Maternal morbidity and mortality in Nigeria: A multi-faceted context

Maternal mortality is widely recognized internationally as a priority for urgent policy and program action. Nigeria, the most populous country in Africa and an influential part of West Africa, has one of the highest maternal mortality rates in the world. As a response in 2006, Nigeria introduced the National Gender Policy which includes an objective to reduce maternal mortality by 35% by 2015. Its success depends largely on an understanding of current conditions, recent trends and obstacles to achieving maternal health. This report seeks to answer these questions by examining findings from the Demographic and Health Surveys of 1990 and 2003 as well as data from other sources. Findings indicate that the country has become more urban and that education of women has improved dramatically; however, fertility has changed very little, unplanned childbearing is on the rise, the incidence of high-risk births remains largely unchanged, and levels of prenatal care have improved only nominally in thirteen years. Other findings, which might underlie these problems, are that (i) women's ability to make autonomous decisions about their heath care is limited and (ii) spending on health care is very low in Nigeria, with private expenditures comprising by far the largest component of total expenditures. The analyses also make clear that progress has been uneven across the regions of this culturally heterogeneous country. If women's health and well-being are to improve in Nigeria, the government must invest in informed and sustainable strategies to enable women to access the care and services they need.