Boosting Family Planning Services To Address Preventable Maternal Deaths In Nigeria

By CHIOMA UMEHA

In line with global calls, boosting family planning services for women who want to delay or prevent pregnancy would address preventable maternal and new-born deaths in the country.

The World Health Organisation (WHO) reports that Nigeria’s maternal mortality rate (MMR) is 814 per 100,000 live births. Furthermore, the WHO report revealed that increased access and use of modern contraceptives by women of reproductive ages between 15 and 45 years would curb maternal mortality. The goal is to achieve a world where every pregnancy is wanted. Experts insist that maternal mortality would be avoidable if family planning is integrated in the country’s health system to control the country’s fertility and maternal mortality rate. A look at Nigeria’s population dynamics reveals that it is made up of a majorly young reproductive populace. Nigeria’s population is put at 215,105,356 as of Wednesday, April 6, 2022, based on Worldometer elaboration of the latest United Nations data.

Unfortunately, Nigeria has majority of middle-aged, young adults and even adolescents, most of whom the country has neglected their sexual and reproductive health. According to population projections by the United Nations for 2020, about 43 per cent of the Nigerian population comprised children of 0-14 years, 19 percent aged 15-24 years and about 62 percent are below age 25 years. By contrast, less than five percent is aged 60 years and above. Similarly, Nigeria’s population growth which is equivalent to 2.64 percent of the total world population ranks number seven in the list of countries (and dependencies) by population. Yet, the country is where nearly 20 percent of all global maternal deaths happen. Between 2005 and 2015, it is estimated that over 600 000 maternal deaths and no less than 900 000 maternal near-miss cases occurred in the country.

In 2015, Nigeria’s estimated maternal mortality ratio was over 800 maternal deaths per 100 000 live births, with approximately 58 000 maternal deaths during that year. By comparison, the total number of maternal deaths in 2015 in the 46 most developed countries was 1700, resulting in a maternal mortality ratio of 12 maternal deaths per 100 000 live births.

In fact, a Nigerian woman has a one in 22 lifetime risk of dying during pregnancy, childbirth or postpartum/post-abortion; whereas in the most developed countries, the lifetime risk is one in 4900.

Statistics from the Federal Ministry of Health (FMOH) confirmed that no fewer than 50,000 women die annually in Nigeria due to maternal causes. Similarly, the 2018 National Demographic Health Survey (NDHS) reports that seven women die every one hour from maternal health causes. The 2018 NDHS further reported that an average Nigerian woman gives birth to 5.3 children, adding that, women in rural areas have an average of 5.9 children compared to 4.5 children among urban women. The report further showed that one in five teenage girls age between 15 and 19 are already mothers or pregnant with their first child. Rural teenage girls are three times more likely to have begun childbearing than urban teenage girls at a figure which is put at 27 percent versus eight percent. But evidence shows that encouraging family planning still remains the preventive method to reduce maternal mortality, by cutting down the risks of unplanned pregnancies and deaths.

For instance, Lagos state said it has averted about 167,000 unintended pregnancies, 59,000 abortions and 1,100 maternal deaths, following growing modern Contraceptive Prevalence Rate (mCPR) from about 22.7 per cent in 2013 to 29.1 per cent in 2018. Experts have blamed poor contraceptive use and family planning service gaps for fueling unplanned pregnancies and maternal deaths in the country. The 2018 National Demographic Health Survey (NDHS) confirmed that contraceptive use is very low in Nigeria.   The NDHS reported that 17 percent only use all methods of family planning, while 12 percent of currently married women use modern methods.

In addition, about one in five women (19 per cent) have an unmet need for family planning. However, analysts say that if all currently married women who want to space or limit their children were to use a family planning method, Nigeria’s contraceptive prevalence rate would increase from 17 per cent to 36 per cent. However, several reasons have been advanced for poor use of contraceptives and family planning, including misconception and costs of procuring them. The 2018 National Demographic Health Survey (NDHS) confirmed that contraceptive use is very low in Nigeria.   The NDHS reported that 17 percent only use all methods of family planning, while 12 percent of currently married women use modern methods.

In addition, about one in five women (19 per cent) have an unmet need for family planning. However, analysts say that if all currently married women who want to space or limit their children were to use a family planning method, Nigeria’s contraceptive prevalence rate would increase from 17 per cent to 36 per cent. The Federal Government, in collaboration with partners and private sector stakeholders, had in 2012, pledged to achieve a Modern Contraceptive Prevalence Rate (MCPR) of 27 per cent in Nigeria, among all women by 2020. But, the family planning target indicators by 2020 showed that Nigeria only achieved 12 per cent MCPR, forcing the timeline to be shifted to 2030. Many analysts believe that Nigeria should channel more efforts to increase its MCPR, if the country must reduce its high maternal deaths and attain the family planning 2030 goal.