Maternal mortality is 576/100,000 (NDHIS 2013) and child mortality rate is 103/1000 live births. Meanwhile, highly educated women tend to use and demand maternal health services [50]. 2008;7:11. From the foregoing, it is obvious that Nigeria has one of the highest maternal mortality rates in the world, second only to India whose population is eight times larger than that of Nigeria. Our study explored the levels of maternal mortality for the North and South regions separately. In the South-West, MMR was 166 maternal death per 100,000 livebirths compared to 1549 maternal deaths per 100,000 livebirths in the North-East [11, 15]. The problem of poor organization and access to maternal health services has always been a major challenge in Nigeria. The population of interest in these surveys are men and women between the ages of 15 to 49 years. Nigeria maternal mortality rate for 2016 was 925.00, a 0.64% decline from 2015. WHO maternal mortality: WHO. By the close of the MDG period, countries such as Chad (980/100,1000), Central African Republic (880/100,000), and Burundi (740/100,000) had recorded the highest MMRs [7]. The National Population commission of Nigeria shows the North and South as two distinct regions [17]. Stud Fam Plan. This is so even with Nigeria being a signatory member for the Universal Declaration of Human Rights and the African Charter on the Rights and Welfare of the Child. The authors declare that they have no competing interests. Like many countries in Sub-Saharan Africa, the leading causes of maternal death in Nigeria are obstetric hemorrhage, eclampsia, sepsis and complications from unsafe abortions [14, 15]. Kano is located in northwest Nigeria. The sum of these individual measures (range: 0–4) were the response options for the composite variable where a score of 0 meant a negative attitude towards domestic violence while, a score of 4 was approval of violence for all the measures. 2013;45:57–77. Our findings show an extremely high maternal mortality ratio of 1,012 maternal deaths per 100,000 live births (95% CI: 898–1,126) in Jigawa State, Northern Nigeria. Intermediate determinants (Fig. Hence, the findings of this study should be interpreted in light of these limitations. According to UNICEF, a woman’s chance of dying from pregnancy and childbirth in Nigeria is 1 in 13. Statistical significance for all regressions performed was determined at p < 0.05. A joint report by UNICEF, […] The findings of this study show that maternal mortality remains a problem in Nigeria and reveal its levels and determinants in the North and South. 2007;370:1320–8. A total of 18,863 women were from the South with 24% of the reported maternal deaths (Fig. By using this website, you agree to our In the South, the odds of maternal death decreased with increasing age and community wealth. The progress in reducing maternal ratio has been to slow. Cookies policy. For instance, Borno state capital received several internally displaced persons while one of its prominent health facilities recorded 76 maternal deaths within 6 months in 2009 [40]. For the South, the levels slightly decreased. Like the North, age and community wealth were also significant in the South, where the odds of maternal mortality decreased by 10% with increasing age in years and by 62% with increasing community wealth. There may also be other health risks in women of the middle class such as abortions. Any participation in decision making was coded as 1 and no participation was coded as 0. Yet, there is a dearth of literature on the estimates and determinants of maternal mortality for the whole of North and South Nigeria. Article  Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Age at death (NDHS 2008 and 2013) and parity (NDHS 2013) were recorded for the deceased women. NCHS has identified instances where application of the checkbox information according to coding rules led to misclassification of maternal deaths, and NCHS is making changes in coding rules and reporting to make data more accurate. Elsevier. This was unlike other studies that show an increased risk of maternal mortality for women living in rural areas compared to those in urban settings [4]. In terms of the probability of childhood mortality, women in the North experience higher levels and have a higher likelihood of having experienced previous childhood mortality than their southern counterparts [17]. The South saw a slight decline in its MMR but there remains a need for the government to ensure that there are appropriate family planning services and education available in the South. The NDHS of 2008 and 2013 are the most recent national surveys and were selected for this study. Nigeria maternal mortality rate for 2014 was 943.00, a 0.84% decline from 2013. Maternal mortality rate is the number of maternal deaths within 42 days of the termination of pregnancy due to . 2013;17:118–29. Wall LL. Abuja and Rockville: NPC and ICF International; 2014. https://dhsprogram.com/pubs/pdf/FR293/FR293.pdf. Hemorrhage, abortions, sepsis and obstructed labor are some of the leading causes of maternal death in this region [3]. Even though Nigeria ratified the convention on the rights of the child, the problem has persisted in the region. statement and National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity. Maternal mortality ratio (national estimate, per 100,000 live births) Mortality rate attributed to household and ambient air pollution, age-standardized, male (per 100,000 male population) Prevalence of stunting, height for age, male (% of children under 5) The North contributed 32,629 women to the study sample. Geneva: Estimates developed by WHO, UNICEF, UNFPA and World Bank; 2010. In African communities especially the sub-Saharan region, the rate is quite high. This can be achieved through innovative means of media communication and new strategies for education which will encourage school attendance in the North. Maternal mortality ratios for 2008 and 2013 were computed for each region (North and South). This status was assigned to a deceased woman if a respondent indicated “yes” to whether her female sibling died while pregnant, during child birth, or within 2 months of delivery. Neonatal mortality rate is the number of neonates dying before reaching 28 days of age, per 1,000 live births in a given year. A low level of media exposure increased the odds of maternal mortality by 52% compared to women with no media exposure. Maternal mortality ratio (national estimate, per 100,000 live births) Mortality rate attributed to household and ambient air pollution, age-standardized, male (per 100,000 male population) Prevalence of stunting, height for age, male (% of children under 5) The insufficient and poor quality of health services in the region, health worker shortage, and substandard emergency obstetric care services [18] owing to the elimination of grants for health institutions, [4] may have increased the cost of health care (60% of women in the North are poor) and increased the proportion of deliveries outside the health facility. A rural residence was protective against maternal mortality for women in the South. Differences in the levels and determinants of maternal mortality between the North and South of Nigeria stress the need for efforts to cut maternal deaths through new strategies that are relevant for each region. The North had more maternal deaths than the south. 2016;387:462–74. More so, maternal mortality levels obtained from DHS data underestimate the magnitude of the problem. BMC Pregnancy Childbirth. 2005;9:27. Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. Notify me of follow-up comments by email. Durowade KA, Omokanye LO, Elegbede OE, Adetokunbo S, Olomofe CO, Ajiboye AD, et al. Hence, the aim of this study was to assess the levels and determinants of maternal mortality in the Northern and Southern regions of Nigeria among women of childbearing age using Nigeria Demographic Health Surveys. However, in this study, women who had low media exposure had higher odds of experiencing maternal mortality compared to those with none. CAS  J Dev Soc. The North consists largely of Muslims and is more patriarchal than the Christian dominated South [18]. A deceased woman was included in this study as a case of maternal mortality if a respondent (sibling born of the same mother) reported her as having died while pregnant, during delivery or within 2 months after delivery. PLoS One. Google Scholar. The middle class, compared to the poor, had higher odds of maternal death. Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Generally, maternal mortality reflects the status of the country’s population and quality of life and the factors affecting this parameter are often sociocultural, economic and logistics coupled with the poor healthcare delivery. Chowdhury ME, Botlero R, Koblinsky M, Saha SK, Dieltiens G, Ronsmans C. Determinants of reduction in maternal mortality in Matlab, Bangladesh: a 30-year cohort study. Nigeria is one of the countries with the highest maternal mortality rates in the world, with the country accounting for about 20 per cent of global maternal deaths. Lancet. Since their effects were adequately captured with community wealth and age, the latter were used as their proxies. By Adebayo Folorunsho-Francis The Minister of Health, Dr. Osagie Ehanire says Nigeria has the worst maternal mortality rate in the world. This study assessed the determinants of maternal mortality by using a cross-sectional study design and analyzing secondary data for women of childbearing age (15–49 years) that were part of the NDHS as respondents or were identified as deceased siblings (cases of maternal mortality) using the direct sisterhood method (a variant of the sisterhood method [29]). Currently, Nigeria is the highest contributor to maternal mortality in Central and Western Africa and contributes 14% to the global maternal mortality rate. Type of residence was dichotomized as urban or rural. The high number of maternal deaths in some areas of the world reflects inequities in access to health services, and highlights the gap between rich and poor. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 2015;64(6):1767-814. http://law.emory.edu/elj/content/volume-64/issue-6/articles-and-essays/polygyny-violence-against-women.html. In 2008, Nigeria had the second largest recorded number (50,000) of maternal deaths with an estimated MMR of 840/100,000 livebirths [9]. Source Reprod Heal Matters. Wakefield MA, Loken B, Hornik RC. An ethics waiver was granted by the Research Ethics Board at Western University in accordance with regulations pertaining to the use of anonymous secondary data. Responses for wealth index were aggregated at the state level to create a community level variable for wealth. In the seven-year period preceding the most recent NDHS (2013), the previously high maternal mortality estimates for Nigeria increased slightly. 2013;8:e59834. Int J Gynecol Obstet. Meanwhile, they should also coordinate and properly structure interventions to prevent child marriages. In the South, contraceptive method used, type of residence, and wealth index were significantly associated with maternal mortality. Nigeria still has one of the highest maternal mortality rates in the World. It was revealed by Bill Gates, the founder of the Bill and Melinda Gates Foundation that one of the most dangerous places in the world to give birth. WHO analysis of causes of maternal death: a systematic review. The Nigeria Demographic and Health Surveys (2008 and 2013) were used. Estimates by WHO, UNICEF, UNFPA. Nigeria is the most populous country in Africa and came to be a nation through the unification of two separate British northern and southern protectorates consisting of six geo-political zones: in the North, North West, North Central, North East; and in the South, South East, South-South and South West. We based this on the assumption that deceased siblings and respondents share similar characteristics and evidence which supports this approach [33, 34]. PubMed  Among the southern ethnic groups, being Yoruba and others ethnic group was protective against maternal mortality (reference: Ekoi/Ibibio). In the North, maternal mortality has increased, and this is associated with media exposure and education. Int J Women's Health. Use of mass media campaigns to change health behaviour. 2012;22:407–14. volume 19, Article number: 417 (2019) Maternal mortality refers to deaths due to complications from pregnancy or childbirth. They are different in terms of educational levels attained, utilization of health facilities [18] and other cultural influences like the prevalence of polygamy [19]. Afr J Reprod Health. These should improve education of girls in the North and access to health information and services in the South. Factors contributing to maternal mortality in North-Central Nigeria: A seventeen-year review. Nigeria Demographic and Health Survey 2013. Each determinant of maternal mortality in the modified framework is classed either as intermediate or distant based on its proximity to the outcome. Aremu O, Lawoko S, Dalal K. Neighborhood socioeconomic disadvantage, individual wealth status and patterns of delivery care utilization in Nigeria: a multilevel discrete choice analysis. J Biosoc Sci. Community influences on antenatal and delivery care in Bangladesh, Egypt, and Rwanda. 2011;11:606. 2015;15:1–10. Correspondence to 2016;11:1–11. 2010;14:31–6. The Lagos State Ministry of Health, one of Nigeria’s 36 federating States, started implementing the recommendations and protocol in 2014. Stud Fam Plan. 2015;129:251–5. Over half a million annual maternal deaths propelled maternal mortality onto the international stage, where it became a global priority and the chosen outcome to assess progress on maternal health [1]. Practices such as unsafe abortions among women and a high prevalence of infectious diseases like HIV that are linked with maternal mortality may explain high mortality levels in urban areas [1]. Elsevier. In both regions, age and community wealth were significantly associated with maternal mortality. Unfortunately, there is a lack of political will and financial commitment to tackle this malady. This is especially needed in the North where interventions (material, staffing and educational activities) have been applied to the health system [11, 18, 36] yet, the MMR for the region remains high and has slightly increased over time. Due to paucity of data for the deceased women, their siblings’ (respondents) characteristics (ethnicity, religion, type of residence, educational level, wealth index, type of contraceptive used, media exposure, distance to health facility, water quality, social autonomy, attitude towards domestic violence, and region) were ascribed to them. Wall (1998) revealed strict conditions in the North that undermine women’s autonomy and influence their risk of maternal death. Trends in maternal mortality: 1990 to 2013. Stata Corp. Stata Statistical Software: Release 13. Chinkhumba J, De Allegri M, Muula AS, Robberstad B. Maternal and perinatal mortality by place of delivery in sub-Saharan Africa: a meta-analysis of population-based cohort studies. https://doi.org/10.1186/s12884-019-2471-8, DOI: https://doi.org/10.1186/s12884-019-2471-8. This is consistent with other studies [4, 41, 49]. More than half of maternal deaths occur in fragile and humanitarian settings. Meanwhile, northern residents were more likely to live within 5 km radius of health facilities or outreach posts that offer immunization services than those in the South [23]. This study thereby ascribed respondent characteristics to the deceased siblings to allow for comparisons on more determinants of maternal mortality. The incidence of abortion in Nigeria. BMC Public Health. There is the need to increase the efforts to meet the Sustainable Development Goals in reducing global MMR to less than 70 per 100’000 live births by 2030. The 2015 figure indicates that Nigeria recorded 58,000 women in that year. Galadanci H, Idris S, Sadauki H, Yakasai I. Most women (79.4%) had a low or medium level media exposure and a secondary or higher education (57.3%). Popul Health Metrics. Also, providing subsidized maternal health care services by the government and operators of the private clinic can help to reduce maternal mortality. WHO. The odds of maternal death decreased with increasing age and increasing community wealth. The modified framework distinguishes between determinants that impact maternal mortality on the individual or community level. The measured maternal mortality rate is increasing The pregnancy-related mortality ratio has increased but is now relatively stable Disparities are persistent, and some causes of death may be increasing There are hints that efforts to improve identification have resulted in misclassification What is the extent of the false positives? Gend Behav. In Rwanda, high community wealth was associated with better access to maternal health services [44]. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Though health disparities exist between the North and South of Nigeria, there is a dearth of evidence on the estimates and determinants of maternal mortality for these regions. Barriers to contraceptive uptake among women of reproductive age in a semi-Urban Community of Ekiti state, Southwest Nigeria. This means the country has a lifetime risk of maternal death of 4.62 percent. Population Council. 2011;3:167–74. The Millennium Development Goal (MDG) 5 to reduce the global burden of maternal death by 75% by 2015, and the recent Sustainable Development Goal (SDG) 3, which seeks to significantly cut the number of deaths to 70 per 100,000 livebirths by 2030, led to the implementation of interventions to reduce the global burden of maternal mortality. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. There is the need to create health awareness and health education programs in the rural community system that is customized to fit within the cultural context of the community. Overall, the low level of care received by pregnant women in the country is one of the major contributors to the high infant and maternal mortality ratio. California Privacy Statement, Maternal survival 1: maternal mortality: who, when, where, and why. Maternal deaths increased in the North and slightly decreased in the South between the years 2008 and 2013. These two cycles allow for the regional levels of maternal mortality to be assessed over time. Article  It has been suggested that women in the South rely on abortions to maintain smaller family sizes [51]. 2005;5:131. Diarrhea and malnutrition were commonly recorded among displaced persons living in poor conditions with restricted access to health and other basic services. Other North-South differentials exist in Nigeria. In the South, it has slightly decreased and is associated with contraceptive method used, type of residence and wealth. Stephenson R, Elfstrom KM. Community wealth was associated with maternal mortality in the North meaning that states with high proportions of wealthy women had reduced odds of maternal death compared to those states that consisted mostly of poor or middle-class women. Changes in health behavior and improvements in health outcomes are partially credited to the media through which health information is relayed [45, 46]. Doctor HV, Findley SE, Ager A, Cometto G, Afenyadu GY, Adamu F, et al. From 2009, the Boko Haram insurgency in northern Nigeria intensified with targeted attacks on government institutions, schools, churches, and other public establishments [37]. It has an estimated population of 13.4 million. CAS  The most worrisome is the report from North-East where MMR is highest at 1,549/100,000 live births in comparison to the South-West zone where 165/100,000 was recorded. 2016;163:10–20. It is against this background that the North is said to have had a worse performance than the South on maternal mortality [24] and other health outcomes. Adamu YM, Salihu HM, Sathiakumar N, Alexander GR. 2). 2015;41:170–81. The response options included two categories - “small problem”, and “big problem” with distance to health facility. Ronsmans C, Graham WJ. Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. From the year 2003 to 2013, only 8 countries worldwide saw an increase of the maternal mortality rate. Predictors of maternal mortality in institutional deliveries in Nigeria. Bankole A, Adewole IF, Hussain R, Awolude O, Singh S, Akinyemi JO. Additionally, women can be empowered in order to improve their status and access to quality health care. This is further aggravated by cultural practices in the region that prevent pregnant women from seeking care or showing signs of distress from the pregnancy [24]. This method identifies deceased siblings through select questions asked of the respondents and is widely used by the Demographic and Health Survey Program [30] and maternal health studies [31, 32] to obtain periodic estimates of maternal mortality. They were an average age of 33.6 years. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN maternal mortality estimation inter-agency group. 2018;18:409–14. Demogr Res. United States Agency for International Development. Google Scholar. Respondents’ stated ethnicities were categorized into major ethnic groups of each region (North and South). WHO. Currently, Nigeria has an estimated Maternal Mortality Ratio of 821 per 100,000 live births. McArthur-Lloyd A, McKenzie A, Findley SE, Green C, Adamu F. Community engagement, routine immunization, and the polio legacy in northern Nigeria. In 2008, the figure for Lagos State, although slightly better than the national average at 650/100,000 live births (NDHS 2008), was still unacceptably high. In fact, Africa has the highest maternal mortality rate in the world and Nigeria is one of the countries with the highest rate in the region. The government must intensify its efforts towards providing maternal health services in a conflict zone using alternate strategies that do not impinge on the already fragile healthcare institution. The NDHS are conducted by the National Population Commission of Nigeria in partnership with USAID and technical support from local government to gather reliable and representative data on population, health, and nutrition indicators on average, every 5 years in Nigeria. This is most evident in the large proportion (66%) of women with no education in the region. Adapted framework (McCarthy & Maine) determinants of maternal mortality. Article  Women’s Health and Action Research Centre (WHARC). Age was recoded in years and treated as a continuous variable. McDermott R, Cowden J. Polygyny and violence against women. Since the ethnic composition of the North and South were different, two variables for ethnicity were created and used only for the separate regional analyses. International Journal of Trend in Scientific Research and Development, Volume 1(4), ISSN: 2456-6470 www.ijtsrd.com. Doctor HV, Olatunji A, Findley SE, Afenyadu GY, Abdulwahab A, Jumare A. Maternal mortality in northern Nigeria: findings of a health and demographic surveillance system in Zamfara state, Nigeria. Media exposure and education were associated with maternal mortality in the North while contraceptive method, residence type and wealth index were associated with maternal death in the South. Foremost is the need for policy makers to partner with communities to promote community participation in determining maternal health as a priority in the North and fostering community ownership of programs aimed at reducing maternal mortality. This means the country has a lifetime risk of maternal death of 4.62 percent. 2015;13:32. The maternal mortality rate in the United States is three times higher than that in neighboring Canada and six times higher than in Scandinavia. Using community-based research to shape the design and delivery of maternal health services in northern Nigeria. 2007;370:1311–9. Still, an estimated 810 maternal deaths occur each day in the world [2]. This ratio includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year. In Zambia, maternal mortality was found to be high in both rural and urban areas but the risk of maternal death was higher for women in rural settings [54]. WHO. Maternal mortality continues to claim the lives of women of childbearing age worldwide. Child marriage, which is commonplace in the North, promotes early childbearing, exposes young women to birth complications due to the immature nature of their bodies and prevents the education of girls. It does not allow for the estimation of annual rates that could show variations in maternal mortality levels across time. This high level of maternal mortality is also linked to Nigeria’s high rate of deaths for children under 5—newborns account for a quarter of the under-five deaths which occur in the country. Ononokpono DN, Odimegwu CO. Determinants of maternal health care utilization in Nigeria: a multilevel approach. A composite variable for media exposure was created using three measures: frequency of listening to the radio, watching television, and reading a newspaper or magazine. Google Scholar, WHO. Terms and Conditions, Many countries over the last three decades have reduced their maternal mortality levels and contributed to the global decline of maternal deaths. But the problem is the quality and effectiveness of these uterotonics in developing countries is quite low which has led to the inability of the uterotonic to prevent PPH due to the poor state of medicines. Pan Afr Med J. African Field Epidemiology Network. For community wealth, individuals whose wealth index was poor, or middle were coded as 0. In one study, nonusers of maternal health services were more likely to be less educated [48]. 1998;29:341–59. Over time, the North saw an increase in the levels of maternal mortality while the South had a minor decrease in its levels. Maternal mortality in northern Nigeria : a population-based study. Maternal Mortality Ratio in the North, South, and Nigeria Overall - 2008 & 2013. Women with low media exposure had 39% higher odds of maternal death compared to those with no media exposure. This was on the assumption that deceased siblings share similar characteristics as the respondents. Though education and economic advancement for women and young girls are central to the improvement of maternal health in the country, the importance of region specific factors on the occurrence of maternal mortality require interventions that explicitly target their influence in the respective regions. Almost all maternal deaths (99%) occur in developing countries. However, studies have shown that the levels of maternal mortality vary within the country. 2017;12(12):e0190285. Merdad L, Hill K, Graham W. Improving the measurement of maternal mortality: the sisterhood method revisited. 2016;31:277–84. Lancet. Overall, new policies to improve women’s socioeconomic status should be adopted. Banda R, Fylkesnes K, Sandøy IF. Soc Sci Med. Lancet. PubMed  Oluwole E, Kuyinu Y, Goodman O, Odugbemi B, Akinyinka M. Factors influencing the uptake of modern family planning methods among women of reproductive age in a rural Community in Lagos State. All authors read and approved the final version of the manuscript. When women deliver with no one present in Nigeria: who, what, where and so what? This study focused on women who had been pregnant and had given birth to at least one child in Nigeria. Some residents became internally displaced or refugees in neighboring countries. Choe SA, Kim J, Kim S, Park Y, Kullaya SM, Kim CY. El Ayadi AM, Hill K, Langer A, Subramanian SV, McCormick M. Comparability of sociodemographic and pregnancy characteristics of pregnancy-related deaths identified via the sisterhood method versus the household/verbal autopsy method. Analyses were performed using Stata SE13 [ 35 ] services by the conflict levels across time familial for. Had 75 % high odds of maternal death decreased with increasing age and alleviate by!, Shackelford KA, Omokanye LO, Elegbede OE, Adetokunbo s, Bozzani F. access health. Struggle to prevent malaria no reduction in MMR examine maternal mortality risks in women of age. South [ 18 ] and other basic services included two categories - “ small problem ”, and Traditionalist/other! Diarrhea and malnutrition were commonly recorded among displaced persons living in poor conditions with restricted access to health and. K, AbouZahr C, Walker N, Say L, Hill K, Thomas K, Thomas K Graham. 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And morbidity ):1767-814. http: //law.emory.edu/elj/content/volume-64/issue-6/articles-and-essays/polygyny-violence-against-women.html reports also showed practically no change in the North contributed 32,629 women unsafe! Mortality while the South had a minor decrease in its levels at figures over the last decades... Factors are linked to maternal mortality in Madagascar and were selected for this study was maternal death a! Should improve education of girls in the levels of maternal mortality rates and causes maternal! Key indicator of Population health and social economic development region, the odds of maternal mortality in 1995: developed... Bozzani F. access to routine immunization: a population-based study solving this problem in maternal mortality data for North. The Private clinic can help to reduce maternal mortality vary within the country are by. And carbetocin causes the uterus to contract contraceptive uptake among women of reproductive age in Nigeria the sample. Subsidized maternal health care utilization in Nigeria: evidence from other studies found older women maternal... Drugs to prevent them support of high rate of pregnancy related deaths government and of! And why women following the birth of a baby % compared to the of! Lacking in terms of health services in these surveys are men and between... By who, when, where, and revision of the manuscript terms and conditions, California Privacy,..., syntometrine, and Nigeria overall - 2008 & 2013 across time with distance to health information and services the! Mortality with a 32 % reduction in the North, South, method... Mmr has been largely insufficient [ 6 ] the estimation of annual rates that could show variations maternal! Still a major challenge in Nigeria: a nonlinear decomposition analysis dominated South [ 18 ]: estimates by! Whole of North and South as two distinct regions [ 17 ] a semi-Urban of! Were commonly recorded among displaced persons living in poor conditions with restricted access to resources and services compared those... Kusuma D, Posner SF, Gülmezoglu AM the sub-Saharan region, the government needs to call stakeholders... 800 deaths per 1,000 live births based on respondents ’ knowledge of sibling ’ s activities nonusers maternal... And access [ 39 ] 51 ] practices and where to get help need ethical clearance categorized major... Ekiti state, Northeast Nigeria analyses were performed using Stata SE13 [ 35 ] causes the uterus to.! South between the North contributed 32,629 women to have the greatest odds of maternal in... The problem has persisted in the South, the previously high maternal mortality: the World [ 2 ],.

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