Maternal health in Northern Nigeria - a far cry from ideal

Objective To determine the level of maternal care in Northern Nigeria. Design A cross-sectional descriptive study design was used. Setting The Study was Community based and carried out in the ten states that constitute UNICEF D zone in northeast Nigeria. Population Women who delivered in the 11 months preceding the survey and resident in the study area. Methods The WHO cluster sampling methodology was used to draw a sample of 210 eligible women in each of the 10 local government areas (LGAs). Main outcome measures Utilization of antenatal care (ANC) services, tetanous toxoid immunization, skilled attendant at delivery and postnatal care. Results Majority of the respondents, 73.2%, were between the ages 20 and 34 years. Overall, 50% of the women attended antenatal clinics during their last pregnancy, with a range of ANC coverage by LGA of 14.0-81.0%. The proportion of women who booked in the first, second and third trimesters was 22.8, 63.0 and 14.2%, respectively. The antenatal services offered ranged from 95.7% for abdominal examination to 41.2% for urine examination. Sixty percent of the women received no tetanus toxoid in their last pregnancy, 11% had one dose and 29% had at least two doses. Home delivery was still the norm throughout the zone with 1791 (85.3%) delivering at home. Up to 80.5% of the deliveries were supervised by personnel with no verifiable training in sanitary birthing techniques. Only 11.4% (233) of those who received ANC had postnatal check-up. Conclusions Maternal health care as evidenced above is far from the ideal. Likewise, the commitment of the 5th Millennium Development Goal is extremely far-reaching: to reduce the maternal mortality ratio by 75% by the year 2015 with this level of maternal care.