ORIGINAL RESEARCH ARTICLE Policy and Programs for Reducing Maternal Mortality in Enugu State, Nigeria

Using in-depth and key informant interviews, and review of literature on maternal health in Enugu State, this study focused on describing and analyzing the extent to which the State government is committed to reducing maternal mortality ratio (MMR) in the State. The results revealed that the reported MMR of about 1,400/100,000 live-births in the State is attributable to preventable medical causes, and is fueled by socio-cultural factors, including poor access to skilled medical personnel. In response to the challenges of high MMR in the State, the Enugu State government initiated a policy on free maternal and child health (FMCH) care in 2007, as a flagship of its maternal health programmes. The FMCH provides free medical, antenatal, delivery and post-natal care for poor women and children in primary and secondary hospitals, and those referred to tertiary hospitals in the State. However, the ratio of doctors to pregnant women in the State (1:1,581) remains abysmally low. Funding of the FMCH also remains inadequate as Local Government Councils (LGCs) demonstrate weak commitment to making contributions to the FMCH programme. We recommend a series of proactive approaches, including high level advocacy as ways to improve political commitment for reducing maternal mortality in Enugu State (Afr. J. Reprod. Health 2010; 14[3]: 19-30)