THE INCIDENCE OF MATERNAL AND CHILD MORTALITY

CHAPTER ONE

INTRODUCTION

1.1     BACKGROUND OF THE STUDY

Maternal and child mortality are not new concepts in the social and medical sciences. They both pose serious threats to human survival especially in the future generations. It is a saying, that the future of any society depends on the health condition of the women and the young population. The sustenance of the society and the economy largely depends on these two groups to this end, their health and security is of utmost importance so as to avert feelings of sadness, depression and loss of lives. According to Myles (1953);

The maternal mortality rate is the number of death registered during year of women dying from cause attributed to pregnancy and child birth for 1,000 registered total (life and still births) in the year while infant/child mortality rate is the number of deaths registered during the year of age per 1,000 registered births in the year.

This is to say that maternal mortality is simply deaths resulting from complications during pregnancy, labour delivery or child birth, while infant/child mortality can be any death occurring under one year or five years of age.

The tenth international classification of diseases (ICD) of year on the other hand, defined maternal death as;

The death of a woman while pregnant or within the days of termination of pregnancy, irrespective of the duration and the site of the pregnancy from any cause related to, or aggravated by the pregnancy or its management, but not form accidental or incidental causes. (pp. 2-3).

Similarly, the America Medical Association (1954) defines maternal mortality rate as:

The death of a woman while she is pregnant or within 90 days of termination of the pregnancy irrespective of duration of pregnancy at the time of termination or regardless of the method by which is terminated. (p. 4).

There are many factors resulting to maternal and child mortality in developing countries, these involves complications arising during pregnancy and child delivery, hemorrhage, that is, severe bleeding generally occurring during post partum, it is unpredictable, sudden and more dangerous when a woman is anaemic. The loss of blood in the process can lead to death if prompt attention is not given. Another factor that may result into maternal and child birth is prolonged and obstructed labour “poverty exist when people lack the means to satisfy their basic needs”. These needs when narrowly put are “those needs necessary for survival or broadly as those needs reflecting the prevailing standard of living the community. In Jos North for example, poverty is indeed a threat to women in reproductive age bracket. This high level of poverty limits their access to health which contributes to a higher percentage of maternal and child mortality in Nigeria and Jos North in particular.

At the end of the last century, sub-Saharan Africa still had high maternal and child mortality rate with the goals of safe motherhood eluding many governments. A documentary report on Nigeria Television Authority (NTA) precisely 3rd May, 2007 revealed that malaria fever is very dangerous to pregnant mothers and children and more deadly then HIV/AIDS. The number of these groups malaria kills in one year is said to be what HIV/AIDS kills in 15 years. According to Dr. Adekunle (an NTA discussant, he stated also that over 80 percent of 270 to 400 million clinical cases occur in the African continent). Similarly, on the 30th of March 2007, another documentary on the same station, (NTA) suggests that children under the age of five and a total of 300,000 Nigeria children and eleven out of hundred pregnant women die of malaria fever every year.

Apart from the death rate being recorded due to malaria fever of both pregnant women and children, it was reported on the Africa Independent Television (AIT) on the 6th August 2007 at the 8:00pm news that Nigeria spends over 130 billion naira on malaria control. Alubo (1997) opined that:

Women in Nigeria suffer from all kinds of ailment and ill conditions and run the risk of sudden deaths in child birth. The main causes of this sudden death in child birth are obstructed labour, uterine infection, anaemia, ectopic pregnancy and cepsis etc.

These complications according to Alubo (1997) account for maternal mortality during labour and after child birth. All the factors by Alubo, as well as the previous presentations of the concept under study revealed that women suffer undue hardship during and after pregnancy. To put it right, many factors and complications can lead to maternal and child mortality as stated all through but of interest is the impact of poverty on maternal and child mortality and it is of sociological importance to identify how poverty affect the health of the mother and the child and the definite responses of government.

1.2     BRIEF HISTORICAL BACKGROUND OF JOS NORTH

Jos North area council shares its boundaries with Jos South Local Government Area in the south and East, Bassa Local Government Area in the West and Turo Local Government Area of Bauchi State in the North.

Jos North metropolis is made up of one district; Gwong and fourteen (14) wards, namely Abba Na Shehu, Ibrahim Kashim, Jos Jarawa, Gangere, Vandapuye, Tafawa Belewa, Jenta Apata, Jenta Adamu, Garba Dawo, Dalhatu, Alikazaure Sarkin Arab, Tudun Wada, Kabong Naraguta “A” and Naraguta “B”. According to its geographical location, Jos is about four hundred (400) feet above sea level and temperature sometimes goes near freezing point. Rainfall usually occurs between April to October yearly. The month of December, January and February are particularly very cold due to dry wind of the harmattan, as well as its latitude and hilly nature. It is also on table land and its vegetation is characterized by scattered forest reserves and farmlands. However, Jos is a built up area, but some of its inhabitants areas are surrounded by hills, the temperature nature of Jos makes tourism a potential industry.

1.3     STATEMENT OF THE RESEARCH PROBLEM

Maternal and child mortality as earlier mentioned above are not strange problems in our society. They are as old as human existence but the trend and pattern varies across generations and socio-economic lines. In this work however, the researcher is interested in unfolding the link between poverty (socio-economic status) in the family with maternal and child mortality.  Death of mothers and children are painful experiences that affect families and also have it’s toll on the society and the economy.

Maternal and child mortality is not an uncommon event in several parts of the developing world. Mothers and children are at highest risk for disease and death. While motherhood is often a possible and fulfilling experience for too many women, it is associated with ill-health and even death (Olatoye, 2009). The death of a woman during pregnancy, labor or peuriperium is a tragedy that carries a huge burden of grief and pain, and has been described as a major public health problem in developing countries. Women have an enormous impact on their families’ welfare. Deaths of infant/children under five are peculiar and closely related to maternal health. One million children die each year because their mother died, and the risk of death of children less than five years doubles if mothers die in child birth. More than 25,000 children die everyday and every minute a woman dies in child birth. Worldwide, every year about 500,000 women die due to child birth and over 9 million children under age five die mostly from preventable and  diseases. (WHO, 2003).

Available evidence indicates that Africa accounts for the highest burden of mortality among women and children in the world (Udofia and Okonofua, 2000; Prata. Et al, 2008).

In the light of the above, the researcher, who is a social work student of University of Jos,  a woman and a mother who  has observed with keen interest, over the years the prevalence of the above situation in Jos North area of Plateau state on how mother and children die of this preventable situation and has therefore, embarked on the research using Plateau State Specialist Hospital has her resource/data collection base.

Armstrong and Roystone (1990) asserted that:

The most easily recognized factors responsibly for maternal and child mortality are the women age and the

number of her previous pregnancy. These factors to them are not limited to developed countries societies alone, but have confined to exist even in developed countries and report shows that teenage marriage is widespread in developing countries which may result in maternal death or other damage as a result of child birth such as VVF (i.e., Vesico Vagina Festula).  Women in developing countries run the  risk much more, since they bear more children than women in the developed world.

Putting the observation of both authors in critical analysis, some of factors responsible for maternal and child mortality are not peculiar to developing countries where most of its population are poor but continue to exist even in developed countries. (Alubo, 1997; Armstrong and Roystone  1990).

1.4     STATEMENT OF RESEARCH QUESTION

There arose questions in relation to this research and getting answers to them will be beneficial to humanity and they are;

1. What is the relationship between poverty and mortality rate in women and children
2. What are the other factors responsible for children and maternal mortality?
3. What is the level of awareness of the residents on maternal mortality and family planning?
4. Are there policies of government towards the reduction of maternal and child mortality rates?
5. How effective are government policies in addressing the problem of maternal and child mortality?

1.5     STATEMENT OF THE RESEARCH OBJECTIVES

           Objectives of the study

The general objective of this research is to analyze the impact of poverty on maternal and child mortality in Jos North Local Government Area and the specific objectives are:

Specific Objectives

1. To find out the rate at which poverty affects women and children’s health status.
2. To find out factors responsible for the incidence of death in women of reproductive age and children below 1 year.
3. To find out the level of awareness of Jos North citizens on family planning.
4. To find out the level of the prevalence of maternal and child mortality among Jos north residence.
5. To make recommendations to the appropriate authority on how to make maternal and child mortality among Jos North residence

1.6     RESEARCH HYPOTHESIS

According to Osuala (2001), “Hypotheses are conjectural statement of the relationship between two or more variables”. They are guide to the investigator in the entire process of research on the main study. In fact, hypotheses are generally useful guides to effective research. Hypothesis formulation goes hand in hand with the selection of a research problem. The hypothesis for this research is as follows:

Ho1:  There is a relationship between socio-economic status in maternal and child mortality.

Ho2:  The health of mother and child is largely dependent on their socio-economic status.

1.6     SIGNIFICANCE OF THE STUDY

Basically, this study will help residents in Jos North Local Government learn  preventive measures on maternal and child mortality. It will also help policy makers and authorities of Plateau State Government improve on development programmes thereby taking adequate steps towards reducing and alleviating maternal and child death in our society. It is also intended and desired that it will enable medical officials and expectant mothers to embark on preventive measures against such mortality.

Furthermore, this study will equip men with the necessary information concerning infant, and maternal mortality in the society such that they will begin to provide more and adequate care for their wives, mothers and children (both born and unborn). These ones represent the future of the society.

1.7     SCOPE AND LIMITATIONS OF THE STUDY

This study is basically centered on Jos North Local Government Area. It is aimed at determining the magnitude damage poverty has done on the lives of women of reproductive age during child birth and death of children between 0-1 year.

1.8     DEFINITION OF BASIC CONCEPTS

Impact: The advanced learner’s dictionary puts it as “to have strong impression or effect on e.g., the economy. Also, a significant or strong influence. Here, we are determining the effect/influence of poverty on mother and child mortality.

Poverty: The absence of those needs necessary for human survival. The new encyclopedia Britannica volume 9, Chicago: Encyclopedia Britannica 2003. It is also a major barrier to human development. Poverty can also defined as the situation of people whose “resources (material, social and cultural) are so limited as to exclude them from the minimum acceptable way of life in the countries where they live. (Defining poverty, http://www.anglicare.com)

Maternal: Maternal means a mother, related through the mother’s side of the family. (Advanced Learners Dictionary).

Child: children, a young person birth to the age of 7 full physical development, a boy or a girl; a child of size. (Advanced Learners Dictionary).

Mortality: Means death and dying, the irreversible caesarian of life and the imminent approach of death. (Encarta – Encyclopedia 2002).