The Current Health Statute in Nigeria is Alarming,at least about 60,000 women d

ie on account of maternal mortality in Nigeria.

The number of maternal deaths in Nigeria is second only to that of India. The ma
jority of these
maternal deaths, as in the rest of the world, are preventable, and while the cau
sal factors can be
multiple and complex, governments must be held accountable when their actions or
inaction contribute
to this ongoing loss of womenâ s lives. To that end, this report from Women Advocates
Research and
Documentation Centre (WARDC) and the Center for Reproductive Rights (CRR) focuse
s specifically on
the Nigerian governmentâ s responsibility for the dire state of maternal health in th
e country. Although
this report highlights these issues in the context of maternal health, many of t
he problems discussed
here have repercussions for the health system overall and the general health of
all Nigerians.
While the Nigerian government has repeatedly identified maternal mortality and m
orbidity as a
pressing problem and developed laws and policies in response, these actions have
not translated into
a significant improvement in maternal health throughout the country. A number of
factors inhibit the
provision and availability of maternal health care in the country, including: th
e inadequacy or lack
of implementation of laws and policies, the prevalence of systemic corruption, w
eak infrastructure,
ineffective health services, and the lack of access to skilled health-care provi
ders. The separation of
responsibilities for the provision of health care among the countryâ s three tiers of
government both
contributes to and exacerbates the harmful impact of these various factors.
The failure of the government to adequately regulate and fund the health system
manifests itself in a
variety of ways. One key structural issue is the division of health-care respons
ibilities among the three
tiers of government: federal, state, and local. The Nigerian Constitution, which
outlines the powers and
responsibilities of each tier, is silent about their specific health-care respon
sibilities. In the absence of a
constitutional sharing of powers and outlining of responsibility for health care
, the 1988 National Health
Policy and Strategy to Achieve Health for All Nigerians (1988 National Health Po
licy) allocates the
primary health sector to the local government, the secondary health sector to th
e state government, and
the tertiary health sector to the federal government. The federal government has
little control over both
the state and local governments in the discharge of their duties. In addition, t
he 1988 National Health
Policy lacks legal force; unlike the constitution or other legislation, it canno
t impose legal obligations.
As a senior official at the Federal Ministry of Health explained: â We [the federal g
overnment] can only
appeal to the conscience of the local governments, because the health policies a
re not backed by
law so the local governments do not see it [primary health-care provision] as th
eir responsibility.â
The absence of a constitutional or other legal prescription of health-care respo
nsibilities has resulted in
a dysfunctional health-care system in which all three tiers of government have f
ailed to prioritize their
health-care duties, and have faced no political or legal repercussions for doing
so. The problem is
particularly visible at the primary health-care level, which constitutes the fir
st point of contact with the
health-care system, and has particularly deleterious effects for women seeking m
aternal care.