Nigeria’s Maternal Health Crisis: Addressing High Mortality Rates

By Darius Spearman (africanelements)

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Maternal Mortality in Nigeria

Nigeria faces a severe maternal health crisis, making it the deadliest country in the world for childbirth. In 2023, the nation accounted for over one-quarter (29%) of all maternal deaths worldwide. This translates to an estimated 75,000 women dying in childbirth in a single year, which means one death every seven minutes (bbc.com). The maternal mortality rate in Nigeria in 2020 was 1047 deaths per 100,000 live births (joghr.org). This figure is more than ten times greater than the Sustainable Development Goals (SDGs) target of 70 deaths per 100,000 live births (joghr.org). The SDGs are a collection of 17 interlinked global goals designed to be a "blueprint to achieve a better and more sustainable future for all." They were set in 2015 by the United Nations General Assembly and are intended to be achieved by the year 2030. The target for maternal mortality aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births.

Maternal mortality rates can vary due to different estimation methods, data collection challenges, and the dynamic nature of health crises and interventions. Nigeria continues to face a high burden of maternal mortality, with significant regional disparities. Africa, as a continent, continues to have the highest maternal mortality ratio in the world, accounting for 57% of global maternal deaths (sciencedirect.com). The tragic loss of a mother has enormous consequences, not only for families but also for the broader society (annalsofglobalhealth.org). A woman dies every two minutes due to pregnancy and childbirth complications (bmcpregnancychildbirth.biomedcentral.com). Most of these deaths could be prevented with timely and appropriate care (bmcpregnancychildbirth.biomedcentral.com).

Nigeria's Share of Global Maternal Deaths (2023)

29%
of all maternal deaths worldwide

75,000
estimated women dying in childbirth in one year

1 death
every seven minutes

These figures highlight the severe maternal health crisis in Nigeria. Source: bbc.com

Conflict and Crisis Impact

Conflict and humanitarian crises significantly worsen the maternal health crisis in Nigeria, particularly in the northeast. More than half of maternal deaths globally occur in fragile and humanitarian settings (who.int). Fragile and humanitarian settings refer to areas affected by conflict, violence, or natural disasters, where governance is weak and populations are highly vulnerable. These environments disrupt health systems, displace communities, and limit access to essential services. In Borno State, where Boko Haram militants continue attacks, clinics have been destroyed, doctors are scarce, and many towns have become heavily militarized (africanews.com). Boko Haram is an Islamist terrorist organization based in northeastern Nigeria, known for its extreme violence and abduction of civilians. Their ongoing insurgency has devastated the region, leading to widespread displacement and a collapse of public services, including healthcare.

Women in deep field locations face difficulties accessing reproductive health services because they are either out of reach or located in militarized areas (africanews.com). Reproductive health services encompass a range of healthcare services related to the reproductive system, including prenatal care, childbirth services, postnatal care, family planning, and treatment for reproductive health issues. The International Rescue Committee (IRC) provides free care, including referrals to hospitals in case of emergency, for approximately 150 women each month at their reproductive health clinic in Bakassi (rescue.org). This vital support helps address some of the immediate needs in these challenging environments.

Healthcare Access Challenges

A major contributing factor to maternal deaths in Nigeria is the lack of access to quality healthcare. This includes insufficient facilities, a shortage of trained personnel, and a scarcity of essential medication. Challenges in accessing care include a lack of good hospitals, workers, medication, and doctors (africanews.com). Furthermore, difficulties with transportation, especially at night, pose significant barriers (africanews.com). Delays and challenges in referring patients to higher-level care can significantly impact health outcomes (rescue.org). Obstetric referral is the process of transferring a pregnant woman or a woman in labor from a lower-level health facility or community setting to a higher-level facility with more specialized care. This can potentially decrease neonatal mortality by 18%, stillbirths by 27%, and maternal deaths by 50% (rescue.org).

Poor women in remote areas are the least likely to receive adequate healthcare (who.int). This disparity highlights the impact of socioeconomic factors on health outcomes. While the data focuses heavily on northeast Nigeria, it is important to acknowledge that significant intraregional disparities in maternal and child health interventions exist across Africa (sciencedirect.com). This indicates that issues are not confined to a single region. Africa continues to suffer from the highest rates of child mortality as well as 57% occurrence of maternal deaths, leaving the continent with the highest maternal mortality ratio in the world (sciencedirect.com). This constitutes a global burden that requires urgent attention.

Maternal Mortality Rate: Nigeria vs. SDG Target (2020)

1047

Nigeria (deaths per 100,000 live births)

70

SDG Target (deaths per 100,000 live births)

This visualization compares Nigeria's maternal mortality rate to the Sustainable Development Goals target. Source: joghr.org

Funding Cuts and Dwindling Aid

The maternal health crisis in Nigeria is further exacerbated by funding cuts and dwindling aid. The humanitarian crisis has been worsened by the withdrawal of hundreds of millions of dollars in U.S. foreign aid (africanews.com). In addition, the Nigerian government's decision to slash family planning budgets by 97% in 2025 will have severe consequences (africanews.com). The U.S. government has been involved in supporting global maternal and child health efforts for more than 50 years (kff.org). This support has helped contribute to worldwide success in reducing maternal and child mortality (kff.org). USAID has been a major development partner for Nigeria, with a portfolio of funding and support that addresses critical challenges across various sectors, including health, education, and humanitarian efforts (civichive.org).

The unexpected funding gap from USAID has put a strain on health system infrastructure, including laboratory networks, supply chain systems, and technical support for health systems (civichive.org). Furthermore, the funding freeze jeopardizes the sustainability of long-term projects across key sectors such as maternal and child health, nutrition, HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases (NTDs) (civichive.org). These cuts create significant challenges for maintaining and expanding essential health services, directly impacting the lives of women and children in Nigeria. The reduction in resources means fewer trained healthcare workers, less access to vital medications, and a decline in the overall quality of care available to pregnant women.

Comprehensive Solutions Needed

Addressing maternal mortality requires a multi-faceted approach involving improved healthcare services, community initiatives, and policy-level changes. The focus must be on addressing identified barriers and enhancing facilitators. Key facilitators include improved healthcare understanding and women's self-efficacy at the individual level (BMC Pregnancy and Childbirth). Additionally, family support and positive social influences at the interpersonal level are crucial (BMC Pregnancy and Childbirth).At the health facility level, high-quality services, reliable transportation, compassionate care, and health education are essential (BMC Pregnancy and Childbirth).

Community initiatives, gender equality, and maternity waiting homes at the community level are also important facilitators (BMC Pregnancy and Childbirth). At the policy level, free maternity services and health extension programs can make a significant difference (BMC Pregnancy and Childbirth). Future initiatives should focus on addressing barriers while enhancing facilitators across individual, interpersonal, health facility, community, and policy levels (BMC Pregnancy and Childbirth). This requires woman-centered, evidence-based strategies (BMC Pregnancy and Childbirth).Fostering collaboration among governments, healthcare providers, and communities is essential for improving access to the maternal continuum of care (BMC Pregnancy and Childbirth). Without these concerted efforts, the prospects for safe motherhood in Nigeria, particularly in the conflict-affected northeast, will remain bleak.

Key Facilitators for Maternal Healthcare Improvement

Individual Level: Improved healthcare understanding, women's self-efficacy.

Interpersonal Level: Family support, positive social influences.

Health Facility Level: High-quality services, reliable transportation, compassionate care, health education.

Community Level: Community initiatives, gender equality, maternity waiting homes.

Policy Level: Free maternity services, health extension programs.

These elements are crucial for improving maternal healthcare access and outcomes. Source: bmcpregnancychildbirth.biomedcentral.com

ABOUT THE AUTHOR

Darius Spearman has been a professor of Black Studies at San Diego City College since 2007. He is the author of several books, including Between The Color Lines: A History of African Americans on the California Frontier Through 1890. You can visit Darius online at africanelements.org.