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Maternal mortality amidst COVID-19 and Boko Haram insurgency in Borno

Maternal mortality is one of the leading causes of death in women of productive age. 

Maternal mortality especially in semi-urban and rural areas are caused by several factors which include home deliveries, unskilled health providers, inadequate facilities and insecurity.

This challenge is further compounded by the outbreak of epidemics like the novel coronavirus, lassa fever, and other emergencies.

Falmata Bukar a mother of 7 and Fatima Ali mother of 3 {Left} attending antenatal sessions at Dalaram Primary Healthcare centre in Jere local government area of Borno state. 

They are among hundreds of women of reproductive age from communities ravaged by Boko Haram insurgency that willingly attend antenatal services.

The World Health Organisation WHO said more than two-thirds of health facilities in Borno state have either been partially or completely destroyed by insurgents thereby putting a sizeable population at risks of preventable but life threatening diseases.

Accees to quality anti-natal service during pregnancy prevents maternal deaths which according to a 2018 National Demographic and Health survey stands at 31 percent. 

Pregnant women in these challenging environment like where Fatima and Falmata resides, encounter difficulties accessing maternal services due to inadequate and functional health centre as well as unskilled health providers.

This situation was further compounded with the outbreak of the deadly COVID19.

Dalaram Health centre which is among the functional facility in Jere provides services to many displaced women and children from Zabarmari, Gongolong Lawanti, Old Maiduguri, Tuba and Shuwari.

Facility Manager of the Centre, Yagana Lawan said although maternal mortality has drastically reduced in the facility, some women are still averse to hospital delivery. 

” A woman from Zabarmari was brought to the clinic in a Keke Napep tricycle bleeding and unconscious to the extent that she doesn’t even know where she was, we rushed her to the labour room and conducted the delivery successfully and later discharged them in good condition “, narrating the story of a woman who had never attended antenatal clinics.

With only 2 midwives and 5 community Health workers, the hospital attended to over thirty five thousand patients and  recorded about a thousand deliveries in the last six months.

Human resource remains a major challenge in the health sector in Borno state. 

Due to Boko Haram insurgency, the healthcare workforce has weakened and declined with many professionals either displaced, killed or injured.

To address this gap, College of Nursing and Midwifery in Maiduguri increased its intake of students for the first time in more than four decades.

Hajiya Rukaiya Shettima is the Provost of the college.

With this full accreditation, the College will be able to produce more health workers. Our health indices are not good especially maternal mortality, it is based on this, that we requested Nursing and Midwifery Council to be given Community midwifery who would be working at the community level”, she said.

With more pregnant women like Falmta and Fatima ready to deliver in health facilities, more frontline health workers are required to strengthen the system. 

Dauda Iliya is Radio Nigeria’s correspondent in Borno State

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