MATERNAL HEALTH CARE DELIVERY IN NORTHERN NIGERIA: AN ASSESSMENT OF ROTARY INTERNATIONAL’S INTERVENTION PROGRAMME (2000-2007)

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CHAPTER ONE

INTRODUCTION

1.1        Background to the Study

Maternal Mortality or maternal death is defined as “the death of a woman while pregnant, or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to, aggravated by the pregnancy or its management, but not from accidental cause” (WHO, 1993).

The death of a mother is more than a personal tragedy; it represents an enormous cost to her nation, her community and her family. When a mother dies, her children lose their primary care giver, communities are denied her paid and unpaid labour and countries forego her contributions to economic and social development (Fathala, 1992).

An estimated 585,000 (over half million) mothers die each year from causes related to childbirth, ninety-nine percent (99%) of these in developing countries (Maine, 1987). In Nigeria, 1 in every 13 women face a lifetime risk of maternal death. Yet, most maternal deaths are preventable mainly through medical intervention and political will by the government (Shiffman and Okonofua, 2007).

Maternal mortality has received global attention. The reduction of maternal mortality is one of the Millennium Development Goals (MDGs), specifically, it is number five (5th MDGs) of the MDGs. The target is to reduce it by 75% by the year 2015. The state of maternal and child health is one of the indicators of a society’s level of development, as well as an indicator of performance of the health care delivery system.

According to Goulet (1992:470), development is “a two-edged sword which brings benefits but also produces losses, and generates value conflicts. One of the benefits is the improvement in maternal well-being. But the gains or benefits of development will be felt differently according to factors such as: ‘who are you’ and ‘where you live’, among others” (Turner and Hume, 1997: 10). Development administration was created in the post-war period to play a major role in facilitating development through a system of bureaucracy. Bureaucracy has however been found to be affected by a number of issues such as: size of bureaucracy, poor administrative capacity, a nation’s culture, bureaucratic bias against the rural poor, corruption, and issues of gender, to mention a few. Maternal mortality is certainly a gender issue. Awareness to gender issues were brought to the fore in 1981, when the then UN Assistant Secretary General stated that women would not make full contribution to development ‘until there were more women involved in the planning process, in the administration at all levels, and in all sectors’. And that this would increase women’s participation in decision-making in public bureaucracies leading to “increase in overall productivity, to increase in public sector responsiveness to women’s needs…” (Turner and Hume, 1997:97).

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MATERNAL HEALTH CARE DELIVERY IN NORTHERN NIGERIA: AN ASSESSMENT OF ROTARY INTERNATIONAL’S INTERVENTION PROGRAMME (2000-2007)