Daily Trust - Nigeria’s maternal mortality ratio and post 2015 agenda
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Nigeria’s maternal mortality ratio and post 2015 agenda

It was a brief presentation on the findings of the 2012 MDG Survey that was done surreptitiously by the MDG office without the knowledge of almost everybody in that national conference. The way and manner even the findings were shared in the meeting revealed that it was a survey conducted in a clandestine manner without credibility and scientific relevance. The methodology, the sampling techniques and the stakeholders involved were all faulted and as of today the MDG office is reluctant to share the full report or publish it in any respectable journal and/or newspaper.
However our President Goodluck Jonathan is already busy sharing the good news about the dramatic fall in the Nigeria’s MMR in many meetings and was confident that Nigeria will be close to meeting the MDG 5 target by 2015. It is desirable to refresh our mind including that of our President that Nigeria commits to allocate 15% of its budget to health in line with 2001 Abuja Declaration and to spend $54 per health capita. Our current health budget is about 6% and we are spending about $20 per capita annually. The Maternal Mortality Ratio of (MMR) of 545 in Nigeria compared to other countries of Africa is unacceptably high. (NDHS 2008).
Nigeria was prematurely applauded during the 2012 London Summit on Family Planning for committing to in addition to our current annual funding of US$3 million for the procurement of reproductive health commodities to add US$8,350,000 annually over the next four years from 2012 making a total of about US$45 Million. This was an increase of 300%. Regrettably as we enters 2014, the 2013 allocation wasn’t release. Another significant action in Nigeria is the campaign to pass in to law the long awaited national health bill which serves as a veritable tool to address funding gap in the health sector and ensures improved quality of care. Other challenges in Nigeria are; inadequate skilled attendants at birth, more women attending antenatal care but fewer coming back to deliver in the facilities due to lack of confidence and poor infrastructural facilities.
With these unfulfilled commitments mentioned above, it will not be out of point for the MDG office to provide evidence of interventions which resulted in the remarkable decline of the MMR from 545 to 350 and how they arrived at that MMR. In relation to that it is important as a country for us to be aware of the ongoing consultation of the ‘Ending Preventable Maternal Mortality (EPMM) Working Group’ for the post 2015 Agenda that took place in January 16-17, 2014.  
The EPMM Working Group aims to mobilize global and country-level commitment for reducing maternal mortality, build consensus on targets and strategies to end preventable maternal deaths, and elaborate a framework for maternal health in the context of the reproductive, maternal, newborn and child health continuum of care within the post-2015 development agenda. A strategic framework to achieve the targets was developed collaboratively under the leadership of the World Health Organization (WHO) and the US Agency for International Development (USAID) and in consultation with stakeholders from Cameroon, India, Indonesia, and Nigeria.
The draft Communique of the January 16-17, 2014 had identified action steps needed to ensure inclusion of maternal health/maternal mortality goals within the health component for the post-2015 development agenda.
1.      Metric: The proposed targets use the metric of the Maternal Mortality Ratio (MMR), defined as the number of maternal deaths per 100,000 live births. This ensures consistency over time and with previous development frameworks such as the MDGs.
2.      Global target: The proposed global MMR target for post-2015 is 50 (per 100,000 live births) by 2035 (or 70 per 100 000 live births by 2030) with milestone targets at 5-year intervals from 2020 through 2030.
3.      Annual rate of reduction: Numerical targets are proposed for different groups of countries, based on the assumption of an Annual Rate of Reduction (ARR) of 5.75% between 2010 and 2035. This rate is slightly higher than that required to achieve the maternal mortality goal in the MDGs (5.5%).
4.      Country targets: Countries enter the post-2015 period with widely varying baseline maternal mortality ratios. By 2035, no country should have an MMR >100. The proposal introduces the innovation of 5-year milestones, allowing for the development and implementation of context-specific strategies and trajectories for achieving the 2035 target.

The meeting emphasised that;
1.      Countries with a baseline MMR > 400 in 2010: proposed target is MMR of <100 by 2035, with country-specific 5-year milestones;
2.      Countries with a baseline MMR between 100-400 in 2010: proposed target is MMR of <50 by 2035, with country-specific 5-year milestones;
3.      Countries with a baseline MMR < 100 in 2010: proposed target is <50 across all internal subpopulations by 2035, with a particular focus on elimination of inequities among groups with poorer outcomes.
Is Nigeria adopting the 350 MMR as a baseline for the post 2015 agenda? To what extend could Nigeria adopts uniform methodology in measuring, monitoring and reporting annual progress in MMR?
All comments to Dr Aminu Magashi at healthweekly@yahoo.com

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Nigeria’s maternal mortality ratio and post 2015 agenda

It was a brief presentation on the findings of the 2012 MDG Survey that was done surreptitiously by the MDG office without the knowledge of almost everybody in that national conference. The way and manner even the findings were shared in the meeting revealed that it was a survey conducted in a clandestine manner without credibility and scientific relevance. The methodology, the sampling techniques and the stakeholders involved were all faulted and as of today the MDG office is reluctant to share the full report or publish it in any respectable journal and/or newspaper.
However our President Goodluck Jonathan is already busy sharing the good news about the dramatic fall in the Nigeria’s MMR in many meetings and was confident that Nigeria will be close to meeting the MDG 5 target by 2015. It is desirable to refresh our mind including that of our President that Nigeria commits to allocate 15% of its budget to health in line with 2001 Abuja Declaration and to spend $54 per health capita. Our current health budget is about 6% and we are spending about $20 per capita annually. The Maternal Mortality Ratio of (MMR) of 545 in Nigeria compared to other countries of Africa is unacceptably high. (NDHS 2008).
Nigeria was prematurely applauded during the 2012 London Summit on Family Planning for committing to in addition to our current annual funding of US$3 million for the procurement of reproductive health commodities to add US$8,350,000 annually over the next four years from 2012 making a total of about US$45 Million. This was an increase of 300%. Regrettably as we enters 2014, the 2013 allocation wasn’t release. Another significant action in Nigeria is the campaign to pass in to law the long awaited national health bill which serves as a veritable tool to address funding gap in the health sector and ensures improved quality of care. Other challenges in Nigeria are; inadequate skilled attendants at birth, more women attending antenatal care but fewer coming back to deliver in the facilities due to lack of confidence and poor infrastructural facilities.
With these unfulfilled commitments mentioned above, it will not be out of point for the MDG office to provide evidence of interventions which resulted in the remarkable decline of the MMR from 545 to 350 and how they arrived at that MMR. In relation to that it is important as a country for us to be aware of the ongoing consultation of the ‘Ending Preventable Maternal Mortality (EPMM) Working Group’ for the post 2015 Agenda that took place in January 16-17, 2014.  
The EPMM Working Group aims to mobilize global and country-level commitment for reducing maternal mortality, build consensus on targets and strategies to end preventable maternal deaths, and elaborate a framework for maternal health in the context of the reproductive, maternal, newborn and child health continuum of care within the post-2015 development agenda. A strategic framework to achieve the targets was developed collaboratively under the leadership of the World Health Organization (WHO) and the US Agency for International Development (USAID) and in consultation with stakeholders from Cameroon, India, Indonesia, and Nigeria.
The draft Communique of the January 16-17, 2014 had identified action steps needed to ensure inclusion of maternal health/maternal mortality goals within the health component for the post-2015 development agenda.
1.      Metric: The proposed targets use the metric of the Maternal Mortality Ratio (MMR), defined as the number of maternal deaths per 100,000 live births. This ensures consistency over time and with previous development frameworks such as the MDGs.
2.      Global target: The proposed global MMR target for post-2015 is 50 (per 100,000 live births) by 2035 (or 70 per 100 000 live births by 2030) with milestone targets at 5-year intervals from 2020 through 2030.
3.      Annual rate of reduction: Numerical targets are proposed for different groups of countries, based on the assumption of an Annual Rate of Reduction (ARR) of 5.75% between 2010 and 2035. This rate is slightly higher than that required to achieve the maternal mortality goal in the MDGs (5.5%).
4.      Country targets: Countries enter the post-2015 period with widely varying baseline maternal mortality ratios. By 2035, no country should have an MMR >100. The proposal introduces the innovation of 5-year milestones, allowing for the development and implementation of context-specific strategies and trajectories for achieving the 2035 target.

The meeting emphasised that;
1.      Countries with a baseline MMR > 400 in 2010: proposed target is MMR of <100 by 2035, with country-specific 5-year milestones;
2.      Countries with a baseline MMR between 100-400 in 2010: proposed target is MMR of <50 by 2035, with country-specific 5-year milestones;
3.      Countries with a baseline MMR < 100 in 2010: proposed target is <50 across all internal subpopulations by 2035, with a particular focus on elimination of inequities among groups with poorer outcomes.
Is Nigeria adopting the 350 MMR as a baseline for the post 2015 agenda? To what extend could Nigeria adopts uniform methodology in measuring, monitoring and reporting annual progress in MMR?
All comments to Dr Aminu Magashi at healthweekly@yahoo.com

texem
More Stories