Many of the 241,000 newborn deaths would also be averted, said renowned Nigerian obstetrician and gynaecologist, Prof. Emmanuel Otolorin during the MamaYe Media Roundtable on Family Planning and Maternal Health in Abuja on 20 October 2016.
He pointed out that the survival of newborn and other young children is linked to that of their mothers, saying a study in Bangladesh in 2010 found that 23.8 per cent of children less than 10 years old who lose their mothers do not survive for long.
While pointing out that unplanned pregnancies silently drive Nigeria’s high prevalence of maternal deaths, abortions and abortion-related deaths, as well as rapid population growth rate, Prof. Otolorin argued,
If you don’t get pregnant, you cannot die of pregnancy. Many women don’t want or need the children they have, but they are forced to carry unplanned pregnancies and have unwanted children because they lack access to good family planning. Many abort or try to abort such pregnancies.
Each year, he said, there are 610,000 abortions in Nigeria, 60 per cent of which are unsafe and account for a substantial number of maternal deaths. Altogether, Nigeria, with 2.4 per cent of world population, accounts for 14 per cent of global maternal mortality. The maternal death ratio is 474 per 100,000 live births. However, a 2015 study by the Guttmacher Institute put the estimated number of abortions in Nigeria in 2012 at 1.25 million.
According to Prof. Otolorin, Nigeria’s already large population and uncontrolled population growth are a recipe for poverty and underdevelopment, as well as national and regional conflicts.
The nation’s fertility rate—5.5 children per woman—is the second highest in the world. With a population that is already 185 million, the nation’s population growth is on a very fast track. Unchecked, Nigeria’s human population will reach 441.7 million by 2060, making the nation the third most populous after China and India.
Most experts agree that if this happens, the physical, social and economic consequences can be devastating. Already, Otolorin said, high numbers of people in a struggle for resources, including land and water—for living and farming, and pastures for livestock—underlie many of the conflicts around the country.
As Prof. Oladapo Ladipo, another renowned obstetrician and gynaecologist, had pointed out, Otolorin said conflicts such as the Boko Haram insurgency in Nigeria’s north east region occur, or are prolonged because of the availability of hordes of deprived and uneducated youths without a future, who are easy to manipulate by demagogues, and probably feel a need to hit back at the society they perceive to have wronged them.
Otolorin also pointed out that because of the need for pastures for livestock, Abuja, the federal capital, has been lately overrun by herds of cattle, giving rise to a parody of the Federal Capital Territory as ‘Federal Cattle Territory.’
Other experts at the roundtable also decried the rather low uptake of family planning in the country due partly to a combination of poor policy implementation, wrong interpretation of religious injunctions, and low literacy rates among the people, particularly women.
These included Dr Jennifer Anyanti, Chief Strategy Officer of the Society for Family Health, who chaired the roundtable; Dr Ejike Oji, Chair of the Association for the Advancement of Family Planning, and Dr Tunde Segun, Country Director of MamaYe-Evidence for Action.
The issues noted by the experts included the fact that Nigeria continues to struggle with a modern contraceptive prevalence rate of 10 per cent under the admixture of factors, particularly religion, when the bases of the same religions—Islam and Christianity—and many countries that are seen to be more Christian or Moslem, and less endowed nations all have rates over 50 per cent. These include Italy, Saudi Arabia, Iran, Egypt, and the Gambia.
They also pointed out that scholars have produced books on the correct religious position, which is that no religion forbids family planning, and that some religious bigots only play on the intelligence of the people and use other sentiments to frustrate efforts to get people to use modern contraceptive devices because natural, traditional and so-called rhythm methods have higher failure rates.
The inadequate financial commitment of government to providing family planning services was also partly blamed for the situation. According to Prof. Otolorin, the annual financial requirement for family planning services is about $14-15 million. In 2012, Nigeria promised to provide $3 million annually, but has never kept the promise in full.
Also, most of the contraceptive products available are provided by donor nations and organisations, but usually, such products are available in drug stores around the nation but not sufficiently at service delivery points because funds are not provided for transportation.
Professor Otolorin is the Country Director of Jhpiego Corporation, a maternal and child health programme funded by the United States Agency for International Development.