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A FIVE–YEAR REVIEW OF MATERNAL MORTALITY AT THE FEDERAL TEACHING HOSPITAL, ABAKALIKI, EBONYI STATE.

CHAPTER ONE

 INTRODUCTION 
 Background to the Study
 Maternal mortality remains a major challenge to health systems worldwide (Margaret, Moshen et al; 2010). Of the eight United Nations Millennium Development Goals (MDGs), that of reducing maternal mortality (5th MDG) remains the furthest from reaching its target (MDG report, 2011; Lozano, Wang, et al; 2011). Maternal death is a tragedy for the woman, the child, the families and the communities. The tragedy is that these deaths are largely preventable. Worldwide, maternal mortality is the health index that shows the greatest disparity between developing and developed countries (Fathalla, 2006: Neilson, 2005). It is an important indicator of women’s health, social and economic status in both developing and developed countries. It is also an indicator of an access to antenatal care and delivery services, and of the quality of these health care systems overall (Fathalla, 2006: Hoj, Dasilva, et al., 2003). Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth (WHO/UNICEF, 2007). Of these, an estimated 98% occurred in developing countries (WHO/UNICEF, 2007). These high figures occurred despite the Safe Motherhood Initiative (SMI) launched in Kenya in 1987 and Nigeria in 1990, aimed at reducing maternal mortality in Africa. An estimated 289,000 women suffered maternal mortality in 2013 (Anne, 2014). This represents a fall of 45% since 1990 where there were 529,000 deaths annually (WHO/UNICEF, 2007). This decline was mainly observed in developed countries. Nearly a third of deaths occurred just in two countries: India with 17% (50,000 deaths in 2013) and Nigeria with 17% (40, 000) of maternal deaths (Anne, 2014; WHO/UNICEF/UNFPA, 2014). Sub-Saharan Africa is the region with the highest MMR (510 maternal deaths per 100,000 live births) accounting for 62% (179,000) of global maternal deaths (Anne, 2014, WHO/UNICEF/UNFPA, 2014), whereas it accounts for only 10% of all women of reproductive age (15 – 49 years) in the world. South Asia and sub-Saharan Africa together accounted for 86% of maternal deaths globally, though they accounted for 22% of all women of reproductive age. These figures when compared with MMR of 9/100,000 and the life time risk of maternal deaths of I in 7300 for the developed regions indicate that pregnancy related deaths in Sub-Saharan Africa is exceedingly high (WHO UNICEF, UNFPA 2007). The cumulative lifetime risk of maternal death is 332 times higher for women in Sub-Saharan Africa (where lifetime risk of maternal death is 1:22) compared to the developed regions (7300/22=332). Perhaps, there is no other health indicator that shows such a high degree of inequality. In additions for every maternal death, there are at least 30 women who suffer short or long-term disabilities (genital fistula, genital prolapsed, infertility, anemia, chronic pelvic pain). Hence, motherhood can be considered one of the most dangerous occupation (or business) especially in Sub-Saharan Africa, Nigeria inclusive. Nigeria still has one of the highest maternal mortality ratio (MMR) in the world currently accounting for about 12 – 17% of global maternal deaths as compared with her 2% contribution to global population (WHO/UNICEF/UNFPA,2014). In 2013, about 40,000 maternal deaths occurred in Nigeria and this figure is second only to India which recorded 50,000 deaths (WHO/UNICEF/UNFPA, 2014). A global analysis of maternal mortality by the WHO showed a MMR of 11 per 100,000 live births for North America and 17 per 100, 000 live births for Europe (WHO, 2005). In developing countries, the figures are higher, influenced perhaps by the quality of obstetric care in the countries. In Cuba, India and Egypt, the MMRs were 45 per 100,000, 450 per 100,000 and 130, per 100,000 live births respectively (WHO, 2005). In Sub-Saharan Africa, the figures ranged from 650 per 100,000 for Ghana and 950 per 100,000 for Burundi (WHO, 2005).

Project detailsContents
 
Number of Pages54 pages
Chapter one Introduction
Chapter two Literature review
Chapter three  methodology
Chapter  four  Data analysis
Chapter  five Summary,discussion & recommendations
ReferenceReference
QuestionnaireQuestionnaire
AppendixAppendix
Chapter summary1 to 5 chapters
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