poor. The reasons are due mainly to bad politics, bad policy and bad leadership.
It is estimated that over 500,000 women die each year globally from complications with pregnancy and childbirth. In Nigeria alone the figure of deaths from these complications is about 55,000. While the country constitutes about 2% of global population, it, however, accounts for 10% of maternal deaths at childbirth, this puts it next to India. Of this 55,000 deaths, well over 70% is in the rural areas, and northwest and northeast of the country accounts for about 65% of the mortality ratios.
It is also estimated that while the risk of death from complications at childbirth for women in developing nations is 1 in 61, and 1 in 29 for Sweden, it is 1 in 18 for Nigeria. Debilitating and long-lasting health problems associated with birth maternal health complications is rampant and affects 30 women for every one that dies at childbirth. About 40% of women, about 800,000, that suffer from vesico-vaginal fistula globally are in Nigeria. Haemorrhage is responsible for 23% of deaths among women that suffer maternal mortality while others are killed by narrow pelvis (11%), eclampsia (11%), abortion (11%), anaemia (11%), infection ((17%) and malaria (11%).[1]
It is estimated that about 600,000 women die of clandestine or illegal abortions in Nigeria every year and about 20,000 die from complications arising from abortion. A range of social, economic, health, and other family pressures and complications are responsible for these abortions. But most women, especially in the peri-urban areas resort to abortions under the “supervision” of unqualified or quack persons posing as medical personnel and the laws are rather weak to punish such criminal activities. Of course, those that survive such abortions, end up with severe problems of infertility and ectopic pregnancy with the accompanying pressures on the family and individuals.
Due to very poor medical facilities at the disposal of the majority of the people, Nigeria records 71 per 1000 infant mortality rate, 140 per 1000 live births of under-five mortality rate, 51 per 1000 live births of perinatal mortality rate. Based on these figure, it is obvious that Nigeria’s record is very poor. Nigeria’s record is below countries such as Liberia, Sierra Leone, Ghana, Kenya, South Africa and Liberia. Under the WHO indicator of Equality of Child Survival (ECS) that measures “the extent to which under-five mortality reflects pure chance of death (equal to all children) rather than variations in underlying factors.”[2] With the highest value at 1 to represent “complete equality of child survival, unaffected by underlying factors” Nigeria scored 0.336 and 4th lowest of 191 ranked nations embarrassingly slightly ahead of countries such as Liberia, Mozambique and Central African Republic and worse than Sierra Leone and Angola.