The neglected rural dwellers and maternal mortality in Nigeria

The type of women most underserved by the limited government programmes and provisions available were clearly the women with low socioeconomic status, living in rural regions. They tend to be mainly helpless, due to their depth of poverty and lack of basic amenities. Also, they are more culturally oriented, more likely to place cultural practices and beliefs highly.

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More than one decade after the launch of the Safe Motherhood Initiative, the burden of maternal mortality still takes a heavier toll in the rural dwellers compared to their urban counterparts (Ugwuoke et al., 2015). This is most likely because of the reported underutilisation of skilled birth attendants during pregnancy and delivery. The rural women often seem invisible, they have limited access to infrastructural development, low education and income levels (Ugwuoke et al., 2015). The effectiveness of interventions should equally depend on the focus on the issue of the rural dwellers otherwise they may have limited effects if they don’t tender to the needs of the underserved population. 

The principal means of survival for these rural women are farming and agriculture (Fabiyi and Akande, 2015). If maternal death interventions are to be efficient, the women have to be empowered to make effective decisions especially those requiring finance (e.g., hospital registration, transport to infrastructure and healthy diets). To reduce the women’s poverty level, some states in Nigeria have implemented poverty alleviation through agriculture. Bello and Ashimolowo (2014) reported that the women who participated in the agricultural empowerment projects in Ogun State, Nigeria stated that such programs had a positive impact on their balanced emotion, income, business expansion, and access to credit facilities. Nlerum et al. (2012) reported that majority of the rural women in Eleme community (Rivers State) stated that they had no access to agricultural information and technologies (e.g., such as poultry production, snail rearing etc). But the few respondents who had access to information reported that this raised their farm productivity level (Nlerum et al., 2012). Implications of this are that using less expensive empowerment techniques such as transferring agricultural technology knowledge may potentially increase the Rivers State women productivity rate, thereby, placing them in a better position financially to support proper health care decision-making.

Education and residential area were other influencing factors in the women’s choice of health care provider, their choice on the decision to self-medicate or not, the fear of caesarean section and their general health care seeking behaviour. Studies have shown that women’s formal educational is the most potent tool for the reduction of the Nigerian maternal mortality rate (Igberase, 2009; Moore et al., 2011; British Council, 2012). Unfortunately, some studies have also reported that the Nigerian economy since its independence in 1960 has marginalised the benefits of education (Ikeako et al., 2006). Since most women with low socio-economic backgrounds can not afford to get a proper education, the potential key is in the stimulation of these women to attend health facilities by relaying critical risk communication and using effective communication strategies. Importantly, if communication is successful, to ensure that these women continue proper health care practices, the services and facilities should be made equally services accessible and affordable (Wasabi, 2013).

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