High-birth Niger strives to lower maternal mortality

June 28, 2014 by Boureima Hama

With the world's highest birth rate in a country where first-time mothers are often barely past puberty, having a baby in impoverished Niger can be tantamount to a death sentence.

The West African state and humanitarian groups have worked to slash both birth and rates, but despite strides results are not good enough, the UN warned this week.

"Every two hours, a Niger woman dies from complications linked to pregnancy or childbirth," deplored Monique Clesca, the UN Population Fund (UNFPA) representative in the country.

Some 3,000 people, mainly women, gathered in the western city of Tahoua as part of a new push to rein in the birth rate and reduce maternal mortality.

"Dying while giving life is a social injustice," railed Malika Issoufou, wife of Niger's President Mahamadou Issoufou, while visiting women suffering from gynaecological complications in the Tahoua hospital.

The trend has not been easy to buck in a culture that encourages early marriage, big families and pregnancies in quick succession, and where some clerics in mainly Muslim Niger have blasted contraception as against Islam and "dictated by white people from the West".

"The more kids you have, the more you're worth," said Clesca, describing traditional views. "When girls marry, they're under pressure to prove they're fertile within the first year."

This has left landlocked Niger, where more than 60 percent live below the poverty line, with the highest birth rate in the world, an average of 7.6 children per woman, official figures show.

In 2006, Niger made all pre-natal care free of charge, as well as birth by Caesarian, which up to then was prohibitively expensive. Contraceptive products are also distributed at no charge.

"Ten years ago, no one dared broach demographic questions. Now, everyone is talking about them, starting with the government, the president," said Isselmou Boukhary, Niger's deputy representative for the UN children's fund, UNICEF.

Even if the situation remains "quite worrisome", it's slowly improving, Boukhary told AFP.

With 535 mothers dying for every 100,000 live births—meaning one woman for every 186 viable births, Niger is among the world's top 15 countries with the worst maternal mortality.

Yet the situation has improved since 2006, when 648 women died for every 100,000 births, according to Niger's health ministry.

During the same period, contraceptive use has gone from five to 12 percent, the ministry said.

Girls married before age 15

A tradition of early marriage has not helped. Nearly 80 percent of Niger women are wed by the time they reach 18 and 40 percent before the age of 15, making complications frequent.

"At this age, the body is still fragile and not ready for maternity," said Yahaya Mani, a doctor working in the Niger countryside.

Official records bear this out, according to the UN which said a third of maternal deaths are among girls 15 to 19.

"The parents know the risks. But they prefer to marry their girls off early rather than risking a pregnancy outside marriage, which would damage the family's honour," said Clesca.

After the first baby others follow quickly, giving Niger one of the world's top population growth rates at 3.9 percent per year, according to official figures.

Young mothers often have "one baby on the breast, one on their back and another at their feet," which can leave them weak, said a humanitarian source.

High-risk pregnancies among older women are also abundant, along with a shortage of proper birthing facilities.

Home births

"The closest centre is often five kilometres (three miles) away. And by the time they find a cart to get there, it's often too late," said Doctor Mani.

Health ministry official Gali Asma said 80 percent of Niger's occur outside proper health facilities, and yet 70 percent of Niger women give birth at home with traditional midwives.

Some men still oppose their wives receiving prenatal care, and national family planning campaigns have particularly annoyed Islamic radicals and fundamentalists, whose numbers have grown in this country bordering Mali and Nigeria where Islamic militant activity has intensified.

They say it goes against the teachings of Allah and is part of a "Western attempt to stop births" in Niger.

The government, however, defends the drive as critical for Niger's future.

From three million in 1980, the population has hit more than 17 million today and, if nothing is done, could soar to 40 million by 2050, officials say, a level a country subject to drought, food shortages and malnutrition could never sustain.

Explore further: 2,500 Niger children die of malnutrition in 2013: UN

Related Stories

2,500 Niger children die of malnutrition in 2013: UN

October 16, 2013
More than 2,500 children under five have died of malnutrition in Niger this year, the UN Children Fund said Wednesday.

Child mortality in Niger plummets

September 19, 2012
Niger, one of the world's poorest countries, has bucked regional trends to achieve dramatic reductions in child mortality in recent years, according to a Countdown country case study published in The Lancet.

Niger leads pack making progress on child mortality: NGO

October 23, 2013
Niger has made the most progress worldwide on reducing child mortality since 1990, according to a study out Wednesday.

Somalia worst place to be a mother

May 5, 2014
Somalia is the worst country on Earth to be a mother, according to a report published by Save the Children on Monday which calls for more action to protect mothers and children in crisis-hit areas.

Recommended for you

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

Why sugary drinks and protein-rich meals don't go well together

July 20, 2017
Having a sugar-sweetened drink with a high-protein meal may negatively affect energy balance, alter food preferences and cause the body to store more fat, according to a study published in the open access journal BMC Nutrition.

Opioids and obesity, not 'despair deaths,' raising mortality rates for white Americans

July 20, 2017
Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according ...

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Parents have critical role in preventing teen drinking

July 20, 2017
Fewer teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Australian school students, based on the findings of the latest study by Adelaide researchers.

Fresh fish oil lowers diabetes risk in rat offspring

July 19, 2017
Fresh fish oil given to overweight pregnant rats prevented their offspring from developing a major diabetes risk factor, Auckland researchers have found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.