1.1 Background to the Study
mortality remains the leading cause of death and disability for
reproductive-age women in resource-poor countries. The impact of a
mother’s death on child outcomes is likely severe but has not been well
quantified (Oestergaard, et al., 2011).
is a leading cause of death and disability for adult women worldwide,
responsible for an estimated 289,000 deaths in 2013 (WHO, 2014). It
represents true excess burden of disease since the overwhelming majority
of maternal deaths are due to preventable causes; and could be treated
with well-understood interventions that have long been available in the
global North (Medhin, et al., 2010). Maternal mortality
highlights large inequalities between and within countries; the maternal
mortality rate in resource-poor countries is 15 times higher than that
in wealthy nations, and within countries, the poorest women see the
greatest risk of dying during pregnancy or childbirth (Ronsmans and
Graham, 2006). Reducing maternal mortality ratios (MMRs) by 75% from
1990 levels was therefore included in the United Nations’ Millennium
Development Goals, as integral to reducing global poverty. Less
well-characterized, however, are the short- and long-term consequences
of maternal deaths on children, families and communities. Often a
maternal death can have spillover effects onto child health, via
obstetric complications, infant feeding behaviors, and care for orphans
(Molla, et al., 2015). It thus is critically important to look
beyond MMRs to fully characterize the harm caused by the loss of a
mother (Whetten, et al., 2011).
There are a number of mechanisms through
which a maternal death may affect outcomes for infants and children.
The main direct causes of maternal mortality obstetric complications
such as eclampsia, sepsis, obstructed labor and hemorrhage can also put
neonates at increased risk of death (Kusiako, et al., 2000 Chan, et al., 2013; Vogel, et al.,
2014). If the infant survives birth but the mother does not, the
resulting lack of nutritional support from breastfeeding leaves the baby
vulnerable to malnutrition, which can itself be fatal or may increase
the risk of disease or death from infection (Lindblade, et al., 2003; Ronsmans, et al., 2010; Braitstein, et al., 2013). Older siblings also may suffer in many ways without maternal care: among orphans, the risk of child labor (Whetten, et al., 2011), poor learning outcomes and lower educational attainment (O’Donnell, et al.,
2012), and disrupted living arrangements (Hosegood, 2009) can impose
trauma that has detrimental impacts on health and well-being.
Qualitative research from rural Nigeria found that orphans of women who
died of maternal causes girls in particular were likely to be
undernourished in infancy and beyond, face education-related challenges,
and receive compromised medical care (Yamin, et al., 2013).
This study also found adverse household effects, including economic
drains a finding echoed in a recent study from Nigeria, where maternal
death was associated with significant household income and expenditure
declines (Ye, et al., 2012; Wang, et al., 2013).
Detrimental household economic impacts were also seen in a study from
Burkina Faso, where the high and unforeseen expense of emergency
obstetric care was reported as difficult to repay, triggering long-term
consequences on physical, psychological, social and economic well-being
(Storeng, et al., 2008).
Infant mortality is thus only one
adverse outcome associated with maternal death, but it is crucially
important. An analysis from Nigeria found a significantly worse survival
trajectory of orphaned children but cautioned about generalizing the
findings, due to contextual factors that may differentially impact
orphan survival such as household composition, the role of the father
and HIV prevalence (Ronsmans, et al., 2010). Recent analyses,
however, have found similarly negative outcomes in sub-Saharan Africa
(Grepin and Klugman, 2013). A cohort study in Benin found an elevated
risk of mortality among infants born to women who experienced serious
complications during childbirth (near-miss cases), even in the absence
of maternal death (Filippi, et al., 2010). Recent research in
Nigeria found an elevated mortality rate among babies of women who died
after childbirth (Darmstadt, et al., 2005; Family Care
International, 2014). It is against this background that this study is
carried out to examine the effect of infant child and maternal mortality
on the economy of Nigeria using Asaba and its environs, Delta State as a
1.2 Statement of Problem
of poor health go far beyond physical pain and suffering. Learning is
compromised, returns to human capital diminish, and environments for
entrepreneurial and productive activities are constrained. It comes as
little surprise that no country (in the region) has attained a high
level of economic development with a population crippled by high infant
and maternal mortality, pervasive illness of its work force, and low
life expectancy (Joses, et al., 2016).
Organization (WHO) estimated that 493,000 women died in 1998 of
complications of pregnancy and delivery. About forty percent (194,000)
of those deaths occurred in the WHO African Region. 24.1 % deaths were
attributed to haemorrhage, 15.9% to sepsis, 12.3% to hypertensive
disorders of pregnancy, 8.2% to obstructed labour, 13.3% to abortion,
and 26.2% to other maternal conditions. The maternal mortality rate
(MMR), the number of women who die during pregnancy and child birth per
100,000 live births, in the African Region is the highest in the world.
It averages 940 deaths per 100,000 live births, with disparities among
countries and between urban and rural areas in the same countries. The
main risk factors for maternal mortality include illiteracy, poverty,
poor nutrition, low weight prior to pregnancy, minimal weight gain
during pregnancy, first pregnancy or higher than fourth pregnancy
(excessive fertility), maternal age younger than twenty or older than
thirty-four years, poor outcome of prior pregnancies, infections (e.g.
STIs and HIV/AIDS) and illnesses during pregnancy (e.g. anaemia, cancer
of the cervix), female genital mutilation, unintended pregnancies and
unsafe abortions, smoking, and inadequate health care during pregnancy
In Africa, women support
families through their productive labor (cash crop labor, subsistence
farming, and other remunerative work), cooking for household members,
providing household members with sanitary services, nursing the sick
household members (at times when even they themselves are not in good
health) and educating the children. Thus, the loss of a mother through
death or disability robs a household of a nurturer, provider, and de
factor household head. There is need to sensitize national policy-makers
and international development partners to the health and economic
consequences of inaccessibility to the aforementioned six pillars of
Safe Motherhood Initiative. To the best of the researcher’s knowledge,
to date no study in Africa has attempted to examine the effect of infant
child and maternal mortality on the economy and estimate the burden of
maternal deaths on the GDP. This study represents a limited attempt to
bridge this knowledge gap. This study is therefore conducted to bridge
this gap and address the aforementioned problems.
1.3 Aim and Objectives
The aim of
this study is to critically examine the effect of infant and maternal
mortality on the economy of Nigeria using Asaba and its environs, Delta
State as case study.
The following specific objectives were designed to guide this study. The objectives of this study are:
- To identify the causes of infant and maternal mortality in the study area.
- To examine the socio-economic status and economic growth in Asaba and its environs and its environs.
- To identify the consequent effect of infant and maternal mortality in Asaba and its environs.
- To examine the effect of infant and maternal mortality on the economy of the study area.
- To examine whether there are significant relationship between infant
maternal mortality and economic growth in Nigeria particularly around
Asaba and its environs at different income levels.
- To suggest solution(s) to the problems associated with the effect of
infant and maternal mortality on the economy of Nigeria (Asaba and its
environs, Delta State in particular).
1.4 Research Questions
The following questions were designed to guide this study;
- What are the causes of infant and maternal mortality in Asaba and its environs?
- What are the socio-economic status and economic growth in Asaba and its environs?
- What are the consequent effect of infant and maternal mortality in Asaba and its environs?
- What are the effect of infant and maternal mortality on the economy of Nigeria particularly Asaba and its environs?
- Is there significant relationship between infant/maternal mortality
and economic growth in Nigeria particularly around Asaba and its
environs at different income levels?
- What do you think are the possible solution(s) to the problems
associated with the effect of infant and maternal mortality on the
economy of Nigeria (Asaba and its environs in particular)?
1.5 Research Hypotheses
hypotheses stated in the null and alternative form to guide this study
will be tested using appropriate statistical tools.
- H0: There is no significant relationship
between infant/maternal mortality and economic growth in Asaba and its
environs at different income levels.
H1: There is
a significant relationship between infant/maternal mortality and
economic growth in Asaba and its environs at different income levels.
- H0: Infant and maternal mortality has no significant effect on the economy of Asaba and its environs.
H1: Infant and maternal mortality has significant effect on the economy of Asaba and its environs.
1.6 Significance of the Study
This research work will be of immense
help to geographers, demographers, population analysts, educational
professionals, educationists, geologist, sociologists, and all those
involved in geography and fertility education as well as academicians
and the government in general on the need to take a critical look at the
effect of infant and maternal mortality on the economy of Nigeria using
Asaba and its environs, Delta State as a case study. This study calls
for the need of inculcating death control measures among
infants/children through advanced improvement in medical and health care
facilities to prevent infant and maternal mortality especially among
pregnant women and delivery mothers.
The findings of this study will be of
great important to the Nigeria youths, the Nigeria government,
geographers, demographers, population analysts, and academicians to
include many others. The findings will be of immense use to young female
youths and women in general, for it builds reluctant skills, academic
knowledge and personal competencies required in the child birth control
and health care delivery.
Also it is of great importance to the
Nigeria government, because of its positive effect on national
development, through death control measures to enhance economic growth,
and it will also provide pregnant women and nursing mothers with the
necessary skill needed to control infant and maternal mortality, and
finally it will equip the graduates with the awareness of the consequent
effect of infant and maternal mortality on the economy and how it
also affects the people in general.
1.7 STUDY AREA
The study area will be discussed under the following sub-topics;
1.7.1 Location and Position
area (Asaba and its environs) is located in the South-South
Geo-political zone of Nigeria and Delta North Senatorial District, Delta
State in the Niger Delta Region. The study area lies between the
geographical coordinate of latitudes 060 251 0511N and longitudes 060 301 0511E
of the Greenwich meridian. It is located in the South-South
Geopolitical zone of Nigeria and in the Niger Delta Region. Asaba is one
of the biggest cities in Delta State which developed into a metropolis.
It is found in Oshimili South Local Government Area of Delta State.
Neighboring towns around Asaba include; Okwe Community, Igbodo,
Ogwashi-Uku, Anwai, Illah, Onicha-Olona, Onicha-Ugbo, Ubulu-Uku, and a
host of others.
1.7.2 Size and Boundary
Asaba covers an area of 189km2 (73mile2).
Geographically, Asaba is situated in the North-West region of Delta
State and falls under the Delta-North Senatorial District. It shares
common boundary with Onitsha and very close to the popular River Niger
Bridge and Onitsha international market which have world class market
facilities. Asaba is bordered in the North by Oshimili North Local
Government Area, in the West by Aniocha South Local Government Area, in
the East by Onitsha South Local Government Area of Anambra State and in
the South by Ndokwa East Local Government Area of Delta State.