Maternal death surveillance and response system in Northern Nigeria

Introduction: The maternal death surveillance and response (MDSR) responds to MDG 5 and Sustainable development goal 3. It was designed to achieve this goal by obtaining and strategically using information to guide public health actions and monitoring their impact. Objective: To determine the burden and avoidable causes of maternal mortality in midwives service scheme (MSS) communities in Northern Nigeria. Methodology: This was a cross-sectional study using baseline MDSR data on confidential enquiry into maternal deaths in all health facilities and their host communities under the MSS in Northern Nigeria from July 1st to December 31st, 2011. Results: The MMR was 181/100,000 live births. Most (80.9%) of the deaths were due to direct obstetric complications with obstetric hemorrhage and eclampsia accounting for 66.6% of the deaths. Most deaths occurred postpartum (93.6%) with the first 48 h accounting for 85.1% of cases. At presentation, 76.5% were in critical conditions. The TBAs conducted 50.0% of the deliveries. Delays in decision making contributed to 51 (63.8%), delay in arriving at the facility accounted for 48 (60.0%), financial constraints 28 (35.0%), unsafe traditional practice 27 (33.8%), and use of traditional medicines 22 (27.5%). The TBA failed to refer early in 42 (52.5%), failed to recognize dangers signs in 27 (33.8%). Stillbirths occurred in 22.2% of cases. Conclusion: Most maternal deaths in Northern Nigeria are preventable. Operational research using the MDSR is very useful in determining the causes and designing appropriate response to maternal deaths at the community level in Nigeria.