End-use of health policy analysis – the case of maternal mortality reduction in Nigeria

Nigeria presently has one of the highest rates of maternal mortality (MM) in the developing world. As part of efforts to reduce her MM, Nigeria's Federal Ministry of Health has formulated policies on sexual and reproductive health, health sector reform and safe motherhood. However, actual implementations of these policies have been less successful, resulting in persisting high rates ofMMin the country. Part of the reasons for this state of affairs includes the non-inclusion in the policy development process, of issues such as unsafe abortion, adolescent sexuality and early marriage. Secondly, although MM is largely driven by poverty and under-development, there is very poor understanding of this inter-relationship, with little attention given to addressing the various multisectorial issues that impact on MM. Thirdly, the lack of a conscientious and organized policy network to drive the process of policy implementation has ensured that health policies have never been implemented at a sustainable level. However, there is some evidence that political will for safe motherhood has recently increased in Nigeria, with efforts being given to prioritizing the problem as a major developmental and public health issue. Disappointingly, major challenges still remain in the actual implementation of health policies relating to the reduction of MM. We believe that strategic advocacy and public health education, improved coordination of policy networks and the use of the human rights and gender analysis frameworks will ensure better use of policy analysis for the reduction of MM in Nigeria. Key words End-use, health policy analysis, maternal mortality reduction, Nigeria