Factors Responsible for High Infant and Maternal Mortality in Nigeria; A Case Study of Abakaliki, Ebonyi State.
High infant and maternal mortality death is a tragedy, many children are rendered motherless, such children are deprived of maternal care which goes a long way to affect adversely both their physiological and psychological development. Equally, many mothers are rendered childless. The majority of these pitiable situations are due to infant and maternal mortality.
Procter (1996) defined infant and maternal morality as the death of a child or mothers caused by diseases and other conditions related to pregnancy and childbirth. Therefore, infant and maternal mortality is the death of mother or child caused by diseases and other condition related to pregnancy, labour and childbirth.
The international federation of gynecologist and obstetricians (1979) defined child and maternal death as one occurring during pregnancy or labour as a consequence of pregnancy within forty two (42) days after delivery or abortion. The World Health Organization (WHO, 1998) estimated that 585,000 women die every year from pregnancy related causes, a rate of 430 deaths per 100,000 life birth. This maternal death due to associated causes and maternal condition (pregnancy) is regarded as secondary causes of death. For example, it is well know that cardiac diseases may be aggravated by pregnancy and a pregnant patient who has cardiac disease and dies, will be grouped them under associated causes (Brown and beneath, 1999). And maternal mortality rate is the number of infant or maternal deaths due to pregnancy and child bearing one thousand (1000) registered live and still births.
Nigeria has one of the highest maternal and infant mortality rates in the world and this necessitated the greater attention given to Maternal and Child Health (MCH) services in the country’s Bamako Initiative (BI) programme. MCH consumers, who are often poor, are also at extraordinary risk of receiving poor or no health care. Nigeria’s infant mortality rate is about 96 per thousand live birth in rural area against 75 per a thousand live birth in urban area (East African Medical Journal, 2004).
Infant mortality (death of children under one year) and under-five mortality are 100 and 210 per 1000 live birth respectively and these deaths are from preventable causes such as malaria (24%) pneumonia (20%), diarrhea (16%), measles (6%) and HIV/AIDS account for more than 71% of the estimated one million under 5 death in Nigeria in 2004 (FMOTT, 2007).
Some of the contributory factors to infant mortality in Nigeria include malnutrition, poor environmental hygiene, low access and utilization of quality health care services by women and children other include but not limited to low female literacy level, poor family health care practices, lack of access so safe water.
Tindall (1997) defined maternal mortality as death due to pregnancy or childbearing, the commonest causes of which are hypertensive and hemorrhagic disorders. Infant and maternal mortality is an important indicator of the standard of health care of different communities (Brown & Benneth 1999).
Although pregnancy is a physiological phenomenon, pregnant women commonly experience physiological and psychological changes. Pregnancy may be accompanied by complication that could be of fatal consequences, pregnant women are thus prone to risk, it follows therefore, that the care of a pregnant women deserves the highest priority in every community especially Abakaliki metropolis where the present sturdy is to be conducted.
Infant and maternal mortality has implication not only to the family and community but also to the nation at large. With high accidence of infant and maternal mortality, a nation is regarded as a developing country. A study carried by Waboso (1993) shows that every year hundreds and thousands of Nigerians children and women die from complication of pregnancy, childbearing and puerperium be it directly or indirectly.
It is obvious that some women are more liable to maternal mortality than others in Nigeria. The women who are rural dwellers are less privileged and thus are more liable to maternal mortality. There liability could be as the result of the following; medical factors; some of the direct medical causes of maternal mortality include, hemorrhage or bleeding, infection, unsafe abortion, hypertensive disorders and obstructed labour, social-cultural factors that relate to low status of women (gender disparity in education, access to productive resources etc) poverty harmful traditional practices and other factors that act as barriers to utilization of available health service have influenced the maternal mortality rate. Health service causes lack of access to essential obstetric care, lack of access to family planning counseling and service, lack of drugs, equipment, essential materials, instruments, consumable etc in hospital.
Neonatal death (death of infant within the first 28 days of life) in Nigeria is 48 per 1000 live births (NDHS, 2003) and almost half of infant death per annum results from poor maternal health and poor care at time of delivery. The major causes of these deaths are asphyxia, preterm, sepsis, neonatal tetanus, congenital conditions, diarrhea and others.
Nigeria is also working towards the improvement of maternal and child health through the primary health care component of maternal and child health. The objective of these maternal and child health services are to ensure that as far as possible women remain healthy throughout pregnancy, that they have healthy babies and recover fully from the effects of pregnancy, the objectives also include detecting mothers at risk and giving prompt treatment to them during complicated pregnancy, labour and puorpenum (Gilles & Lucas, 2004).
This research study focuses on factors responsible for high infant and maternal mortality rate in Abakaliki urban. The cause of infant and maternal mortality is an outcome of nexus of interaction of a variety of factor namely the distant factors (socio-economic, cultural) which act through the proximate or intermediate factor (health and reproductive behavior, access to health services) and in turn influences outcome (pregnancy complication, mortality) Campbell and Graham (1990). The socio-economic and cultural factors for example the issue of women right especially the reproductive and sexual rights, female education, employment and empowerment, gender inequality, both the distant and the proximate factors operate together to impact mortality rather than a unidirectional causality. These factors were included in the present study in order to give direction for the study.
Abakaliki metropolis is an urban community in Abakaliki local government area of Ebonyi State. The people living in the community are mainly migrants from far and near communities, some are traders and most, people living in the metropolis are civil servants, majority of the inhabitants are educated, their level of education would provide basis for difference imperceptions regarding infant and maternal morality.
Infant and maternal mortality is a major health problem all over the world. According to World Health Organization (WHO), more than one woman, die every minute from pregnancy and child birth, about 585,000 die every year. Abakaliki metropolis is not an exception and the rate of children and women that die of pregnancy and child birth in the area is not known, that necessitated this study.
Statement of the Problem
For any country who wants to achieve the objective of the World Health Organization (WHO), that is, reduction on the risk associated with child birth and childbearing, such country must equip all the health care services in her country. This work tends to emphasis on the factors responsible for high infant and maternal mortality rate in Abakaliki urban, Ebonyi State. Despite the fact that the establishment of the institution of safe motherhood initiative in the health sector, maternal mortality was still very high, ignoring the main aim of safe motherhood initiative. Mothers in Abakaliki metropolis are involved and their range is not known.
The factors influencing maternal mortality are outlined as follows:
- Traditional belief
- Accessibility to hospitals
- Carelessness by the obstetricians. Maternal mortality rate is influenced by the above factors in Abakaliki local government area that necessitated this study.
In order to get data for this study, the following research questions were posed;
v Can poverty contribute to the increase of high infant and maternal mortality rate?
v Can poor health care faculties contribute to the increase on high infant and maternal mortality?
v Can unskilled health care personal contribute to the increase of high rate of infant and maternal mortality?
v Can socio-economic status contribute to the high rate of infant and maternal mortality?
For the purpose of the research study, the following hypothesis is formulated;
v Poverty can not necessary affect the increase in infant and maternal mortality rate.
v Poor health care can not necessary affect the increase on high infant and maternal mortality?
v Relationship between poor roads and unskilled health care personal can not necessary affect the increase in high rate in infant and maternal mortality.
v Socio-economic and cultural factors can not necessary affect the increase in high rate of infant and maternal mortality.
Delimitation of the Study
This research study is limited to only Nurses, obstetricians, Gynaecologists and pregnant mothers in Abakaliki urban in Ebonyi State. The researcher will not promise to research in all its ramifications, factors responsible for high infant and maternal mortality rate as a whole but will be restricted.
Limitation of the Study
In the course of carrying out this research work. There are some limitation constraint to the scope of this research work, which include;
v Time constraints; the time given for this study did not allow for detailed investigation into factors responsible for high infant and maternal mortality rate.
Significance of the Study
This research study is significant for many reasons. It provides information on the factors responsible for high infant and maternal mortality rate in Abakaliki urban in EBonyi State. The data collected will be useful both to the government and health personnel’s and equally useful to the expectant mothers.
Definition of terms
HOSPITAL: Hospital is a place or building where people who are ill/sick or injured are giving medical treatment and care.
PRIMARY HEALTH CARE: primary health care is the medical treatment one received first when sick.
PREGNACY: pregnancy is a period where a woman is having a baby developing inside her.
MATERNAL MORTALITY: is the death of a woman during or after delivery.
INFANT MORTALITY: is the death of a child during or after delivery.
NURSE: a nurse is a person whose job it is to take care of sick or injured people, usually in a hospital.
DOCTOR: A doctor is a person who has been trained in medical science, whose job it is to treats people who are ill or injured.
REVIEW OF RELATED LITERATURE
Studies have been reported in different part of the world and in some parts of Nigeria regarding to factor responsible for high infant and maternal mortality. However, literature related to the study is hereby presented under the following headings;
v Concept of infant and maternal mortality
v Infant and maternal mortality trend in developed/ developing countries.
v Causes and risk factors of infant and maternal mortality.
v Previous studies on maternal and infant mortality.
v Summary of literature
Concept of infant and maternal mortality
Maternal mortality rate for any year is the number of death attributed to pregnancy and child bearing per 1000 registered total births, (Benneth and Brown, 1999). Maternal death occurring more than 42 days after pregnancy or childbirth are no longer included in the figure, this is in line with the international definition of maternal death, which states that maternal death is the one occurring during pregnancy or labour or as a consequence of pregnancy within 42days after delivery or abortion.
The international classification of diseases, injuries and caused of death (ICD, 1994) defined a maternal death as the death of a woman within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. This definition is in accordance with the definition adapted by the international federation of Gynaecology and obstetrics. Child bearing kills so many women in the developing world of which Nigeria is one. In many developing countries, complication of pregnancy and childbirth are leading causes of death among women of reproductive age. According to WHO (1996) more than one women died every minutes from such cause, and 585,000 women die every year from the causes, less than one percent of thee deaths occur in developed countries demonstrating that they could be avoided in developing countries, Nigeria, if resources and services are available.
Davies (2005) stated that maternal mortality is a measure of the risk to the mother connected with childbirth. Maternal deaths are only counted if they are directly related to pregnancy. Or example, death from renal failure, which had commenced with a severe toxaemia of pregnancy and pyeblonephritis, would be counted as a maternal death even if the woman died years later. However, deaths from completely unrelated cause, such as road accident, medical or surgical emergency, would not be counted as maternal death even if it took place during pregnancy. Thus maternal deaths due to associated cause are recorded where death I due to a disease (e.g. cardiax disease, pulmonary tuberculosis, malaria, pyelonephriti, raised blood pressure and diabetes mellitus) and a maternal condition (e.g. pregnancy) I given as a secondary cause of death. It is well known (Benneth and Brown, 1999) in the medical profession that cardiac disease may be aggravated by pregnancy.
Neonatal death (death of infants within the first 28 days of life) in Nigeria is 48 per 1000 live birth (NDHS, 200) and almost half of infant death per annum results from poor maternal health and poor care at time of delivery (compass project: making motherhood safe in Nigeria). According to the National Demographic health survey 200, the highest neonatal rates were recorded in the North-East and North-West zones while the lowest rates (34 per 1000) were seen in the South-East zone. Most of these deaths occur in the first week of life and it is a reflection of the link with quality of maternal care (FMDH, 2007). About 5.3 million children are born annually in Nigeria, that is, 11,000 per day. One million of these children die before the age of five (5). Nigeria’s children new born death rate (28 per day) is one of the highest in the world.
Infant and Maternal Mortality Trend in Developed/ Developing Counties
The 2006 census estimated that there are about 65 million females in Nigeria out of which 30 million are of reproductive age (15-49 years). Each year about 6 million women become pregnant, 5 million of these pregnancies result in child birth (WHO, UNICEF, UNFPA, 2007). Available data indicate that 59,000 women die yearly as a result of complications in child birth (WHO, 2007). A Nigeria woman is 500 times more likely to die in childbirth than European counterpart. Mortality ratio is about 800-1,500 per 100,000 live births (NDHS, 2003) with marked variation between geo-political zones- 165 in South west compares with 1549 in the North-east and between urban and rural area (NPC, 2008) and the second number of absolute maternal deaths, only outranked by India in the world (NARHS, 2005). More disturbing is the SOGON study that revealed a maternal mortality of 3,380 in Lagos state 783 in Enugu, 2977 in Cross River state, 846 in Pleateau state, 727 in Borno state and 7523 in Kano state indicating very serious health system failure. One in 20 Nigerian women died of pregnancy delivery related causes (Advocacy Brief, 2007) compares to 29,800 for Sweden and Finland. Thus for all human development indictor, maternal mortality ratios show the greatest disparity between developed and developing countries. These deaths are largely preventable. Equally of concern is that yearly, about 1,080,000-1,620,000 Nigerian women and girls will suffer disabilities caused by complication during pregnancy and child birth (Hill, world law, 2001).
For every one that dies 20-30 more suffer long term and short term disabilities such as chronic anawmia maternal exhaustion or physical weakness vesico-vaginal or Rector-vaginal fistula, stress incontinence, chronic pelvic pain, PID infertility Ectopic pregnancy and Emotional Depression. The UNFPA estimates that 2 million women suffer vesico vaginal fistulae globally, 40% of these (800,000) women are in Nigeria, majority due to prolonged obstructed labour that often terminate in still birth or neonatal death (UNFPA, 2003). Child survival is equally affected too as the chances of survival of a child in the absence of his or her mother is greatly reduced. In Nigeria, 340,000 infant die annually during delivery and shortly after delivery especially if the mother dies in child birth. These deaths are not unconnected with the poor maternal death services in the country and could be avoided through provision of quality and effective maternal and child health service.
Causes and risk factors of infant and maternal mortality
The cause of maternal mortality is an outcome of nexus interaction of a variety of factors namely-the distant factors (socio-economic, cultural) which act through the proximate or intermediate factors (health and reproductive behavior, access to health services) and in turn influence outcome (pregnancy complication mortality). Campbell and Graham (1990). This follows other models which have their basis on the premise that social and economic determinants of mortality operate through a common set of biological mechanism and proximate, determinants to exert an impact on mortality (Campbell and Graham, 1991). The health behavior are action that people do or do not take for their health, e.g attending antenatal care or seeking help when complications arise. Reproductive behavior includes issues like age, birth spacing, wontedness of pregnancy e.t.c. access to health services is a concept raging from whether adequate facilities exits (adequate supplies, personnel, good quality of care) and if people can reach the service provided (cost, distance information.)
Some of the direct, medical causes of maternal mortality include-hemorrhage or bleeding, (23%) sepsi (17%) unsafe abortion (11%) hypertensive disorder, and obstructed labour (11%) other causes include ectopic pregnancy, embolism and anesthesia related risks (WHO, 2001, Ogunkelu B. 2002). Condition such as anemia (11%), diabetes, malaria (11%), sexually transmitted infections (STTS) including HIV/AIDS and others can also increase a woman risk for complication during pregnancy and childbirth, and thus, are indirect causes of maternal mortality and morbidity.
Lack of access to essential obstetric care, lack of access to family planning (FP) counseling and service, lack of drugs, equipment, essential materials, instruments, consumables e.c.t in hospital, non-availability of health workers on essential duties, deficient transportation, communication and utility (power, water etc) facilities all contribute to increased maternal mortality in Nigeria. Most maternal deaths occurs during delivery and during the postpartum period.
Reproductive health causes, a number of studies have shown that certain groups of women are at increased risk of maternal mortality. They include, too young (<18years), 7oo old (>35years), Too many (having 5 or more delivery) Too frequent (having spacing of their deliveries less than 2 years apart) and Too sick (pregnancies contraindicated or at very high risk of life). Other contributory factors include; unsafe abortion-610,000 per year High prevalence of malaria, high rate of malnutrition 16%, HIV/AIDS pandemic 5.4%-90%.
Social-cultural factors that relate to low status of women (gender disparity in education, access to productive resources e.t.c) poverty harmful traditional practices other factors that act as barrier to utilization of available health service have influence the maternal mortality rate in Nigeria.
Maternal death without doubts is associated with considerable grief and depression. It also directly affects child survival as it increases the chances of newborn death by 2-4 times. The loss of woman in the prime and productive part of her life also adversely affect family income and increase the social economic burden on the man and children. Indeed, women’s economic contribution is essential to reducing poverty in Nigeria, and projected losses from maternal mortality death on the national economy over a 10 year period (2001-2010) are estimated at about 38 billion naira (Reduce, 2003)
Previous Studies on Maternal and Infant Mortality
Studies have been carried out in many countries on maternal and infant mortality; such studies either reveal the causes, risk factors, or effects of infant and maternal morality. In some other studies, the rates of infant and maternal mortality in different countries were revealed.
The Nigeria multiple indicator cluster survey 2007 (MIC, NBS UNICEF) reports that some progress have been made, despite the economic and political climate. For example, the infant mortality rate was 86 while the under five morality rate was 138 compared with 191 in 2006. The Nigeria male child has greater probability of dying as an infant or as under five than his female counterpart, 92 versus 79 per 1000 at infant and 44 versus 131 per 1000 live births at under five, respectively. Infant morality decreased from rural to urban sector of the population (94 to 62 per 1000) from the non educated to secondary school or higher educated mother 94 to 63 per 1000 from the richest to the poorest household (101 to 54 per 1000).
There is considerably geographical zonal disparity in infant mortality rates from 86 per 1000 in the North-West.
Child Mortality Rate, Nigeria 2007
|INFANT MORTALITY RATE
|LENDER FIVE MORTALITY RATE
The prevention of maternal mortality network identified social distance as a barrier to access services for many respondents interview in rural communities “social distance” is described by the study as consisting of differences in languages behavior and expectation between the customer of health care and its providers.
In the year 2000, Nigeria and other members of the United Nation agreed on a number of Millennium Development Goals (MDG) to improve the welfare of the people in their countries in the 21st century. Two of the health related goals concern reducing death among children under 5 years old by two-third (MDG 4 i.e. reduction from 230-77 per 100,000 live births) and reducing maternal death by three-quarter (MDG) by the year 2015, when compared with the 1990 figures (from 1000/100,000 live births to 250). Mid way to 2015, Nigeria still records a rather appalling maternal and infant mortality rates compared with other developed countries.
MDGs Maternal Mortality Rate 2008 Report UNICEF
Maternal Mortality Ratio (2005)
Lifetime risk of maternal death
Studies conducted by Mohammed and SFCA (2000) under the auspices of World Health Organization. The objective of the study was the review evidence on the levels of maternal mortality according to different estimation technique. The WHO “maternal mortality and morbidity review database” was search for in the article of 1988. Studies were selected according to their methodological quality and included its reported maternal death with reported sample size of 200 and above. From the results most of the studies indicated an underestimation in maternal mortality compared with their findings. The methods for data collection were either direct (vital registration system) or by using special surveys (indirect sisterhood methods). The review revealed that there was an increase in maternal mortality in some regions, while there was marked reductions in others. The leading causes of maternal deaths were preedampsia/eclampsia, sepsis, pulmonary embolism and abortion related complications (WHO, UNICEF and World Bank Statement, 1999).
Summary of Literature
The magnitude of maternal and infant mortality is perhaps the greater social injustice of our time. Children and mothers are dying because those who have the power to prevent their deaths choose not to act. Our inability to act positively is but a symptom, of a larger social injustice of discrimination against women and denial of women’s human rights. This indifference by politicians, policy makers, researchers and civil society is a betrayal of our collective hope for a stronger and more just society, one that value every life no matter how young or hidden from public view that life might be. As health professionals, we should not accept this pervasive disrespect for human life. No woman should die in the process of giving us life. We have voice, platform and a constituency that should be an instrument for radical change.
Maternal and infant mortality rate are indicators for measuring development of any country, hence, maternal health is a national priority in combating extreme poverty and hunger (MDGs).
Methods and procedures
This chapter will be discussed under the following headings:
Research design, population, Sample and Sampling techniques, Instrument for data collection, Reliability and Validity of instrument, Procedure for data collection and procedure for data analysis
This survey design will be used for the study. The survey research design was considered appropriate because Nworgu (1991) opined that the cross-sectional survey is used for a group of people or items analyzing data from only a few people or items is considered to be representative of the entire group. Mohammed (2000) successfully used the design in carrying out a similar study in Sudan.
The population for the study comprised all childbearing mothers in Abakaliki Local Government Area, who attended antenatal, postnatal and infant welfare in some hospital and health centers in the metropolis. Equally the population of the study extended the nurses mothers, pediatrician and gynecologist.
Sample and sampling technique
The simple random sampling technique of balloting without replacement was utilized to draw the sample in which ten hospitals were selected. The respondent consisted of 120 mothers of whom 12 were selected from each hospital/ mortality home.
Instrument for data collection
The instrument for data collection was a literature-based questionnaire. The investigation taking cognizance of the purpose of the study developed the questionnaire. The question consists of seven items, which sought to determine the factors responsible for high infant and maternal mortality rate in Abakaliki metropolis.
Validity and Reliability of the Research Instrument
In order to ensure content and face validity of the instrument, the researcher submitted the draft copy of the questionnaire to three other lectures in the department of Human Kinetics and Health Education, Ebonyi State University, Abakaliki, who have expert knowledge of survey research design. They were requested to criticize the items in terms of charity and adequacy in content to meet the objectives of the study, based on their corrections and suggestion and with the approval of the supervisor the final copy was produce.
Before the full study for this research work was conducted, a pilot study was carried out in Ebonyi State University Teaching hospital, Abakaliki. The result of the study made it possible for the full study to be conducted.
Procedure for Data Collection
In order to gain access to the respondents, a letter of introduction from the supervisor was presented to the health officers in charge of the hospital/maternity homes. The respective officers introduced the investigator to the mothers. The investigator with friends help distributed one hundred and twenty copies of the questionnaire, the investigator then helped the illiterate mothers to fill out the questionnaires. The filled out questionnaires where collected at the spot by the investigator.
Procedure for Data Analysis
The returned copies were examined as copies were found usable giving a working rate of 79.1%. These copies were used for analysis of the data. The data collected were tabulated and put into frequency distribution tables. The frequencies were converted into percentages and these were used to answer the research questions posed in the study.
Result, Analysis and Discussion of Findings
This chapter is devoted to the presentation of result, analysis and discussion of findings.
The results are hereby presented in table according to the research questions, which guided the study.
Research Question 1
Can poverty contribute to the increase of high infant and maternal mortality rate? The data for the above question are contained in table 3.
Can poverty contribute to the increase of high infant and maternal mortality rate (n=95)
On this questionnaire item, 86 person of 90.5% strongly Agree that poverty contribute to the increase of high infant and maternal mortality, 9 respondent or 9.5% Agree on the same issue, 0 respondent or 0% Disagree and 0 respondent or 0% strongly Disagreed that poverty contribute to the increase of the increase of high infant maternal mortality rate.
Research Question 2
Can poor health care facilities contribute to the increase on high infant and maternal mortality rate? The data for the above question are contained in table 4.
Can poor health care facilities contribute to the increase on high infant and maternal mortality rate. (n=95)
On this questionnaire item 78 respondents or 82.1% strongly Agree that poor health care facilities contribute to the increase on high infant and maternal mortality rate, 12 respondents or 12.6% Agree on the same issue, 3 respondent or 3.2% disagreed and 2 respondent or 2.1% strongly Disagree that poor health care facilities contribute to the increase on high infant and maternal mortality rate.
Research Questions 3
Can relationship between poor roads and unskilled health care personnel contribute to the increase on high rate of infant and maternal morality? The data for the above question are contained in table 5
Can relationship between poor roads and unskilled health care personnel contribute to the increase on high rate of infant and maternal mortality? (n=95)
On this questionnaire item, 73 respondent or 76.8% strongly Agree that relationship between poor roads and unskilled health care personnel contribute to the increase in high rate of infant and maternal mortality, 15 respondent or 15.8% Agree on the same issue, 5 respondent or 5.3% disagreed and 2 respondent or 2.1% strongly Disagree with same issue.
Research Question 4
Can socio-economic and cultural factors contribute to the high rate of infant and maternal mortality? The data for the above question are contained in table 6:
Can socio-economic and cultural factor contribute to the high rate of infant and maternal mortality? (n=95)
In this questionnaire item; 52 respondent or 54.7% strongly Agree that socio-economic and cultural factors contribute to the high rate of infant and maternal mortality, 26 respondent or 27.4% Disagreed on the same issue, 10 respondent or 7.40% strongly Disagree on the same issue.
Discussion of Findings
The discussions of the study are hereby presented according to the research questions that guided the study;
Research Question 1
Can poverty contribute to the increase on high infant and maternal mortality rate?
According to the respondents (90.5%) strongly agreed that poverty contribute to the increased on the high infant and maternal mortality this goes to agree with Lucas and Gilles (2003) that, factors that prevent women in developing countries from getting life saving health care they need include ignorance, lack of knowledge of the available resources and poverty. Macleod and Rhode (1998) also outline risk factors to maternal care, illiteracy, poor or lack of antenatal care, illiteracy among pregnant women.
In many developing countries, antenatal care given to mothers during pregnancy is usually below the required standard or is not available (Beanneth and Brown, 1999), these pregnant mothers are at the mercies of traditional birth attendants who lack knowledge of normal physiological processes during pregnancy and labour. Most mothers die or get bed ridden due to poor care.
Can poor health care facilities contribute to the increase in infant and maternal mortality rate?
According to the respondents (82.1%) strongly agreed that poor health care facilities contribute to the increase in infant and mortality rate, this goes to agree with (Benneth and Brown, 1999) that lack or inadequate facilities to deal with obstetric emergencies is a serious risk factor to maternal mortality. If a woman comes to the hospital and the equipment to use in restoring her life is not available, definitely such life is in danger.
Research question 3
Can relationship between poor roads unskilled health care personnel contribute to the increase rate of infant and maternal mortality?
According to the respondent (76.8%) strongly agreed that relationship between poor rounds and unskilled health care personnel contribute to the increase rate of infant and maternal mortality, this is in agreement with Lacus and Gilles (2004) factors that prevent women in developing countries from getting the life serving health care they need include; Lack of knowledge of availability and usefulness of health care services, distain from health services, cost including direct fees as well as the cost of transportation, lack of motorable roads. The poor quality of services, including poor treatment by health provider, also makes some women reluctant to use services.
Research question 4
Can socio-economic and cultural factors contribute to the high rate of infant and maternal mortality?
According to respondent (54.7%) strongly agreed that socio-economic and cultural factors contribute to the high rate of infant and maternal mortality, Macleod and Rhode (1998) outline risk factors to maternal mortality to include poor or lack of antenatal care, delay in referral from peripheral, harmful traditional beliefs and practices and inadequate facilities to deal with obstetric emergencies.
Summary, Conclusion and Recommendations
This study was designed to determine the factors responsible for high infant and maternal mortality rate, in Abakaliki metropolise. The sample consisted of 120 mothers of childbearing age drawn from 10 hospital and maternity homes in Abakaliki metropolise. The instrument for data collection was the questionnaire. Out of 120 copies of the questionnaire distributed 95 copies were collected and used for data analysis. To answer the research questions posed for the study, the data were analyzed using frequency distribution tables. The finds showed that;
- (90.5%) strongly agreed that poverty contribute to the increase on the high infant and maternal mortality.
- (82.1%) strongly agreed that poor health care facilities contribute to the increase in infant and maternal mortality rate.
- (76.8%) strongly agreed that relationship between poor road unskilled health care personnel contribute to the increase rate of infant and maternal mortality.
- (54.7%) strongly agreed that social-economic and cultural factors contribute to the high rate of infant and maternal mortality.
Based on the findings and discussion, the following conclusions were drawn in the study;
- Poverty is one of the factors that are responsible for high infant and maternal mortality rate.
- Poor health care facilities are equally another factor that is responsible for high infant and maternal mortality rate.
- Poor roads and unskilled health personnel are another factor that is responsible for the high infant and maternal mortality rate.
- Socio-economic and cultural factor is equally responsible for high rate of infant and maternal mortality.
Based on the findings and conclusions of the study, the following recommendations were made:
- Community health education programme should be carried out to encourage pregnant women to attend antenatal clinics to help detect problem and take good care of them.
- Government should site health facilities in area reachable to those in remote areas and also employ trained health personnel to render qualitative care.
- Continuing education in safe delivery procedure should be organized periodically for mid wives to enhance their skills.
- Safe motherhood initiative programmes should be propagated and made accessible to all women of childbearing age.
- Finally planning services should be accessible for couples to prevent unwanted pregnancies.
- Women of childbearing age should be heath educated in the factors responsible for infant and maternal mortality and how to prevent them.
—-This article is not complete———–This article is not complete————
This article was extracted from a Project Research Work Topic:
“FACTORS RESPONSIBLE FOR HIGH INFANT AND MATERNAL MORTALITY IN ABAKALIKI URBAN, IN EBONYI STATE,”
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