Maternal deaths in Nigeria have been described in many quarters as unacceptably high. As Nigerians celebrate the World Population Day, UZOAMAKA AJAH and ABIGAIL KUSIMO examine the relationship between access to reproductive health in Nigeria and healthy population.
Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of reproductive diseases or infirmity. It deals with the reproductive processes, functions and system at all stages of life.
According to the International Conference on Population and Development Programme, reproduction health implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when, and ho3w often to do so.
The above assumption is a condition that can only be achieved if the women are informed and have access to safe, effective, affordable and acceptable methods of family planning and other reproductive services of their choice to regulate fertility which are not against the law and the right to access appropriate health care services that will enable them go safely through pregnancy and child birth.
A healthy population is dependent on impeded access to reproductive health facilities. That is why this year’s World Population Day focused on granting universal access to individuals that need reproductive health services.
Marking the World Population Day on July 11, the Secretary-General of United Nations (UN), Ban Ki-moon, called for global efforts to help those in need of reproductive health services by bridging the gap between demand and supply of reproductive healthcare services.
Studies have shown that those in dire need of reproductive health care are mostly women of reproductive age (15 to 44).? This was recognised by Nigerian-born Executive Director of the UN Population Fund (UNFPA), Babatunde Osotimehin, in his message for the Population Day. Osotimehin said: “Working for the survival and the well-being of women and girls is a human right imperative. And in order to take advantage of women’s full potential in the development of their nations, they must be able to plan their lives and families.”
Lack of access to reproductive health services has been a major issue in managing population and preventing maternal deaths.
According to UNFPA, reproductive health problems remain the leading cause of ill-health and death for women of childbearing age worldwide. Some 222 million women who would like to avoid or delay pregnancy lack access to effective family planning, while nearly 800 women die every day during birth.
Osotimehin said meeting the needs of those 222 million women would help prevent 21 million unplanned births, and help prevent 79,000 maternal deaths and 1.1 million infant deaths. This would definitely lead to a controlled population that governments can cater for.
A recent United Nations report called “Trends in Maternal Mortality”1990 to 2010 showed that 14 per cent of the world’s maternal deaths are in Nigeria. This leaves Nigeria with about 10, 000 maternal deaths a year. The nexus between reproductive health services and maternal deaths is clear. When women have access to reproductive health services, there is a steep reduction in maternal deaths and a rise in the health of the populace.
Miss Ngozi Echeoke a nurse and midwife with the University of Benin Teaching Hospital (UBTH) said that most of the maternal mortality cases in Nigeria results from the many reproductive challenges faced by women of reproductive age.
She itemised these challenges to include female genital mutilation, infertility, gender inequality as most parents prefer to educate the male child to the female child there by denying her a quality education that will prepare her to face and tackle her reproductive health problem as it takes as informed mind to know what family planning and contraceptives are.??
Similarly, Advocacy Nigeria, a nongovernmental organisation that focuses on reproductive health, agreed that maternal mortality is the single most important health issue facing obstetricians and gynaecologist in Nigeria. It traced Nigeria’s high maternal mortality rate to poor reproductive health system which ignores the needs of women of reproductive age. It admitted that reasons for the poor reproductive health system in Nigeria are complex but can be reduced to indifference shown by national policy makers on reproductive health, weak health care and service delivery system, inability to put reproductive health at the core of health development, poor leadership at all levels of governance, unacceptable poverty levels, condition of living and quality of life of the majority poor, poor implementation of signed conventions due to cultural and religious prejudices and general ignorance on reproductive health issues and their impact on development.
Of all these challenges, the apathy of political leaders over reproductive health issues remains the most perplexing. Little or no monetary budget is made for reproductive health services at all levels of government. To many health analysts, it benumbs the mind that a country with the highest mortality rate in the world virtually invests nothing in reproductive health services. Advocacy Nigeria captures it thus: “What is now needed is the political will, monetary and human resources to make basic health services available so that women can have children without fear of death.”
On the way out, UNFPA said that the strategy for preventing maternal mortality should include family planning to reduce unintended pregnancies, skilled care at births, and timely emergency obstetric care for all women who develop complication.
When women have access to family planning methods, they can choose when and how to have children. The methods available are varied, thus each woman can choose which method is best suited for her health, family and religious needs. Safe pregnancy begins with planning. To plan, a woman must know the options available to her and her family.?
The 2008 edition of the Nigerian Demographic and Health Survey (NDHS) shows that only 9.7 per cent of married women use a modern method of contraception, while 20 per cent of women have an unmet need for family planning services. With access to information on methods to delay and space births, family planning unmet needs tend to rise as more women want to use contraception.
Since the early 1990s, the international community has recognized that sound population and development policies depend on improving the status of women and protecting their rights by increasing their access to quality and safe reproductive health services. As a result, there is a general international agreement that the provision of universal education, especially for girls and women; ensure women’s and men’s access to reproductive health care; and empower women through equitable social and economic development are national goals worth pursuing. Women and men should be unencumbered in deciding the number and spacing of their children. They also should have access to reproductive health information, options and services that allow them to attain good health.
Achieving these goals will help create an environment in which Nigerian women can to contribute fully to national development. No nation has ever attained economic and political greatness when half of its population are not properly catered for.
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