ABSTRACT
he purpose of this study was to determine the influence of maternal mortality
on community development in Njikoka Local Government Area of Anambra
State. The major research questions developed for the study were as followed;
1. What are the causes of maternal mortality in Njikoka Local Government
Area of Anambra State? 2. In what ways does maternal mortality influence
economic development of communities in Njikoka Government Area? 3. In
what ways does maternal mortality influence educational development on
communities? 4. In what ways does maternal mortality influence social lives
of a community? 5. In what ways does maternal mortality influence health
development of the people? Adults in Idemili Local Government Area of
Anambra State between the ages of 18 – 51 years and above were used as the
target population while four hundred (400) adults were sampled for the study
using simple random sampling technique. In collecting data the structured
questionnaire was used. The data obtained were organized and analyzed using
percentage, mean score and standard deviation to answer the research
questions. The hypothesis for the study was tested using the z-test statistics.
The findings of the study included the following; 1. A close observation of the
findings in section 1 of the questionnaire reveals that responses from males are
more than responses from females. 2. Adults who were within the age range of
41 – 45 years formed majority, while those within the age range of 18 – 22
years old were fewer. 3. Those who obtained WAEC or O/L certificate formed
majority of the respondents, while only few of the respondents have university
qualification. 4. About 75% of the entire sampled population used for the
study were married while singles, engaged, divorced and widowed represent
only 25%. 5. Majority of the respondents were traders covering about 45% of
the sampled population.
TABLE OF CONTENTS
Title page – – – – – – – – – i
Approval page – – – – – – – – ii
Certification – – – – – – – – iii
Dedication – – – – – – – – – iv
Acknowledgment – – – – – – – v
Table of contents – – – – – – – vi
vi
List of Tables – – – – – – – – viii
Abstract – – – – – – – – – ix
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study – – – – – 1
1.2 Statement of the Problem – – – – – 7
1.3 Purpose of the Study – – – – – – 8
1.4 Significance of the Study – – – – – 8
1.6 Scope of the Study – – – – – – 10
1.5 Research Questions – – – – – – 11
1.7 Hypothesis – – – – – – – – 11
CHAPTER TWO: LITERATURE REVIEW
2.1 Conceptual Framework on Maternal Mortality – 12
i) The concept of maternal mortality on
community development – – – – 13
ii) Causes of maternal mortality – – – 14
iii) Influence of maternal mortality on community
Development – – – – – – 21
– The concept of community – – – 22
– The concept of development- – – – 22
– The concept of community development – 22
iv) Influence on Economic Development – – 24
v) Influence on educational development – – 25
vi) Influence on social development – – – 27
vii) Influence on health development – – – 29
viii) Prevalence of maternal mortality – – – 30
ix) Intervention Strategies by the Government – 36
2.2 Theoretical Framework – – – – – 40
i) Health belief model – – – – – 41
ii) Theory of reasoned Action – – – – 43
iii) Gather theory – – – – – – 45
2.3 Empirical Studies – – – – – – 48
2.4 Summary of the Literature Review – – – 53
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Design of the Study – – – – – – 56
3.2 Area of the Study – – – – – – 56
3.3 Population on the Study – – – – – 57
3.4 Sample and Sampling Techniques – – – 58
3.5 Instrument for Data Collection – – – – 58
3.6 Validation of the Instrument – – – – 60
3.7 Reliability of the Instrument – – – – 60
3.8 Procedure for Data Collection – – – – 61
3.9 Method of Data Collection and Analysis – – 61
CHAPTER FOUR:PRESENTATION AND ANALYSIS
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OF DATA
Results – – – – – – – – – 63
Summary of major findings – – – – – 70
CHAPTER FIVE: SUMMARY OF MAJOR FINDINGS,
DISCUSSION, RECOMMENDATIONS
5.1 Summary of Major Findings – – – – 72
5.2 Discussion of Findings – – – – – 74
5.3 Implication of the study – – – – – 80
5.4 Recommendations – – – – – – 81
5.5 Suggestions for further Studies – – – – 82
5.6 Limitations of the Study – – – – – 82
5.7 Summary of the Study – – – – – 83
5.8 Conclusion – – – – – – – – 83
References
Appendices
CHAPTER ONE
INTRODUCTION
1.1 Background Of the Study
The act of giving birth is the most serious labour in the world.
(Ademowore, 2001). Apart from a small number of privileged and
conscientious countries that have succeeded in reducing maternal mortality to
close to zero, each pregnancy and birth remains a risky potentially fatal
experience for hundreds of millions of women worldwide.
In case study conducted by Adamson (1998) on maternal mortality,
some 600,000 women died in agony every year. Adamson further stated that it
is not an exaggeration to say that the issue of maternal mortality, fast in its
conspiracy of silence is in scale and severity the most neglected tragedy of our
time.
Adewumi (2000) stated that a staggering number of 585,000 women die
during pregnancy and childbirth, and these are not deaths like other deaths.
They die, hundreds of thousands of women whose lives came to an end in their
teens and twenties and thirties, in ways that set them apart from the normal run
of human experience.
In the 1990’s and early 2000’s for instance, studies carried out by
different researchers such as Adamson (1998), Caffrey (2000) revealed that a
lot of young women die in thousands and millions every year. And they
continue to die at the rate of 1,600 every yesterday, today and tomorrow. In the
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worst part, these are deaths not of the ill, the very old and of the very young,
but of healthy women in the prime of their lives upon whom both young and
old may depend.
Mahmound (1999) opined that, maternal mortality is not about statistics.
It is about women; women who have face, faces which we have seen the throes
of agony, distress and despair. Faces which continue to hurt our dreams, not
simply because a maternal death is one of the most terrible ways to die…. But
above all because it could be avoided and should never have been allowed to
happen.
Millennium Development Goals (2006) see maternal mortality as the
death of a woman while pregnant or within 42 days of termination of
pregnancy, irrespective of the duration of the pregnancy or its management but
not from accidental or incidental causes. As a result of advances in medical
science, economic resources and human welfare, it is possible to avoid
mortality almost entirely expect in the most extreme cases or as a result of
accidents. MDGs (2006) further stated that children are most vulnerable in the
first few months and years of life. Yet, in the advanced countries, the underfive
mortality rate fell during the 20th century to extremely low levels,
averaging only 6 per thousand live births (1998 UNICEF).
Beazley (2002) showed that the causes of maternal death are similar
throughout the world. Globally, around 80 percent of all maternal deaths are
the direct result of complications arising during pregnancy, delivery or the
puerperium. The most common direct obstetric causes include the following:
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haemorrhage, sepsis, preeclampsia, anaemia, cephalopelvic disproportion,
malaria and abortion.
Women who are at higher risk of maternal mortality need to be
identified early, so that appropriate timely measures can be taken. Beazley
(2002) showed that these more vulnerable mothers include those who deliver at
extremes of maternal age (particularly those under 20 years or over 40 years).
The early age at which many women begin childbearing is therefore a serious
cause for concern.
Nigeria Millennium Development Goals (2005) in Nigeria Demographic
and Health Survey (NDHS, 1999) reported that 44 percent of women aged 20 –
24 had given birth before they were 20 years old, 27 percent before they were
15 years old. The survey found that 22 percent of teenagers aged 15 – 19 were
either already mothers or pregnant with their first child. The figures were
much higher in the rural areas than in the urban areas. Early pregnancy is
likened to one of the main reasons for the high rates of maternal mortality
among the young women of childbearing age.
In recent years, MDGs (2005) also indicated that illegally induced
abortion has increasingly been recognized as a major cause of mortality in
women of childbearing age, particularly among the young women. Maternal
mortality has become a threat to families, nations and the world at large. Many
families have lot their loved ones through maternal mortality and those gaps
which have been created can never be bridged because women are the nation
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builders. They contribute to a large extent to the development of economic,
education, social and health sectors of every community.
With particular reference to Njikoka Local Government Area in
Anambra State, with a population of about one million National Population
Census (2006) people who engage mostly in subsistence farming, driving and
trading, the level of poverty is significantly high. Due to its location, Njikoka
L.G.A consists of semi-urban communities though it lacks most social
amenities which include adequate health resources, qualified doctors and
nurses, good road networks, educational facilities etc. The poverty and
illiteracy level within the community undoubtedly predisposes it to maternal
mortality. This is because women are nation builders in all sectors of
development throughout the whole world which is why their mortality hinders
development of the community thereby bringing under-development in the
community.
Ikedife (1999) said that there are complex problems associated with
providing good obstetric care for our women of childbearing age. The
expected joy from pregnancy and childbirth often eludes our women. Many
times, the hope of having a healthy baby and the joy of motherhood have been
replaced by bitter bereavement through the loss of a spouse or a caring mother.
In the 1990’s and early 2000’s maternal and perinatal mortality have continued
to maintain a disproportionately upward trend which is a great threat to our
community development.
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Ikedife (1999) further stated that conditions of poverty, supervision,
poor nutritional status, illiteracy, infections and infestation affect obstetrics on
a wide scale. In addition facilities are grossly inadequate in all spheres of
medicine. Also compounding the situation is the facts that some clinical
conditions, which have apparently been confirmed, are now found in our
localities.
Harrison (2000) has written that over the years, there has been an
unjustifiably poor allocation to the health sector by the government and this has
accounted for inadequate and poorly equipped health facilities. The annual
health budget has always been far below the minimum five percent
recommended by the World Health Organization for developing states and
countries.
Harrison (2000), regretted that the few maternal health facilities that
exist are poorly utilized. It is therefore not surprising that the magnitude of
problems that face the practicing obstetrician, as well as women and children
are staggering.
All these, lead to high rate of maternal mortality in Njikoka Local
Government Area. This high maternal mortality in Njikoka has direct impact
on the development of the communities.
1.2 Statement of the Problem
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Maternal mortality has become a threat to families, nations and the
world at large. Maternal mortality is not about statistics, it is about women;
women have names, women who have face, faces which we have seen in the
throes of agony, distress and despair. Faces which continue to live in our
memories and continue to hurt our dreams. Not simply because a maternal
death is one of the most terrible ways to die… but above all because it could be
avoided and should never have been allowed to happen. Maternal and perinatal
mortality have continued to maintain a disproportionately upward trend which
is a great threat to development of our communities.
No meaningful development can take place without women. They play
roles such as trading, farming, weaving, taking care of families, rendering
financial support to their husbands, contributing to the growth of communities
in the areas of health, social, educational development.
Maternal mortality hinders all these roles women played; hence, the
researcher was interested in studying the influence of the maternal mortality on
community development in Njikoka Local Government Area of Anambra
State.
1.3 Purpose of the Study
The general purpose of this study was to find out the influence of
maternal mortality on community development in Njikoka Local Government
Area of Anambra State.
Specifically, the study was meant to find out:
1. The causes of maternal mortality in Njikoka Local Government Area;
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2. How maternal mortality influences economic development of
communities in Njikoka Local Government Area;
3. How maternal mortality influences educational development of
communities in Njikoka Local Government Area;
4. How maternal mortality influences social development of communities
in Njikoka Local Government Area;
5. How maternal mortality influences the health development of
communities in Njikoka Local Government Area.
1.4 Significance of the Study
It is hoped that the findings of this study will be of benefit to Parents,
Health Workers, Community Workers, Government and Non-Governmental
Agencies.
Parents will be able to understand the various ways of minimizing the
incidence of maternal mortality in their communities by patronizing adequate
health facilities during pregnancy, delivery and after birth. Health workers will
be able to know the right steps to take in creating awareness and knowing the
appropriate preventive measures of maternal mortality that is good for different
women during ante-natal programme. Community workers will also be
properly informed on the various modern health practices available in the
country and the world at large which will, in no small measure, reduce the rate
of maternal mortality in the society and Njikoka community in particular.
Those they can convey to the people through seminars, workshops and so on.
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Government and Non-Governmental Agencies will see the areas of need
in order to intensify their efforts in implementing preventive measures geared
toward reducing maternal mortality in the rural areas.
It will also expose the male folk to the need for allowing their women
receive adequate medical care during pregnancy rather than engaging in the
obsolete methods of medication and child delivery which has been the method
inmost homes in Njikoka Local Government Area.
It is equally hoped that the findings of this will serve as a starting point
for both the government, community workers and other enlightened
stakeholders on their roles in reducing maternal mortality in our communities
and the society at large through enlightenment campaigns programmes.
1.5 Research Questions
The following research questions guided the study:
1. What are the causes of maternal mortality in Njikoka Local
Government Area?
2. In what ways does maternal mortality influence economic
development of communities in Njikoka Local Government Area?
3. How does maternal mortality influence educational development
of communities in Njikoka Local Government Area?
4. How does maternal mortality influence social development of
communities in Njikoka Government Area?
5. In what does maternal mortality influence the Health Development
of communities in Njikoka Local Government Area?
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1.6 Scope of the Study
The study was carried out in Njikoka Local Government Area of
Anambra State. The study covered economic, education, social and health
sectors and how maternal mortality influences the development of these sectors
in the various communities in Njikoka Local Government Area of Anambra
State.
1.7 Hypothesis
1. There is no significant difference between the mean score of males and
females responses to the influence of maternal mortality on community
development.
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