Community perspective of maternal mortality: Experience from Konduga local government area, Borno state, Nigeria

Background/objective : High maternal mortality in Nigeria in particular and Sub-Saharan Africa in general has remained one of the key indicators of our poor health care services, infrastructural facilities and negative socio-cultural attitudes to healthy living. The objective is to identify barriers to prompt and effective treatment of obstetric complications leading to maternal mortality in order to develop appropriate strategies to address them at the community level. Method : The study took place between 10th October and 10th December 2003. An in-depth interview guide developed by the network for the prevention of maternal mortality (NPMM), which contains mainly open ended questions, modified to suit our socio-cultural setting was used. Results : There was a good understanding among the people of the area that women are dying during pregnancy, labour and puerperium. 28(93.3%) of the respondents recognized some obstetric complications. The main obstacles to accessing the hospital for emergency obstetric care were lack of money and transportation difficulties. Equipping the health facilities, employment of qualified staff, community supported emergency funds for obstetric emergency and the provision of reliable, effective and affordable transport are identified as necessary measures to prevent maternal mortality. The Local Government Areas and community leaders are to champion the cause for the provision of these facilities in their localities. Conclusion : There is a good understanding of obstetric complications in the community leading to maternal death. The main reasons for delay in seeking care are ignorance, poverty, lack of transportation and distance. Community enlightenment, health education, training of TBAs, poverty reduction and effective, affordable and reliable transportation are means of obviating delays in the decision and transportation leading to maternal mortality. Upgrading and re-equipping of health facilities to provide emergency obstetric care services are mandatory. Community participation in the safe motherhood drive can be ensured using the traditional rulers, religious leaders and the Local Government Authority.