By Osita Okonkwo
Maternal mortality is too often framed as a tragic but inevitable outcome of poverty, culture, or individual health behaviors.
This framing is not only wrong, but dangerous. Maternal deaths are, in the overwhelming majority of cases, preventable. When a woman dies during pregnancy or childbirth, it is not merely a medical emergency; it is a failure of policy, systems, and the political will to act for the common good.
Clinical causes of maternal death, including postpartum hemorrhage, eclampsia, sepsis, and obstructed labor, are well known. Consequently, providing skilled birth attendance, timely referral, blood availability, essential medicines, and respectful maternity care are essential preventive measures.
When these are lacking, the question is not what went wrong clinically, but why the system allowed it in the first place. Traditionally, government policy determines whether facilities are staffed, roads are passable, ambulances function, and care is affordable at the point of need.
Evidence has shown that countries with high maternal mortality ratios consistently underinvest in primary health care and emergency obstetric services.
Budget lines and fund releases tell these stories. When maternal health is fragmented across donor projects rather than embedded in domestic financing, services become fragile and inequitable.
Universal Health Coverage (UHC) that explicitly includes maternity care, especially antenatal, delivery, and postnatal services, dramatically reduces deaths. This is not theory; it is evidence echoed by the World Health Organization (WHO).
It is essential to note that maternal mortality is not about where women live; it is about how systems are governed.
Women die in urban slums minutes from tertiary hospitals because referral protocols fail or informal fees delay care. They die in rural areas because transport policies ignore last-mile realities.
Strong governance systems that provide clear standards, accountability mechanisms, and data-driven decision-making matter more than GDP numbers alone.
The report shows that too many maternal deaths go uncounted or are misclassified. Robust civil registration and maternal death surveillance are policy tools, not academic luxuries, and should be emphasized.
When deaths are reviewed transparently and recommendations enforced, mortality falls. When reports gather dust, maternal deaths repeat over and over again.
From the point of socioeconomic consideration, maternal mortality disproportionately affects adolescents, the poor, migrants, and marginalized ethnic groups.
These disparities persist because policies fail to address social determinants, such as education, nutrition, gender-based violence, and women’s autonomy. Equity-focused policies, not blanket averages, are what close gaps.
In reframing the narratives, referring to maternal mortality as a “health challenge” softens responsibility. Rather, calling it a policy failure sharpens it.
Governments have committed, through the Sustainable Development Goals (SDGs), to reduce global maternal mortality to fewer than 70 deaths per 100,000 live births. Meeting this target requires more than establishing health clinics; it requires implementable laws, budgets, roads, workforce planning, monitoring, and accountability.
Every maternal death is a signal that policy did not protect a woman at her most vulnerable moment. Re-imagining maternal mortality as a policy failure is not about blame; it is about power: the power to prevent the next death by choosing better policies today, and the political will to bring these policies to reality.
Establishing policies and having the political will to implement them effectively for the common good would change the batteries and save women’s lives in our communities.
Dr. Okonkwo is a Public Health Policy Analyst and writes from Abuja.