International Journal of Management and Applied Science, ISSN: 2394-7926 Volume-3, Issue-8, Aug.-2017 http://iraj.in MATERNAL MORTALITY IN JIGAWA CENTRAL SENATORIAL DISTRICT: TREND AND CAUSES MUHAMMAD ABDULKADIR School of preliminary studies Sule lamido university, Kafin hausa Email: [email protected] Abstract: The study examines the spatio temporal pattern of maternal deaths in Jigawa Central Senatorial District of Jigawa State, Nigeria. The objectives of the study include: to determinethe temporal trend and spatial pattern of maternal death and maternal mortality ratio and to identify the common cases of maternal deaths. Hospital based data for the period of five years, from 2010 to 2014 were obtained from General Hospitals, Federal Medical Centre Birnin Kudu and Rasheed Shekoni Specialist Hospital Dutse. Descriptive and inferential statistics(X2 and two way Anova) as well as geographical information system were used for the data analysis. The finding shows that the maternal deaths keep on increasing until in 2014 the figure decline. The 861/100,000 was estimated for the whole five periods, 2014 with the 3,654 per 100,000. The MMR computed for the seven LGA in the study area shows that Birnin Kudu has 1,624 deaths per 100,000, Buji LGA with the 213 death per 100,000 and Miga has 94 deaths per 10,000 which is the lowest. The major obstetric causes of maternal deaths are identified to be anaemia, eclampsia, malaria in pregnancy, PPH and retained placenta. Anaemia is the most important common cause of maternal death in the Jigawa central senatorial district. The finding further gives the recommendation: special attention should be given to the leading causes of maternal deaths. There is also need for the government to develop effective programmes of intervention like that of Ambulance services as promised this will reduce the maternal death in the study area. I. INTRODUCTION 1.2 Maternal Health in Nigeria: The Present Position Maternal mortality, also known as maternal death, Nigeria has one of the worst records of maternal continues to be the major cause of death among deaths in the world and this situation is worsening women of reproductive age in many countries and with time. The problem of poor organization and remains a serious public health issue especially in access to maternal health services has always been a developing countries (WHO, 2007). As explained in major challenge in Nigeria. Omo-Aghoja et al (2008) Shah and Say (2007), a maternal death is defined as asserted that maternity care in Nigeria is organized the death of a woman while pregnant or within 42 around three tiers: primary, secondary and tertiary days of termination of pregnancy, irrespective of the care levels. Primary health centres are located in all duration and site of the pregnancy, from any cause the 774 local government councils in the country. related to or aggravated by the pregnancy or its Pregnant women are to receive antenatal care, management but not from accidental or incidental delivery and postnatal care in the primary health causes. Globally, the estimated number of maternal centres nearest to them. In case of complications they deaths worldwide in 2005 was 536,000 up from are referred to secondary care centres, managed by 529,000 in 2000. states, or tertiary centres, managed by the federal government. According to the WHO Factsheet (2008), 1500 women die from pregnancy or pregnancy-related 1.2.2Regional Variations in Maternal Mortality complications every day. Most of these deaths occur Incidence in developing countries, and most are avoidable. Of The overall national maternal mortality statistics is, all the health statistics compiled by the World Health however, insufficient to understand the challenge of Organization, the largest discrepancy between the problem in Nigeria as it masks considerable developed and developing countries occurred in geographical disparity. Among the different areas of maternal mortality. Ujah et al. (2005) noted that while the country, the northern geo-political zones 25 percent of females of reproductive age lived in (comprising of North-West and North-Central zones) developed countries, they contributed only 1 percent have a far higher maternal mortality compared to the to maternal deaths worldwide. A total of 99 percent south The North-west zone which recorded the of all maternal deaths occur in developing countries. highest figure of 1,549/100,000 has almost tentimes More than half of these deaths occur in sub-Saharan the maternal mortality of the south-western zone Africa and one third in South Asia. The maternal (165/100,000). Maternal mortality has a higher mortality ratio in developing countries is 450 incident in rural area (828 deaths per 100,000 live maternal deaths per 100,000 live births versus 9 in births) compared to the urban areas (351 maternal developed countries. deaths per 100,000 live births). Maternal Mortality in Jigawa Central Senatorial District: Trend and Causes 34 International Journal of Management and Applied Science, ISSN: 2394-7926 Volume-3, Issue-8, Aug.-2017 http://iraj.in 1.4 Current Efforts to Reduce Maternal Mortality for the upgrading of obstetric care facilities in in Nigeria hospitals, the recruitment of obstetricians and Although attempts have been made in the past aimed gynaecologists and the provision of ambulances at the at reducing maternal mortality in Nigeria, such local level to transport pregnant women experiencing attempts, especially by the Federal and state delivery complications to health facilities all under a governments, have generally not proved very programme called HAIHUWA LAFIYA (successful successful in achieving the desired results. Some delivery), but still the number of women dying as a promising results however have recently begun to be result of pregnancy related problems is unacceptable. recorded through some policy initiatives by a few 1.6Objective of the Study state governments. In Anambra state, the state house The objective of this study is to: of assembly approved a bill in 2005, guaranteeing i. Examine the temporal trend and the spatial free maternal health services to pregnant women patterns of maternal death and maternal (Shiffman and Okonofua, 2007). The state mortality ratio in the study area between commissioner of health, who is an obstetrician and 2010 and 2014 based on the hospital records. gynaecologist, played a central role in its development and adoption. In Kano state, the state i. Identify the reported cases of obstetric government included in its budget a line item for free complication as well as the obstetric causes maternal health services. The former state of maternal deaths in the study area. commissioner of health together with a senior 1.7. Literature Review obstetrician and gynaecologist, played central roles Different analytical frameworks have been used in in creating this positive environment for maternal studies on maternal mortality. Mojekwu (2005) health. In Jigawa state, state and local budgets have categorized the causes of maternal deaths into provided funds for the upgrading of obstetric care medical factors, health factors, reproductive factors, facilities in hospitals, the recruitment of obstetricians unwanted pregnancy and socioeconomic factors. Ibe and gynaecologists and the provision of ambulances (2008) employed a multistage sampling technique at the local level to transport pregnant women while Okaro et al. (2001) carried out retrospective experiencing delivery complications to health comparative analysis of maternal deaths for two ten- facilities. The former executive secretary for primary year periods. health care, who subsequently became state The main finding of the study was that since the commissioner for health, stood behind these launching of the Safe Motherhood Initiative, maternal initiatives. mortality ratio increased five-fold as a result of 1.5 Statement of the Problem institutional delays and deterioration in the living Past efforts to reduce maternal mortality ratio in standards of Nigerians. During the period under Nigeria were concentrated on making direct review, the health sector, like all other sectors, improvements to the health system. These efforts suffered from underfunding, industrial unrest, have not involved enough resources to successfully inconsistent policies, and mass exodus of health care reduce maternal mortality in the country. personnel from the public sector to either the private According to (Jigawa State Health Strategic Planning, sector or foreign countries. Liljestrand and 2010) Jigawa state has unacceptably high mortality Pathmanathan (2004) presented a model to guide rates and burden of diseases profile. The 2008 analyses of national health systems based on evidence Multiple Indicators Cluster Survey (MICS) and from case studies from Sri Lanka and Malaysia and National Demographic and Health Survey (NDHS) seven other developing countries. The study largely show the following rates: confirms recent recommendations of the major a. Infant Mortality Rate: 101/1000 live births multilateral agencies that improvement of maternal b. Under 5 Mortality Rate: 166/1000 live births health standards requires focused prioritization, c. Maternal Mortality Ratio: 2000/100,000 planning and implementation over many years. The live births study found no visible progress in maternal mortality Jigawa State is one of the States with poor health reduction at the global level. Ibe (2008) conducted a indices in Nigeria. The benchmarking exercise study in Anambra