Maternal mortality in urban slums: A focused review

Abstract

Background: Maternal mortality is a public health crisis that has persisted since the dawn of mankind. This malady robs the earth of its precious human resource, women, leaving behind a profound void in families and the society at large. Despite all global efforts to eliminate this crisis through the “Millenium Development Goals (MDGs)” and “Sustainable Development Goals (SDG)”, the global maternal mortality ratio still remains high, with the values in urban slums alarmingly high. The reason for this occurrence is not far-fetched. Urban slums are a persistently marginalised population in the urban settlements who do not have access to basic public amenities, let alone maternal health services. These socio-economic conditions coupled with other socio-cultural and physical factors further exacerbate their vulnerability to maternal mortality. This study critically analyses maternal mortality in slums in Nigeria, identifies factors responsible for this crisis and proffers evidenced based solutions to the problem.

Methodology: Relevant literature on maternal mortality in urban slums in Nigeria and other parts of the world were reviewed. Sources of the literature included Google Scholar, National Library of Medicine, African Journal Online, Wiley Library using the appropriate keywords.

Result: This article reveals that there is a paucity of literature on the issue of maternal mortality in urban slum areas in Nigeria. The studies obtained consistently showed a high prevalence of maternal mortality in urban slums compared to urban settlements and the national average. The exclusion of slums from urban health initiatives have significantly contributed to the disparity in the maternal mortality ratio in slum and non-slum areas as slums receive less attention compared to rural and urban settlements.

Conclusion: Maternal mortality in slums is alarmingly high and the disparity in the maternal mortality ratio of slum and non slum areas have been masked by the national average. As a result there is an urgent need for more research focused on the state of maternal health services in slums to obtain an accurate statistic of the maternal mortality in Nigeria. In order to achieve the SDG 3 target, Nigeria’s public health stakeholders must collaboratively prioritise maternal health in slum areas and provide interventions targeted and tailored to their unique contexts. Some of these interventions include the establishment and strengthening of primary health care centres in slums, enrolment of slum dwellers under the “National Health Insurance Scheme (NHIS)”, incorporation of digital interventions into maternal health interventions, training of “Traditional Birth Attendants (TBAs)”, conduction of outreach services in slum areas, advocacy for female empowerment and maternal health facilities in slums, policy reformations to incorporate slums into urban health initiatives.