The struggle to reduce high maternal mortality in Nigeria

According to UNICEF estimates for Nigeria, maternal mortality ratio is 1100 per 100,000 live births, antenatal care coverage 47 percent, institutional delivery rate 33 percent, and each woman bears six children on the average. Reducing the high maternal mortality ratio, which is the prime concern, has hitherto concentrated on transforming the health system through bringing resources and expertise to bear on the high maternal mortality per se including some of its surrounding elements. It has failed. High maternal mortality must be tackled at a much more fundamental level. In the complexities and uniqueness of Nigeria's current situation, it is suggested that the fundamental remedy is to stamp out the chaos in the country by getting the politics and governance structures right. Accurate population census is paramount. Compulsory registration of births and deaths, fixing the broken-down educational system and bringing back the public service ethos the country once had, are core issues.