With 1,100 women dying during pregnancy or childbirth for every 100,000 live births, Nigeria has one of the highest maternal mortality ratios in the world. In 1994, the Nigerian government committed to reducing maternal mortality by signing on to the Program of Action at the International Conference on Population and Development in Cairo. Yet, a new analysis finds that while the government has adopted policies aimed at reducing maternal mortality by 75% by 2015, those policies have not been implemented effectively and are seriously underfunded.

The study, Barriers to Safe Motherhood in Nigeria, released today by the New York-based Guttmacher Institute and the Women’s Health and Action Research Center in Benin City, Nigeria, compared nationally representative data for 1990 and 2003 and found that the provision of prenatal care—critical to reducing maternal mortality—has not improved over time. More than 40% of Nigerian women still do not visit a trained health care provider during pregnancy. And while the proportion of women whose delivery is attended by a trained provider has increased—from 30% in 1990 to 37% in 2003—Nigeria still has one of the lowest rates of births assisted by trained health providers in West Africa.

"Lack of access to contraceptive services, combined with early marriage and motherhood, accounts for the persistent high-risk pregnancies and births," says Akinrinola Bankole, the study's lead author and director of international research at the Guttmacher Institute. "Improving maternal health will require addressing these problems and their root causes—poverty and lack of education."

The report noted that to reduce the pregnancy-related death rate among Nigerian women, the Nigerian government must provide adequate resources, including trained providers, up-to-date equipment and, most importantly, sufficient and sustained funding for safe motherhood programs.

Current efforts to improve safe motherhood in Nigeria are driven by international agencies and nongovernmental organizations, the report points out. The authors conclude that if these efforts are to succeed, the Nigerian government must take a leadership role in the fight to reduce maternal mortality.