On a recent visit to Nigeria, in particular to the Northern States Kano and Kaduna, I [WK] became aware of the needs of the obstetrical services, especially in rural areas. Plenty of information is already available about the high maternal and infant mortality in such states. Despite a huge supply of drugs and other necessities by many non-governmental organisations the tragedy of maternal mortality and obstetric fistula continues and could not be changed over the past 20 years. This was stated again at the “Women deliver” conference last November in London. Millennium development goals 4 and 5 are still far out of reach. It is surprising that no practical concept has been developed up till now to reduce the high maternal mortality rates (MMRs) and perinatal mortality rates (PMRs) and to prevent obstetric fistula. An enormous number of papers analyse the MMR and PMR but a way forward has not been given.
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Published online: September 02, 2008
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.